Gastrointestinal InfectionsHelminths and the modulation of mucosal inflammationElliott, David E.; Summers, Robert W.; Weinstock, Joel V.Author Information Division of Gastroenterology-Hepatology, Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA Supported by grants from the National Institutes of Health (DK38327, DK58755, DK02428, DK25295, AI49382), the Crohn's and Colitis Foundation of America, and the Broad Medical Research Program of the Eli and Edythe L. Broad Foundation. Correspondence to David E. Elliott, Division of Gastroenterology (4611 JCP), University of Iowa College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242-1009, USA Tel: 319 353 8574; fax: 319 353 6399; e-mail: [email protected] Current Opinion in Gastroenterology: January 2005 - Volume 21 - Issue 1 - p 51-58 Buy SDC Abstract Purpose of review Inflammatory bowel disease is an emerging illness associated with socioeconomic development. The current epidemic of immune-mediated diseases may result from our loss of exposure to parasitic worms (helminths). This review summarizes some of the recent findings showing that helminths induce regulatory circuits that could prevent and treat inflammatory bowel disease. Recent findings Inflammatory bowel disease appears to result from a dysregulated immune response. Although genes influence the risk of inflammatory bowel disease, it seems that critical changes in our environment have permitted its expression. One such change is the eradication of helminths. Helminths can impede interleukin-12, interferon gamma, and tumor necrosis factor α release and promote interleukin-10, transforming growth factor β, and regulatory T-cell production. Helminths can prevent and reverse intestinal inflammation in animal models of inflammatory bowel disease. In clinical studies of patients with inflammatory bowel disease, exposure to the helminth Trichuris suis reduces disease activity. Summary If harboring helminths protects against immune-mediated disease, then these animals must be viewed in a new light. Are there "good" helminths in addition to bad? Instead of being detestable objects marked for eradication, helminths should be viewed as useful animals that may produce important compounds helpful for therapy of human disease. © 2005 Lippincott Williams & Wilkins, Inc.