Shit got real at the Republican National Convention this week when norovirus struck attendees, sending at least 13 GOP staffers running for the toilets. The insanely contagious virus, which causes extreme vomiting and diarrhea, circulates rapidly in closed-off environments — say, Cleveland’s Quicken Loans Arena — and people with crappy immune systems are especially prone to infection. Regardless of whether the Californian delegates that caught the runs this week were actually immunocompromised, parasitologists like New York University’s P’ng Loke, Ph.D. would suggest that they might have avoided the ordeal by exposing themselves to a healthy dose of gut worms.
“If you’ve had a lot of exposure to gut parasites, and suddenly you get a norovirus infection, you know how to turn on your immune response to fight off the virus,” Loke, who studies the therapeutic uses of gut worms, tells Inverse. “But you also know how to turn off the immune response after the virus is gone.”
Intestinal worms — freaky things like tapeworms, which can grow to a horrifying 20 feet, or the ubiquitous half-inch pinworm — are terrifying things to find in your gut, or, even worse, in the toilet after you poop. Worm infections can be severe, causing nausea, weakness, and diarrhea; in some cases, they can even be fatal. But when we can control those infections, as Loke is investigating in his lab, worm infections have a silver lining: They seem to boost the immune system by changing the bacteria-laden environment of the gut. While infection won’t guarantee you won’t catch a norovirus infection, there’s reason to believe it’ll decrease your chances of getting sick from it.
To understand why, Loke explains, it helps to think about the immune system as a muscle. “If you exercise regularly, you’re going to be healthy and you’re going to experience physical exertion appropriately. Whereas, if you don’t exercise at all, and then suddenly, you try to run a marathon, then bad things happen.” Noroviruses, together with the thousands of other pathogens that can attack our guts, are our digestive system’s marathons. Worms, in a sense, are our personal trainers.
In recent years, the science community has been obsessed with gaming the bacteria in our guts, linking alterations in our microbiome to improvements in type 2 diabetes, multiple sclerosis, and even depression. But worms are another crucial part of the digestive ecosystem that we shouldn’t overlook; over the course of human evolution, Loke explains, 70 to 80 percent of humans had worm infections, so it only makes sense that our gut bacteria had adapted, over the years, to work with them hand in microscopic hand. Now that those worms have mostly been taken out of the equation, we’re suddenly left with a host of new stomach problems we haven’t had to deal with before.
“Alterations to our immune response in the gut — all these things like food allergies, celiac disease, autoimmune diseases — they’re all increasing, and this has to be due to changes to the environment,” Loke says.
As evidence, he points at populations in the developing world, where worm infection is much more prevalent and autoimmmune gut diseases are a lot more rare. A fellow NYU parasitologist, Kenneth Cadwell, Ph.D., who has studied indigenous people infected with worms in Malaysia, has, similarly, found that their guts are more healthy — that is, less prone to inflammation — because of it.
“The idea is that parasite infections are one of the environmental factors that’s different in places in the world where there’s a high incidence of inflammatory diseases, compared to places like the United States and Europe, where the incidence of these inflammatory diseases is high,” Cadwell told Inverse.
His research, like Loke’s, focuses on what actually happens in the stomach when it’s infected with worms. Looking at models of inflammatory bowel disease, he’s found that worm infections cause a specific type of immune response that triggers a flood of mucus. “Mucus in general is a very protective thing, but we’ve also found that certain bacteria like the mucus,” he says. “When you increase mucus production during parasite infection, you change the content of the microbiome.” In other words, worms throw off the balance of bacteria in our stomachs — for the better.
How? That much remains to be seen. This research is, after all, is only in its infancy. Cadwell’s hoping to characterize those changes in his future research to figure out how exactly they give the immune system a boost.
Though Cadwell and Loke are both zeroing in on the effects worms have, specifically, on inflammatory gut diseases — the kinds where the immune system loses its chill and deploys wave after wave of inflammation, regardless of what’s stimulating it — they’re pioneering a new paradigm of therapy that few had dared to consider. Eating worms — or at least parts of them — to alter our immune systems could someday become as accepted as eating probiotics or receiving fecal transplants.
Loke realizes it’s hard to grasp, especially for the squeamish among us. The best way to think about worms, he suggests, is in metaphor. “Think about a piece of land, like a rainforest,” he says, likening the modern gut to a dysfunctional, disrupted jungle. “You’re trying to recolonize it, you’re trying to repopulate it, you have to repopulate it with all the various components of the rainforest, instead of just trees, you know? Worms could be part of that ecosystem.”