Helminthic therapy and immunoglobulin E (IgE)

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Helminth infections are universally associated with responses characterised by Th2 cytokines, high levels of IgE, eosinophilia and mastocytosis.

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The immune response to helminth infections has long been known to share key features with the allergic response. In particular, both are typified by enhanced T helper 2 (Th2) responses with high levels of interleukin-4 (IL-4), IL-5 and IL-13, accompanied by eosinophilia and abundant IgE production. [1]
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Eosinophilia, mastocytosis, and IgE stimulation are the three main immune alterations observed during a hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. infection in humans… During hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. infection, serum levels of IgE increase 100-fold. [2]
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Serum IgE levels were high in a Papua New Guinean population infested with hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.. Serum IgE and blood eosinophilEosinophils are a specialised type of white blood cell with a variety of both harmful and beneficial functions. Their numbers rise temporarily following inoculation with helminths. levels fell after treatment with anthelmintics. [3]

Individuals who maintain a hookwormA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. colony for therapeutic purposes will typically see an increase in IgE following inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation], but these levels should decrease over time. One doctor who practises functional medicine has reported observing the reduction of an IgE level of 1,000 in a highly allergic patient, to normal, in just a few weeks following the introduction of helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths].

When one individual expressed concern that his IgE antibodies are always elevated above normal levels, even when compared to the time before he hosted hookwormsA helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin., and that this persistent elevation might be permanent, a medical doctor with a special interest in helminthic therapyThe reintroduction to the digestive tract of a controlled number of specially domesticated, mutualistic helminths (intestinal worms) in the form of microscopic eggs or larvae to reconstitute a depleted biome to treat and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy. - who also hosts helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] himself - responded with this:

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To my knowledge, infections do not produce a permanent increase in immunoglobulin levels. The immune system is fluid and is constantly inhibiting and producing different classes of antibodies and T cells depending on what pathogens are being detected by circulating APCs, free IgM and T-cells. IgE antibody production by B-cells will taper off once the inciting agent is cleared, however a more swift and vigorous response to the inciting organism will result next time it is introduced. This is a result of memory cells keeping a record of whats been seen and explains why HWhookworm, usually referring to the human hookworm, Necator americanus rashes get worse over time. It would not make any sense that this would make a disease state worse however; there is no logical explanation I can see in there for that. Just as the therapeutic benefit goes away, so does the increased antibody and eosinophilEosinophils are a specialised type of white blood cell with a variety of both harmful and beneficial functions. Their numbers rise temporarily following inoculation with helminths. production.

William Parker of Duke University has opined that what we consider to be 'normal' in terms of the immune system may be anything but normal.

A medical doctor has commented thus:

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… it is probably normal to have an elevated IgE. The 'normal' values were undoubtedly found by measuring abnormal people! That is, people who lack normal exposure to helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths]. [4]

And a team of researchers looking to improve the diagnosis of helminth infections in travelers and migrants returning to Germany from the tropics concluded that, while eosinophilEosinophils are a specialised type of white blood cell with a variety of both harmful and beneficial functions. Their numbers rise temporarily following inoculation with helminths. counts are clearly associated with helminthic infections, total IgE was not helpful in differentiating helminth infections from other causes of eosinophilia in this group. [5]

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