A life without worms.
Worms have co-evolved with humans over millions of years. To survive, they manipulate host systems by modulating immune responses so that they cause (in the majority of hosts) relatively subtle harm. Anthelminthic treatment has been promoted as a measure for averting worm specific pathology and to mitigate subtle morbidities which may include effects on anaemia, growth, cognitive function and economic activity. With our changing environment marked by rapid population growth, urbanisation, better hygiene practices and anthelminthic treatment, there has been a decline in worm infections and other infectious diseases and a rise in non-communicable diseases such as allergy, diabetes and cardiovascular disease. This review reflects upon our age-old interaction with worms, and the broader ramifications of life without worms for vaccine responses and susceptibility to other infections, and for allergy-related and metabolic disease. We touch upon the controversy around the benefits of mass drug administration for the more-subtle morbidities that have been associated with worm infections and then focus our attention on broader, additional aspects of life without worms, which may be either beneficial or detrimental.
MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.|College of Health Sciences, Makerere University, Kampala, Uganda.
Richard E
RE
Sanya
MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.|Department of Clinical Research, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Gyaviira
G
Nkurunungi
College of Health Sciences, Makerere University, Kampala, Uganda.
Irene
I
Andia Biraro
MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
Harriet
H
Mpairwe
MRC/UVRI Uganda Research Unit, Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.|Department of Clinical Research, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Alison M
AM
Elliott
D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D002318:Cardiovascular Diseases; D003141:Communicable Diseases; D006373:Helminthiasis / Q000276:immunology / Q000473:pathology; D006376:Helminths; D006790:Host-Parasite Interactions; D006801:Humans; D006967:Hypersensitivity; D008659:Metabolic Diseases; D014612:Vaccines
D000871:Anthelmintics; D014612:Vaccines
Allergy; Anthelminthic; Helminths; Infectious diseases; Metabolic disease; Vaccines