Effect of experimental hookworm infection on insulin resistance in people at risk of type 2 diabetes

Doris R. Pierce, Malcolm McDonald, Lea Merone, Luke Becker, Fintan Thompson, Chris Lewis, Rachael Y. M. Ryan, Sze Fui Hii, Patsy A. Zendejas-Heredia, Rebecca J. Traub, Matthew A. Field, Tony Rahman, John Croese, Alex Loukas, Robyn McDermott and Paul R. Giacomin ()
Additional contact information
Doris R. Pierce: James Cook University
Malcolm McDonald: James Cook University
Lea Merone: James Cook University
Luke Becker: James Cook University
Fintan Thompson: James Cook University
Chris Lewis: James Cook University
Rachael Y. M. Ryan: James Cook University
Sze Fui Hii: University of Melbourne
Patsy A. Zendejas-Heredia: University of Melbourne
Rebecca J. Traub: University of Melbourne
Matthew A. Field: James Cook University
Tony Rahman: The Prince Charles Hospital
John Croese: James Cook University
Alex Loukas: James Cook University
Robyn McDermott: James Cook University
Paul R. Giacomin: James Cook University

Nature Communications, 2023, vol. 14, issue 1, 1-11

Abstract: 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.

Date: 2023
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DOI: 10.1038/s41467-023-40263-4

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