title: Parasitic helminths and their beneficial impact on type 1 and type 2 diabetes.
abstract: It is estimated that by the year 2035 almost 600 million people will suffer from diabetes. In the case of type 2 diabetes, the strongest increase of diabetes incidence occurs in developing and newly industrialized countries. This increase correlates not only with a progressing sedentary lifestyle and nutritional changes, but also environmental changes. Similarly, the increase of type 1 diabetes incidence in industrialized countries over the past decades cannot be explained by genetic factors alone, suggesting that environmental changes are also involved. One such environmental change is a reduced exposure to pathogens because of improved hygiene. Parasitic helminths modulate the immune system of their hosts and induce type 2 as well as regulatory immune responses. As pro-inflammatory immune responses are crucial for the onset of both type 1 and type 2 diabetes, helminth-induced immunomodulation may prevent diabetes onset and ameliorate insulin sensitivity. Several epidemiological studies in human and experimental animal models support such a protective effect of helminths for autoimmune diabetes. Recent studies further suggest that helminths may also provide such a beneficial effect for type 2 diabetes. In this review we summarize studies that investigated parasitic helminths and helminth-derived products and their impact on both type 1 and type 2 diabetes highlighting potential protective mechanisms.
authors.affiliation: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany.|Department of Microbiology and Parasitology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Afiat
authors.initials: A
authors.lastname: Berbudi
authors.affiliation: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany.
authors.forename: Jesuthas
authors.initials: J
authors.lastname: Ajendra
authors.affiliation: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany.|Department of Microbiology and Parasitology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.
authors.forename: Ajeng P F
authors.initials: AP
authors.lastname: Wardani
authors.affiliation: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany.|German Centre for Infection Research (DZIF) partner site Bonn-Cologne, Bonn, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Hoerauf
authors.affiliation: Institute for Medical Microbiology, Immunology and Parasitology, University Hospital of Bonn, Germany.
authors.forename: Marc P
authors.initials: MP
authors.lastname: Hübner
mesh_terms: D000818:Animals; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology / Q000517:prevention & control*; D006376:Helminths / Q000276:immunology*; D006801:Humans; D056747:Immunomodulation
keywords: adipose; diabetes; helminth; insulin resistance; obesity; regulatory