James Cook University trial uses hookworms to combat type 2 diabetes

Tiny worms could help with a huge health problem as a world-first human trial at James Cook University successfully uses live hookworms to combat diseases such as Type 2 diabetes.

Hookworm inoculation

What if tiny worms could help cure a host of health problems in humans, including Type 2 diabetes?

A world-first human trial at James Cook University using live hookworms to combat diseases such as Type 2 diabetes has proven successful – sparking interest in a larger-scale international trial.

Dr Doris Pierce from JCU’s Australian Institute of Tropical Health and Medicine recruited 40 people with early warning signs of future metabolic diseases, like type 2 diabetes, to take part in the two-year clinical trial which started during the first waves of the Covid pandemic.

The participants were inoculated with 20 or 40 infectious hookworm larvae or a placebo.

Over two years, they received regular clinical health checks for safety purposes.

Dr Pierce said not only was infecting people with microscopic hookworm larvae safe, but it also had a beneficial impact on their glucose metabolism, significantly reducing insulin resistance levels in most trial participants.

Dr Pierce said metabolic diseases are characterised by “inflammatory immune responses” and that previous studies suggested hookworms were able to “safeguard” the survival of their host by releasing proteins to control their immune system.

Participants were inoculated with 20 or 40 infectious hookworm larvae which significantly reduced insulin resistance levels in most trial participants.

According to JCU, successful efforts to eradicate parasitic worms in developed countries are now also linked to increases in human inflammatory and metabolic diseases, including type 2 diabetes.

Dr Pierce discovered the hookworm-treated recipients saw some considerable metabolic benefits and their insulin resistance levels were restored to a normal, healthy range.

Worm recipients also were more likely to report feeling better, mood-wise, than those in the placebo group.

“That was an interesting observation as well, given that much of the trial took place during the first waves of the Covid-19 pandemic. I think to see any improvement in mood was remarkable in itself,” said Dr Pierce.

Samantha Baxter was the librarian at James Cook University librarian when the call went out for volunteers to be part of the world-first human trial.

“I’ve always wanted to be involved in a scientific trial and I was excited I could meet the criteria,” she said.

Ms Baxter was in the group that received 20 or 40 hookworms and while she didn’t notice any side effects the worms did help reduce her insulin resistance and lowered her cholesterol from previous tests.

After two years, participants were offered a deworming medication or could elect to stay in the trial for a further 12 months. Only one decided to abandon the trial as they needed to “deworm” for a medical procedure.

“I figured I didn’t notice I had them. If they were doing me good I might as well leave them there,” Ms Baxter said.

Dr Pierce’s PhD supervisor, AITHM Senior Research Fellow and immunologist Dr Paul Giacomin, said the trial results warranted follow-up studies on a larger scale.

“This early-phase JCU clinical trial provides proof of concept that infection with live hookworms is safe and appears to lead to some improvements in people’s metabolic health, which will hopefully be confirmed by larger clinical trials in future,” Dr Giacomin said.

“Also, if we can learn more about what hookworms release into the body to influence metabolism we may be able to design protein-based treatments that mimic the effect of the live worm.”

Originally published as James Cook University trial uses hookworms to combat type 2 diabetes