Date Published: 7 March 2011

Could roundworms provide new treatment for sepsis ?

Recent research carried out at Liverpool University (England) indicates that systemic inflammation caused by sepsis can be suppressed by a protein that occurs naturally in a type of roundworm.

Sepsis is a serious inflammatory condition caused by the body over-reacting to infection. The body becomes overwhelmed by bacteria, setting off a series of reactions leading to inflammation and clotting. Sepsis is thought to affects around 20 million people worldwide every year and accounts for a significant proportion of admissions to hospital intensive care units.

The usual treatment for sepsis over the past 30 years has involved use of antibiotics and maintenance of blood flow. Despite these treatments, which are sometimes complicated by antibiotic-induced liver injury or the presence of multi drug-resistant bacteria, mortality rates remain high in some cases. The death rate from sepsis in the cases of patients who are severely affected by the illness and who go on to suffer multi-organ damage and septic shock are as high as 50% in some places and situations. There is therefore an urgent requirement for new treatments for septic shock.

An international research team based at Liverpool University's Medical Research Council Centre for Drug Safety Science in the Institute of Translational Medicine and led by Professor Alirio Melendez, hasdemonstrated that inflammation triggered by bacterial endotoxins in immune cells from patients with sepsis is suppressed by a protein called ES-62 which is secreted by a type of roundworm called Acanthocheilonema viteae.

Roundworms can infect the human digestive tract, lymphatic vessels, skin and muscle. They are extremely common, especially in parts of the world where sanitation and therefore hygiene is poor. It has been estimated that almost 25% of the world's human population is currently infected. It sounds disgusting but roundworm can live in the human body for decades without adverse effects or triggering the immune system.

Scientists already know that the protein secreted by roundworm is capable of suppressing inflammation and that people infected with worms usually benefit from reduced inflammation if they suffer from conditions such as allergies and autoimmune diseases.

Professor Melendez explained:

" The protein secreted by the roundworm stimulates a process called autophagy, a process of 'self-eating' that is essential to clear damage to cellular proteins or organelles and promote cell survival and function during stress situations.
Autophagy reduces inflammation but at the same time permits the clearance of microbial infection. The findings suggest that ES-62 could be used to induce autophagy and reduce the overwhelming inflammation that is responsible for the massive tissue damage seen in sepsis."

He added:

" ES-62 has the therapeutic ability to enhance recovery in septic shock by suppressing and limiting catastrophic inflammatory responses while allowing for bacterial clearance to occur. Administration of ES-62, or a synthetic small molecule derivative, alone or in combination with antibiotics could potentially be used treatment of septic shock as well as other inflammatory diseases."

About this Research: Collaboration and Publication
The research is published in Nature Immunology and was carried out in collaboration with colleagues from the Universities of Strathclyde, Glasgow and the National University of Singapore.

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