Q: I have multiple sclerosis, and I heard that parasites can help fight autoimmune diseases like MS, as well as ulcerative colitis and psoriasis. Can you explain? — Joey G., Skokie, Ill.
A: One type of intestinal parasite that is rarely found in North America — helminthes — is being studied in hopes that it will aid in the development of new immune-system-regulating drugs. In fact, the Food and Drug Administration has granted pig whipworm (Trichuris suis) the status of Investigational New Drug. One company has taken the protein that this parasite produces into phase II clinical trials for fighting Crohn's disease.
The hygiene hypothesis is the reason investigators are heading down this path. This hypothesis credits our runaway problem with autoimmune diseases to our scrubbed-up and sanitized Western world. It seems that when your immune system doesn't have enough work to do, after a slight provocation — possibly from a virus — it goes out of whack and mistakenly attacks your own healthy cells. Autoimmune diseases such as Type 1 diabetes and MS are a lot less common in developing countries where people's immune systems have to battle parasites, bacteria and viruses all the time. So today, scientists are trying to isolate parasite proteins that may help your immune system identify and attack only invading alien cells and not your own. That's good news for you and the 20 million or more folks in North American with one (or more) of the 80 autoimmune diseases. But don't try this at home; we don't know what works and what is harmful.
Q: Antibiotics saved my life when I had pneumonia as a kid and not too long ago when I had cellulitis. Now I hear antibiotic resistance is threatening to put us back into to the pre-antibiotic era. How's that possible? — Mattie K., Westfield, N.J.
A: Antibiotics are one of the most life-changing medical innovations of the past 100 years. These days, we take their benefits for granted. The problem is that bacteria are adaptable, and many have mutated into superbugs that do not succumb to the antibiotics we possess. The Centers for Disease Control and Prevention recently announced that 2 million people a year fall ill from drug-resistant organisms, and 23,000 of them die! Among the most worrisome drug-resistant bacteria are salmonella, E-coli, Y-pestis, and shigella (they're enterobacteriaceae); C. difficile, which triggers potentially lethal diarrhea; and gonorrhea.
What can you do to help? If you're prescribed an antibiotic, ask why: One study found 25 percent of prescriptions (mostly for broad-spectrum antibiotics) are for a condition that the medication cannot treat! That's a sure route for building up resistant bacteria! And don't pressure your doctor for an antibiotic when it won't help. Among the conditions most commonly treated with antibiotics when they are in fact caused by viruses and can't be K.O.'d by the meds: colds, flu, most coughs and bronchitis, sore throats (except for strep) and some ear infections.
When you do take antibiotics make sure to take the full dose as directed. In addition, don't use antibacterial soaps or antibacterial disinfectants. They're no more effective at killing germs than soap, but research indicates that overuse of antibacterial soaps or disinfectants leads to resistant bacteria.
Thanks for asking about this important issue; researchers are working hard to find solutions. Some may be as simple as giving antibiotics by injection instead of orally, and others involve innovative genetic-based approaches to killing off bacteria, or even fecal transplants, which we wrote about in this column several months ago.