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A proof of concept study establishing Necator americanus in Crohn’s patients and reservoir donors
  1. J Croese1,
  2. J O’Neil2,
  3. J Masson3,
  4. S Cooke3,
  5. W Melrose4,
  6. D Pritchard5,
  7. R Speare6
  1. 1Department of Gastroenterology, Townsville Hosptial, Townsville, Australia
  2. 2Department of Gastroenterology, Royal Brisbane Hospital, Brisbane, Australia
  3. 3Department of Gastroenterology, Townsville Hosptial, Townsville, Australia
  4. 4School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
  5. 5Boots Science Building, School of Pharmacy, University of Nottingham, Nottingham, UK
  6. 6School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
  1. Correspondence to:
    Dr J Croese
    Department of Gastroenterology, Townsville Hosptial, Townsville, Q 4814, Australia; jcroese{at}bigpond.com

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The emergence of autoimmunity, including Crohn’s disease (CD) where the immune relationship with commensal bacteria is corrupted, has been linked to hygiene.1,2 A gradual decline in endoparasites is but one argument that might explain this phenomenon.3 Weinstock and colleagues have successfully tested the pig whipworm, Trichuris suis, in patients with inflammatory bowel disease (IBD).4,5 However, repeated inoculation was required and concern has been raised that aberrant migration could occur.6 The haematophagous hookworm, Necator americanus (NA), is proposed as an alternative. We have tested if CD patients tolerate hookworm infection, and the practical issues associated with establishing reservoir donors (RDs).

Over 700 million people remain infected with hookworms. Infective larvae (L3i) are acquired through skin contact with contaminated soil.7 Auto-reinfection, direct person to person infection, aberrant migration, and hypobiosis do not occur. Adult worms live …

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