Parasites useful in ‘dialling back’ the immune response

Research on how hookworms can suppress the inflammatory response in conditions such as coeliac disease and asthma has earned Dr Paul Giacomin the title of Queensland’s inaugural Emerging Science Leader.

Dr Giacomin, from the Australian Institute of Tropical Health and Medicine at James Cook University, is currently involved in a multicentre, placebo-controlled trial of live hookworm in people with coeliac disease.

Earlier, preliminary work has shown that a controlled hookworm infection can help people with coeliac disease tolerate escalating gluten challenges.

In a small, proof-of-principle trial, infected participants with coeliac disease did not develop symptoms, serological or histological changes consistent with gluten toxicity following repeated exposure to pasta.

Dr Giacomin said the current trial, recruiting in Brisbane, Logan, Townsville and Christchurch, would also provide valuable duodenal tissue samples and detailed analysis of gut microbiota.

“Eventually the goal is to replace the requirement for a live worm. We have started to identify key molecules with anti-inflammatory properties and other worm molecules which will we test in the samples from the clinical trial.”

Dr Giacomin said his team had also shown a hookworm protein could suppress airway inflammation in a mouse model of asthma and proliferation of T cells in humans with dust mite allergy.

“Certainly the worms are excreting or secreting molecules which interact with the immune system locally but there is also systemic regulation of the immune response,” he said.

He was optimistic that some of the molecules under investigation would also be useful in metabolic disorders and for limiting mild symptoms in inflammatory bowel disease.

The Emerging Science Leader program identifies a Queensland scientist who is creating breakthroughs in research, leading collaboration, advocating for science, and inspiring others to build a career in science, technology, engineering and mathematics (STEM).

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