Pierce, Doris R., Mcdonald, Malcolm, Merone, Leanne, Becker, Luke, Thompson, Fintan, Lewis, Chris, Ryan, Rachael Y.M., Hii, Sze Fui, Zendejas-Heredia, Patsy, Traub, Rebecca J., Field, Matthew A., Rahman, Tony, Croese, John, Loukas, Alex, McDermott, Robyn, and Giacomin, Paul R. (2023) Effect of experimental hookworm infection on insulin resistance in people at risk of type 2 diabetes. Nature Communications, 14. 4503.

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Abstract

The reduced prevalence of insulin resistance and type 2 diabetes in countries with endemic parasitic worm infections suggests a protective role for worms against metabolic disorders, however clinical evidence has been non-existent. This 2-year randomised, double-blinded clinical trial in Australia of hookworm infection in 40 male and female adults at risk of type 2 diabetes assessed the safety and potential metabolic benefits of treatment with either 20 (n = 14) or 40 (n = 13) Necator americanus larvae (L3) or Placebo (n = 13) (Registration ACTRN12617000818336). Primary outcome was safety defined by adverse events and completion rate. Homoeostatic model assessment of insulin resistance, fasting blood glucose and body mass were key secondary outcomes. Adverse events were more frequent in hookworm-treated participants, where 44% experienced expected gastrointestinal symptoms, but completion rates were comparable to Placebo. Fasting glucose and insulin resistance were lowered in both hookworm-treated groups at 1 year, and body mass was reduced after L3-20 treatment at 2 years. This study suggests hookworm infection is safe in people at risk of type 2 diabetes and associated with improved insulin resistance, warranting further exploration of the benefits of hookworms on metabolic health.

Item ID:	79602
Item Type:	Article (Research - C1)
ISSN:	2041-1723
Keywords:	Hookworm therapy, metabolic syndrome, glucose homeostasis,
Copyright Information:	© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/ licenses/by/4.0/.
Funders:	National Health and Medical research Council (NHMRC)
Projects and Grants:	NHMRC Senior Principal Research Fellowship
Date Deposited:	02 Aug 2023 01:54
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320208 Endocrinology @ 50% 42 HEALTH SCIENCES > 4208 Traditional, complementary and integrative medicine > 420899 Traditional, complementary and integrative medicine not elsewhere classified @ 20% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 30%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200104 Prevention of human diseases and conditions @ 50% 20 HEALTH > 2001 Clinical health > 200102 Efficacy of medications @ 50%
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