A mother has told how she realised her young son had leukaemia after reading a book about a child with the condition and the same symptoms.

Joanne Morris suspected her son Alexander was sick when she noticed he was feeling exhausted and bruising easily on a family holiday aged just four in summer 2009.

She immediately took him to the GP because she remembered reading a book a decade before about a youngster who had bruised easily and had leukaemia.

And her worst fears were confirmed when he was referred to Rochdale Infirmary for tests and just hours later was given the devastating news he had some form of leukaemia.

He was due to join the reception class at Bury Grammar School with his twin sister Annabel that autumn but instead missed the first term because he spent so much time in hospital.

Alexander, now six, will continue to receive treatment until November 2012 but is back in the classroom and enjoying school.

He has coped so well that his headteacher Hilary Hutton has nominated him for a Cancer Research UK Little Star award, acknowledging the challenges faced by youngsters who encounter cancer.

She said: “The news that Alexander was not joining the class and was in hospital being treated for leukaemia came as a big shock to everyone.

“Alexander has been an inspiration to us all. he never complains or expects to be treated differently.”

Alexander’s mum Joanne, 39, and dad Christian, 39, praised their son’s bravery.

Joanne added: “I just knew that Alexander had leukaemia as I remembered reading a book about a child who bruised easily. So, even though the news was a huge blow to the family, it didn’t feel that much of a shock. Alexander was too ill initially to ask us any questions about what was wrong with him, but he now understands that he has ‘poorly blood’ and needs to go to hospital every two weeks.

“He absolutely loves all the staff at the hospital and actually enjoys going there as it’s been such a huge part of his life up to now.”

The awards, in partnership with TK Maxx, are open to all under 18s who have cancer or have undergone treatment in the last five years.

To nominate a child visit cancerresearchuk.org/littlestar .

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BRACKEN VERNON-JELIER Western Morning News (Plymouth, UK) November 22, 2011

Mouth cancer rates have risen by more than 20 per cent in the last 30 years and there are more than 4,000 new cases a year in England. but with a disease that is so prevalent why are so many cases being detected too late? Keith Francis, from Ivybridge in Devon, was 58 when a change to a simple action that he performed every day changed the course of his life. Whilst brushing his teeth one evening he noticed he had begun to spit blood. Assuming it was due to small graze on his tongue; he ignored it and went to bed. Little did he know that he had late stage aggressive mouth cancer and the disease was just weeks away from becoming inoperable.

November is Mouth Cancer Awareness Month and cases like Keith’s are being used to highlight the warning signs of a disease which, without early detection, could claim 30,000 lives over the next decade.

Keith, a retired architectural engineer, said: “I just wasn’t aware that mouth cancer was something you could get. it had never crossed my mind and even when they performed a biopsy I was confident that everything was OK. I couldn’t have been more wrong.”

His dentist, John Gittins, owner and principal dentist of Highland Dental Care in Ivybridge, says there is a worrying lack of public awareness into the often fatal disease. “It is the results of surveys and campaigns like this that really highlight the lack of knowledge on this serious subject. Dental professionals are always on the lookout for signs of anything unusual, but without regular check-ups the six to 12 months inbetween can see a lot of change and we need to make sure that our patients are aware of the symptoms to look out for.”

A study commissioned by the British Dental Health Foundation discovered that more than four in five people failed to know any symptoms of the disease. The survey, which questioned more than 800 people, looked particularly into the behaviours and attitudes of children aged 12-16 and their parents, in a bid to discover their level of understanding in a disease which is rapidly and progressively affecting a greater number of younger people.

It found that more than three in every four parents failed to recognise any early warning signs of the disease which is diagnosed in 6,000 people in the UK every year.

The surgery that followed Keith’s diagnosis was intensive and invasive and confirmed that the cancer was only 3mm away from spreading beyond medical control.

“Getting it checked out saved my life. it was a progressive tumour. The surgeon that treated me at the time told me that it was one of the fastest growing cancers and that amongst the top ten causes were hard drinking, like brandy and whisky – which I didn’t do – and smoking, which I didn’t do either.”

Surgery involved cutting away the tumour, which affected 40 per cent of the left side of his tongue, and replacing the tissue with skin taken from other areas of his body. He underwent five operations with three surgical teams working on him at once. He was off work for six months and for two months he could only breathe through a tube in his throat and be fed through a tube directly into his stomach. He was only able to communicate with his wife and family through writing notes until his mouth was healed enough.

Work with a therapist has meant that Keith’s speech is as clear as it ever was, but he is one of the lucky ones. six years of checkups means that Keith has now been given the all clear. Alec Cross in Modbury is in the early stages of treatment following diagnosis only weeks ago.

“I had a problem on my gum that I put down to rubbing from a clasp that went around my top teeth. but when the problem got worse and I had it checked out, a biopsy confirmed it was cancer. I was very alarmed when they said that they may have to remove all my teeth. Fortunately that has not had to happen, but they have had to remove a large slice of my tongue and my treatment continues.”

His dentist, John, said; “As well over half the population received a dental exam in the last two years dental teams are in the ideal position to share information about the risks and symptoms of mouth cancer with their patients. both Alec and Keith are examples of how a dentist can help to diagnose these problems – we wish Alec all our very best wishes for his continuing treatment and for a very speedy recovery.”

According to BUPA, symptoms of mouth cancer may include an ulcer in the mouth or lip that won’t heal; constant pain or soreness; red or white patches in the mouth; a lump on the lip, tongue or in the neck; bad breath; unexplained bleeding in the mouth, numbness or loose teeth.

Highland Dental Care is based in Ivybridge and will welcome anyone interested for a free mouth check-up during November. to make an appointment please call the reception team: 01752 893152.

Copyright 2011 Western Morning News (Plymouth)All Rights Reserved Western Morning News (Plymouth, UK)

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Imagine suffering from a chronic hacking cough for 12 years seemingly without hope of resolution. Imagine that every doctor you visit tells you the same thing; “you have asthma and need to take inhalers in order to control the cough as best you can”. when Vincent, a 41-year-old male, walked into my office this was the advice he had been given for more than a decade. He was frustrated with receiving the same ineffective advice time after time. He hoped that there might be an alternative solution to his severe cough but I could tell he wasn’t optimistic.

the most important job of a naturopathic physician is to determine the causes and underlying mechanisms of disease and illness. when a patient comes into my office with a symptom I investigate all of the potential causes. when doctors focus on treating or suppressing symptoms they don’t address the actual causes. as a result, the symptoms often return when the therapy is stopped.

for long-term resolution of symptoms to occur it is best to examine all of the potential causes of the symptom. in my practice, this begins with an hour-long Comprehensive Health Assessment involving a complete review of medical history, targeted physical exam, and thorough initial consultation. when patients leave the office after the initial visit most of them comment that they have never been asked so many questions before or examined so thoroughly.

During the Comprehensive Health Assessment with Vincent we uncovered a number of other health concerns. not only did he have a chronic cough that you could hear from outside the office, he also experienced post-nasal drip, heartburn, indigestion, and chronic fatigue. in addition, Vincent experienced high levels of stress due to his debilitating cough and his extreme work responsibilities. upon completion of the initial visit I felt there was a connection between his digestive concerns, fatigue, and chronic cough.

Vincent was encouraged to hear that his symptoms might be connected and that there might be hope. He was always discouraged with the way his symptoms were isolated and treated separately. He was given inhalers for the cough, acid blockers for the heartburn, and anti-depressants for fatigue. however, none of the medications seemed to really help the symptoms.

in Vincent’s case, as with most cases of chronic cough, heartburn, and indigestion we investigated potential food allergies. when I asked Vincent if he had ever been tested for allergies he said he had recently seen an allergist and the results were negative. Unfortunately, the type of testing that had been performed (skin prick testing) is highly unreliable for catching food allergies. Therefore, I informed him about the most accurate form of food allergy testing (a blood test that looks for elevated levels of immunoglobulin G) and he decided to take the test.

Immunoglobulin G is an inflammatory antibody produced by white blood cells as part of what is known as a “Delayed Sensitivity Reaction”. It is produced after the body has been exposed to allergens, particularly from diet. IgG is typically produced anywhere from 2-48 hours after allergen exposure and can lead to a host of chronic inflammatory symptoms and diseases including asthma, acid reflux, fatigue, and chronic pain.

While we waited for the results to come back from the lab we began to work on Vincent’s digestive system. He supplemented with digestive enzymes to help improve the breakdown of carbohydrates, proteins, and fats. He consumed demulcent botanicals to prevent acid reflux and help heal inflammatory damage to the esophagus. Vincent also took probiotics (beneficial bacteria) in order to restore a healthy balance of bacteria in his gastrointestinal tract.

when the results of the food allergy test came back from the lab they showed that Vincent’s immune system was reacting negatively to a number of common foods including dairy, wheat, eggs, and oats. when these foods were removed from his diet his symptoms disappeared within about one week. He continued to take the digestive system supplements for a few more months in order to fully restore the integrity of the GI tract.

after several months of food allergy avoidance Vincent was able to slowly reintroduce many of the foods he once had allergic reactions to without the return of symptoms. the time away from the food allergens allowed Vincent’s immune system to calm down and no longer be so reactive against foods that previously induced allergy. Vincent has been free of the chronic hacking cough for over 18 months and no longer experiences post-nasal drop, heartburn, or indigestion.

Vincent is a great example of a patient who benefited greatly from naturopathic healthcare. To this day, he remains one of my most satisfied and loyal patients. His story is a very important one because it illustrates the importance of identifying and treating the causes of illness. no natural or synthetic remedy had or could have successfully treated Vincent’s symptoms. what he needed was a thorough evaluation of all the potential causes, the performance of the right tests, and the administration of the right therapies.

as a naturopathic physician I get to work with many patients who have stories similar to Vincent. They get a medical diagnosis, they get a pharmaceutical treatment, and they don’t really get better. when they seek other medical opinions they get similar a diagnosis and a familiar treatment. They get frustrated with the system and eventually begin to lose hope they will ever be well again. Fortunately, many of these people make their way into my office or another naturopathic doctor’s office and seek one more opinion.

Arlowen Kuchera has suffered from Alzheimer’s disease for more than a decade, but early signs of the disease started 15 years ago with moments of confusion.

“it was devastating in the beginning,” her daughter, Kay Etter, told the Log.

Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. There is no current cure, but treatments for symptoms are available and research continues.

The Alzheimer’s Association Walk to end Alzheimer’s is the nation’s largest event to raise awareness and funding for Alzheimer care, support and research. the walk is held annually in more than 600 communities, including the Destin area.

The Walk to end Alzheimer’s is important because, “it makes people aware of this devastating disease,” Etter said.

This Saturday participants of all ages will meet at Baytowne Marina in Sandestin Golf and Beach Resort to join the march toward ending the disease. Registration begins at 8 a.m. and the walk begins at 9 a.m. for more information visit alz.org/walk or call 800-272-3900.

Kuchera was an Army wife. Before the disease took over, “she was stubborn and could do anything,” Etter said. “ She worked, sewed, cooked and entertained.”

But after her husband passed away, things began to change. Etter decided to move her mother from her longtime home in San Antonio, Texas, to Athens, Ga.

“She was leaving everything she knew,” Etter said. On the drive to her new home, “we stopped at a convenience store to get some water, and while I was waiting in line she decided to go wait for me outside.”

When Etter came out of the store, her mother was nowhere to be found. She looked under cars and in the field.

“I looked down the road, and I saw this nice Cadillac like my father used to drive — same color and everything,” she said. “She was sitting inside it and had locked herself in.”

Etter begged her mother to get out of the car, but Kuchera just shook her head. it wasn’t until the owner of the Cadillac came out that she was able to reach her mom.

At that point no diagnosis had been made, but “that was a sign right there that something was wrong,” she said.

A few months later, Kuchera was diagnosed with Alzheimer’s and lymphoma at the same time. She’s been through radiation and cancer treatment, but Etter says the memory loss has taken its toll on her.

Her mother was staying at a facility in Georgia, but after several falls and broken bones, Etter decided she needed some “extra TLC.” They decided to move to Sandestin in July. her mother is now a resident of Crystal Bay Memory Care.

“She’s as happy as she can be, but she’s tired and worn out,” she said. “She’s an angel in waiting. She’s in a good place and ready to meet dad again.”

While Alzheimer’s is hard on the people who live with the disease, Etter says it’s also tough for the caregivers.

“it affects our lives, our travel, our marriages — everything you do,” she said. “They don’t really remember, but caregivers remember everyday.”

ANGLE (LON:AGL) is the longest established of the intellectual property groups quoted on the London market. 

Founded in 1994, it listed a decade later. Unlike others, ANGLE does not invest in other people’s businesses.  

Instead it founds, owns, operates and invests in its own businesses from the ground up.  

ANGLE chief executive Andrew Newland says this enables the company to build stronger, more robust businesses with a lower failure rate and risk profile than traditional investor models.

The share price rocketed recently when the group revealed Parsortix, one of its companies, had successfully tested a blood screening device that could change forever the way cancer is treated and monitored.

However there is more to ANGLE than just this one firm. it has two other leading investments, while there is a potential payout from a third which is currently the subject of a bitter legal wrangle.

Parsortix (90 per cent owned by ANGLE)

This is the jewel in the crown of the ANGLE business. it has come up with a small, devilishly simple separation device that has the potential to capture and characterise cancer cells in the bloodstream. 

This of course has all sorts of ramifications for the way the disease is treated and monitored.

For a start it may be possible using the device to determine which treatments are working, and which are not.  

Now this promises a huge improvement in the way chemotherapy is administered. 

The device also has the potential to monitor patients in remission, and to pick up early signs of the return of the cancer, ahead of the patient experiencing any symptoms.  the earlier the treatment, the greater the likelihood the patient will survive.

Furthermore, it may be possible to develop a simple blood test to provide routine screening of healthy people to check for early signs of cancer ahead of any symptoms.

Although still in its infancy, Parsortix technology may ultimately have the ability to identify all the hard tumour types, without knowing in advance which cancer is expected.  

This is a step on from the existing means of identifying circulating cancer cells, where the tests are specific to each cancer type and even then are not totally reliable.  

“we think ours has a much more universal application – hopefully to all solid tumours,” says Newland.

The company is currently in discussions with leading cancer research groups including the Paterson Institute for Cancer Research in Manchester. 

The idea of this and other similar collaborations is to field test the device using blood taken from cancer patients. 

It also allows for development of the separation device and the supporting equipment in a real world setting. 

The potential clinical market is huge and is conservatively estimated by the company to be worth around US$4 billion annually in the United States alone.

However, to be sold for use in hospitals the device requires what’s called 510k approval from the all powerful US Food & Drug Administration and a CE mark here in Europe. 

That process is likely to take a further 18 months of research, development and testing – and cost around £5 million.

Although the company is talking to potential partners, ANGLE may bankroll the development itself. 

It has options to achieve this, including the sale of one of the businesses in the company’s portfolio.

Alternatively it could fund the work by licensing selective use of the separation device to big pharmaceutical companies developing drugs for cancer as what’s called a companion diagnostic.

“That way we would get a big partner working with us, but wouldn’t give away the crown jewels,” Newland says.

“There is the potential to take the separation device rapidly into the research sales market as this does not require regulatory approval and that is our first target.” 

Geomerics (33 per cent holding)

Unless you are under the age of 18, it is unlikely you will have noticed the hype surrounding the launch of Battlefield 3.   

According to commentators the Electronic Arts shoot ‘em up could knock current PlayStation and X-Box number one call of Duty off its perch. 

For Geomerics it is a huge opportunity to showcase its Enlighten middleware, though it is already used in 17 other titles produced by EA and other leading games publishers.   

The aim is to turn Enlighten into the industry standard for top quality computer games lighting and graphics.    

“In commercial terms Geomerics is getting some traction,” says Newland. 

“we are nearly at the stage where the sales income not only covers the operating costs – we have been at that level for a while – but also the development costs and overheads.” 

It has a £2.3 million development deal with a large, but unnamed technology company. 

“we are hoping over the next 18 months Geomerics will emerge as an industry standard in its field and we will then get interest from some of these big players,” says Newland. 

“we are building it so we will hopefully get multiple businesses interested in buying it.”

Novocellus (82 per cent holding)

Its EmbryoSure selection system has the potential to revolutionise in-vitro fertilisation. 

The science behind the product was developed by the University of York, and it tests the amino acid profile of the culture medium used to carry the fertilised egg.  

“we believe EmbryoSure will identify with 95 per cent confidence which one of the embryos is likely to be a top quartile embryo,” says Newland. 

Currently there is no such means of identifying the best eggs. 

Novocellus reckons EmbryoSure has the potential to increase pregnancy rates by a quarter and possibly by as much as 40 per cent. 

As well as increasing pregnancy success rates, this has two other major benefits. the first is cost.  If as touted EmbryoSure reduces the number of cycles of IVF required to get pregnant, the overall IVF cost will fall. 

The second is less obvious and relates to the push from inside the healthcare system towards single embryo transfer instead of double embryo transfer. 

Having a way of spotting to these “top quartile” eggs would aid the transition to single embryo transfer. 

“we believe there is going to be a regulatory drive behind our product,” Newland adds.

Novocellus is partnered with Origio, a Danish firm, which sells the culture medium used in IVF.

Origio has agreed to carry out trials on the product, and in return Novocellus will receive milestone payments of £4.5 million and royalties at a rate of 25 per cent when EmbryoSure goes on sale. 

The current timeline is to complete trials in 2012, although “we are aware that Origio are behind on the trials work”. 

Acolyte Biomedica 

This was the very first company ANGLE set up. it used technology deployed in the first Gulf War to detect anthrax to identify the MRSA super-bug. 

The business was sold to the American giant 3M in 2007 in deal brokered by Porton Capital, Acolyte’s biggest shareholder at exit. by this time ANGLE had been diluted down to 11.55 per cent. 

Porton is currently locked in a court battle over the proceeds from the agreed earn out it says it is still owed. If successful then it paves the way for ANGLE to claim back up to £4.7 million. 

The court proceedings are complete and the judge is expected to give his ruling imminently.  ANGLE is not at risk of any legal costs and the result can only provide an upside benefit.  

What the City Says

The share price, currently 80.5 pence, is nearly double the last documented price target from Collins Stewart and is closing in on the 119 pence valuation placed on the stock by Merchant Securities. 

“we have been encouraged by updates on several of its venture companies, including Geomerics and Parsortix,” said Merchant analyst Navid Malik in a note to clients. 

“we see calendar 2012 as a key year for ANGLE, which could show the signs of significant delivery on commercial deals and progress within a number of the subsidiary businesses.”

JAMES Griffiths has never seen his wife or toddler son, but he thinks that's a small price to pay for their love.

Without the illness that stole his sight and independence, and even critical organs, mr Griffiths would never have met "the most beautiful person" in his life.

Mr Griffiths’s decade-long battle with diabetes took a dramatic turn three years ago when he had a double-kidney and pancreatic transplant.

The rare surgery, performed at Monash Medical Centre, was his only chance of survival.

But within days, the toughest time of mr Griffith’s life became the best.

He fell in love with Taryn Lea, the ward assistant helping him recover from the operation.

"At the start I just liked Taryn’s voice, but then we got talking and we got to know each other. and from there I fell in love with her," mr Griffiths said.

The now Ms Griffiths said she was instantly attracted to his positive attitude.

"A lot of patients feel sad and sorry for themselves, but James was always very nice," she said.

"He made me laugh. It didn’t take long to see he was a very special person."

The couple wed a year later and, despite medical warnings they may never be able to conceive because of James’ illness, had a son. Steven is now 14 months old.

But the highs did not come before some significant lows.

Mr Griffiths, now 30, was just 19 when he was diagnosed with type 1 (insulin-dependent) diabetes.

"they said I’d probably had it for three to six years previously," he said. "I had all the symptoms – I was thirsty a lot, I drank a lot, I sweat a lot – but I was a labourer working outside, so I thought that was normal."

Mr Griffiths has since gone blind, lost feeling in the tips of his feet, and suffered renal failure and bowel problems.

Had he known more about the consequences of diabetes, he believes he could have been able to avoid his run of ill health.

Now he is on a mission to warn people about the dangers of ignoring the warning signs of diabetes, and is teaming up with Southern Health to talk to patients and families about managing the condition.

Nematode parasite, Trichuris suis, found in the intestines of pigs

In 2005 the Johnson family was at its breaking point. Lawrence, the family’s 13-year-old son, was diagnosed with autism at age two and a half, and his parents had valiantly coped with his illness for the ensuing decade.

Throughout his childhood, Lawrence’s disorder progressed along the typical path: he would not engage in pretend play like other children, he repeated himself incessantly, his interests were very restricted, and he was frequently agitated and anxious.

Over the years, the Johnsons tried several treatments to curb Lawrence’s violent and disruptive outbreaks. they started with applied behavior analysis when he was young, and attempted interventions ranging from dietary modifications to music therapy. Lawrence took every pharmaceutical that could potentially treat his problems—antiseizure medications, serotonin-reuptake inhibitors, atypical antipsychotics, lithium, and others in various combinations.

Some of these treatments offered the family momentary reprieves from what Stewart calls Lawrence’s “freak outs.” But any improvements in the boy’s behavior were usually short-lived. “of all of them, the only one that gave us a brief respite was risperidone [a potent antipsychotic], and that actually did, for a brief window, stop his agitation and aggression,” Stewart recalls. But after a year or so, the drug stopped working. while still on risperidone, Lawrence began to gain weight rapidly and his daily bouts of violence and aggression returned.

When traditional pharmacotherapy failed, Stewart began to search outside the medical establishment for ways to help his son. “Lawrence was somebody who had had several trials of other medicines that have been well studied and really hadn’t gotten a therapeutic response,” says his doctor, Eric Hollander, then the head of Mount Sinai Medical Center’s Seaver Autism Center in New York City.

But Stewart, a portfolio manager in Manhattan, eschewed unproven and potentially dangerous alternative autism treatments, such as chelation therapy or intravenous hydrogen peroxide, to which some parents fall prey. Instead he employed a scientific approach, combing Web sites like PubMed and MedLine for published literature on promising treatments. “A large part of my free time and a lot of time I should have been sleeping was given over to researching what, if any, ways there are to try and get a handle on some of these symptoms,” Stewart notes. “I wasn’t looking to cure autism. I was looking for a way to make our lives bearable.”

His search would lead him to an idea that, on its face, might seem just as farfetched as some of the alternative autism treatments Stewart calls “junk science.” He discovered the work of a trio of physician/researchers at the University of Iowa who had successfully treated patients with Crohn’s disease and ulcerative colitis using a nematode parasite found in the intestines of pigs—Trichuris suis, the pig whipworm. both are autoimmune disorders in which the immune system essentially attacks the intestinal walls. Stewart also found data that pointed to a link between some autism symptoms and inflated levels of proinflamma​tory cytokines, an apparent result of the immune system attacking glial cells in patients’ brains.1 Putting these bits of information together, Stewart wrote a short review paper and presented it to Hollander. His central hypothesis was that parasitic worm infection would modulate Lawrence’s immune system and calm inflammation that was causing his disruptive behaviors.

“I had never heard of it before,” Hollander, now at the Montefiore Medical Center University Hospital of the Albert Einstein College of Medicine, admits. “It was a new thought. I looked into the literature and there did seem to be data supporting the basic hypothesis and some data in other conditions in terms of efficacy.” Hollander was impressed with Stewart’s research and agreed to help him obtain sterile, treatment-grade T. suis eggs that were being grown and tested in Europe by the German company OvaMed.

Stewart and Hollander were reassured by the behavior of T. suis in the human gut. Because they have evolved to infect the guts of pigs, the worms only colonize humans in a very limited fashion, are unable to reproduce, and are flushed out of the system after a couple of weeks. like most internal parasites, T. suis cannot complete its entire life cycle in only one host, and in the environment the ova require a 3- to 6-week incubation in moist soil to mature, making inadvertent spread of the parasites to Stewart, his wife, or daughter unlikely.

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After obtaining permission to administer the treatment from the US Food and Drug Administration (FDA) under “compassionate use” rules, Stewart and Hollander navigated customs protocols to import OvaMed’s formulation of T. suis ova, called TSO. they had Lawrence drink a solution containing 1,000 of the roundworm eggs every two weeks for 5 months beginning in early 2006.

The results were beyond disappointing. Lawrence’s aggressive and agitated behaviors abated for just four days during the entire 20-week treatment period. “there were only those four days,” Stewart recalls. “each day subsequent, he went right back to his old self.”

Stewart started looking at residential schools where Lawrence could live under the constant supervision of healthcare professionals. “We couldn’t live like that anymore. We were at our wit’s end,” he says.

But when Stewart contacted OvaMed’s president Detlev Goj to inform him of the dispiriting results, his hope was renewed. Goj told him that Lawrence’s response to the low dose of worm eggs—1,000 ova every two weeks as opposed to 2,500 in the promising Crohn’s and ulcerative colitis trials—actually fit the profile of a potential responder. He recommended that they give Lawrence 2,500 eggs every two weeks for a period and see what happened. Stewart relayed the information to Hollander, and they prepared to conduct another trial, this time at the full dose.

The Iowa studies

The research that initially stoked Stewart’s hopes for treating his son using parasitic worms was conducted a few years earlier in the University of Iowa lab of Joel Weinstock, who is now head of gastroenterology at Tufts University in Boston. Weinstock, along with his colleagues Robert Summers and David Elliot, hit upon the idea of treating inflammatory bowel diseases by infecting patients with roundworms after finding epidemiological evidence linking worms and autoimmune diseases.

The Iowa researchers knew that when people moved from less developed to more developed countries, the rates of autoimmune diseases rose in the immigrant population. for example, in populations moving in the 1970s and 1980s from India, a country with high incidences of worm infection, to the United Kingdom, where such infections are rarer, the incidence of Crohn’s disease increased rapidly.2 and in the 1930s and 1940s epidemiologists had found virtually no occurrence of bowel disorders in children living in the rural southern states of the United States. Because pig farming was done on a regional basis and many rural dwellers lived in close proximity to their livestock, worm infections were much more common outside urban areas. As nationwide programs were launched to tamp down worm infections among rural populations and migration to urban areas increased, autoimmune diseases became more prevalent.

Weinstock and his colleagues hypothesized that rather than the presence of some environmental factor leading to the uptick in certain autoimmune disease, perhaps the absence of something was to blame. maybe steering clear of worm infections was also robbing individuals living in industrialized nations or developed urban centers of crucial immune-system modulation that had arisen through millennia of coevolution with these parasites, they reasoned. “this could be a reason why, if people are infected naturally in a developing country, they might not develop inflammatory bowel disease or other immune diseases,” says Robert Summers.

They settled on the porcine whipworm to test their hypothesis, and administered the helminths to a group of Crohn’s disease and ulcerative colitis patients.

In an open-label pilot study, four patients with Crohn’s disease and three with ulcerative colitis ingested T. suis ova. Symptoms improved in all seven patients.3 In a larger trial in 2005, nearly 80 percent of 29 patients suffering from Crohn’s disease reported significant alleviation of their symptoms after 24 weeks of treatment.4 The team reported more modest but still promising results in a study testing the treatment on patients with ulcerative colitis.5

The Iowa team suspected that their research would be ridiculed, discounted, or followed up on by their colleagues. “We knew that it could be totally ignored, or it may get some real conversation, because anything new makes people talk,” remembers Weinstock.

Though scientists were indeed intrigued by the Iowa research, it took Stewart Johnson’s happening upon the findings and applying them to the treatment of his autistic son for helminthic therapy to really sprout wings.

Second time’s a charm?

The Johnson family anxiously awaited the effects of the full dose of TSO on Lawrence’s violent behavior. within 10 weeks of the higher-dose treatment, the autistic boy stopped smashing his head against walls. He stopped gouging at his eyes. The paralysis and frustration that held him and his family prisoners in their own home lifted. The freak outs ceased. “It wasn’t gradations,” remembers Stewart, who had always kept meticulous notes on Lawrence’s disorder and the interventions they had attempted. “It just went away. All these behaviors just disappeared.” Elated, Stewart called Lawrence’s doctor, Eric Hollander. “He was stunned, because all of that behavior set was gone,” Stewart says. “He was speechless, as I was.”

Hollander and Stewart recognized the potential importance of Lawrence’s reaction to TSO, and after a year or so of closely monitoring the boy’s progress, the researcher asked Stewart to present their findings to his colleagues at the Seaver Autism Center during its annual conference in 2007. Stewart did so, and the team at the research facility, one of the most prominent in the nation, was intrigued. “they were very impressed,” Stewart recalls. “It was very well received.”

The Seaver Center researchers were so impressed, in fact, that they agreed to use the case of Lawrence Johnson as the basis to apply for a more formal clinical trial testing TSO in other autistic patients with severely disruptive and aggressive behaviors. with Stewart’s help, the team submitted an Investigational New Drug (IND) application to the FDA to import and administer TSO for 16 weeks to 10 adult autistic patients with symptoms similar to Lawrence’s.

According to Alex Kolevzon, clinical director of the Seaver Center and the lead researcher of the TSO study, it took some convincing both at the FDA and within the Seaver Center’s own review board to launch the trial. “what I had to convince them of was that we were going to be very safe with using this medicine,” he says. “Everybody who encountered this held it up to a lot of scrutiny.”

Recently, the FDA and Mount Sinai’s internal review board were persuaded to allow the trial on adults to go forward, and Kolevzon and his colleagues are now recruiting 10 patients with the right behavioral profile for the study. Hopes are high for TSO’s potential and for the study’s ability to shed light on the role of immune system functioning in autism. while it may be that TSO will be a benefit, Kolevzon says, “the broader hope is that we’re going to learn something about how the immune system responds to TSO that may lead to other, more targeted treatments.”

using worms to battle other illnesses

Kolevzon’s group at the Seaver Center isn’t the only team of researchers pursuing the treatment approach that Weinstock and his Iowa colleagues launched—and autism isn’t the only disease that scientists are now targeting with the use of parasitic worms. John Fleming, a University of Wisconsin neurologist, is investigating TSO’s safety in multiple sclerosis (MS) patients, testing the treatment as an IND under FDA’s supervision. Fleming was, in fact, the first researcher to start the IND application process, and Kolevzon credits him for laying the groundwork with the FDA that made it possible to get the autism trial started. But Fleming, like Kolevzon, says that getting the FDA to allow him to proceed with the studies was no small task. Fleming’s study, which will treat 18 MS patients with the helminth ova, was approved in a grant from the MS Society in 2004. It wasn’t until last year that the FDA finally allowed him to proceed with the trial under IND rules. “We spent long years in a regulatory wilderness until we got FDA approval,” Fleming says.

Fleming himself needed some convincing when he initially came across the idea. “When I first heard of this I thought it implausible,” he admits. “The evidence from the people in Iowa and thinking about the science behind what they did gradually had an impact on me, and I said, ‘this is plausible and it ought to be tested.’”

While he was awaiting the FDA’s approval to proceed with the helminth studies, Fleming learned of a study in Argentina in which 12 MS patients with naturally occurring helminth infections who were followed for four and a half years showed significantly less neurological damage when compared to 12 MS patients without infections.6 that study “certainly gave at least some hope that the helminth treatment in inflammatory bowel diseases could be applied in multiple sclerosis as well,” according to Fleming. He adds that he is still recruiting patients for the phase I trial.

Another researcher, Harvard pathologist Marie-Hélène Jouvin, has also convinced the FDA to allow her to proceed with trials of TSO, in her case testing its safety in five patients who suffer from severe food allergies, which are caused by overzealous inflammatory responses to particular environmental triggers. like her colleagues working with autism and MS, Jouvin holds hope that helminth infection will eventually open new treatment options for people with food allergies as well as a host of other diseases. “From what we know from epidemiological studies with helminth infections and from animal studies and from the clinical studies done by Joel Weinstock,” she says, “it is clear that there is a good chance that TSO could fine tune or modulate inflammation/immunity in many diseases where it is now clear that inflammation/immunity plays a critical role.” also like her colleagues, Jouvin is still in the process of recruiting patients. As of last November, she had recruited only one.

how do worms work?

The three phase I clinical trials underway in the United States using helminth eggs are, by regulation, designed as safety studies, simply testing the suitability of introducing the parasites into the guts of patients. But given the anecdotal evidence that T. suis infestations in humans have virtually no negative side effects, the underlying scientific push is to understand exactly how the worms are acting to modulate immune responses that lie at the root of certain autism symptoms, inflammatory bowel diseases, and food allergies, among other autoimmune diseases.

Science is uncovering more of the intricacies of the human immune system every day. Ten years ago, prevailing thought on adaptive or acquired immunity held that two types of T helper cells—Th1 and Th2—maintained an equilibrium in the body: Th1 cells spur the bactericidal tendencies of macrophages and ramp up cellular immunity against bacteria and viruses, while Th2 cells induce immune system changes that target parasites, toxins, and allergens. From this model scientists predicted that if parasites like intestinal worms could activate a Th2-type response, the Th1 response, which is usually implicated in autoimmune diseases, would be suppressed. In recent years, however, this simplistic model has fallen out of favor.

Treatment-grade Trichuris suis ova Ovamed

As more is learned about the complexity of immune responses and more lymphocyte subpopulations come to light, recent theories point to a modulation of T regulatory cells—which function to suppress activation of the immune system and prevent it from attacking the body’s own tissues—by worm infection. “The thought is that the helminth can induce T regulatory cells initially in the gut,” says John Fleming, speaking about the worm’s potential effect in MS patients, “but somehow this changes the whole inflammatory milieu and this translates to less inflammation in the brain.” He cautions, however, that other possible mechanisms could be at play.

Clues to the mysterious mechanism behind the ability of parasitic worms to seemingly calm the immune system also come in the form of case reports from patients with concomitant worm infections and autoimmune diseases. for example, a team of researchers from New York and San Francisco recently found elevated levels of T helper (Th2) cells in the intestinal epithelium of an ulcerative colitis patient who had infected himself with Trichuris trichiura, the human whipworm. at spots in his intestine where the colitis was clearing up, T helper cells initiated the production of a protein called interleukin-22, a cytokine involved in mucosal healing, while genes involved in carbohydrate and lipid metabolism were upregulated.7

Working with mice, Joel Weinstock and colleagues at Tufts have found a tantalizing new piece of the puzzle. In a recent study using a mouse model of colitis, they found that dendritic cells, which process and present antigens to other immune cells and in this case were functioning in innate immunity, may be just as important as T cells—the principle agents of adaptive immunity—in driving the autoimmune attack on intestinal tissues that is characteristic of colitis. The researchers found that infection with the helminth Heligmosomoides polygyrus could reverse colitis by interacting with dendritic cells to influence pathogenic T cells.8

While the complicated mechanisms behind the effect of worm infections on the human immune system will come to light only after many years of careful study, the fact that the FDA has sanctioned preliminary trials is something of a watershed moment. The three ongoing clinical trials with TSO represent the first time that the FDA has allowed studies of a whole-organism therapeutic agent.

Although the FDA cannot legally comment on unapproved products, an agency spokesperson did write that, “The FDA does recognize the potential importance of alternative therapies, including certain intestinal worms,” in an e-mail to The Scientist.

One happy ending

Meanwhile, Lawrence Johnson, now 20 years old, continues to respond positively to treatment with T. suis eggs. Because the parasites are flushed from his system regularly, he takes a dose of TSO as his father sees the need, roughly every two weeks. though this costs Stewart and his family about 600 Euros a month, he says the treatment has changed their lives and that it’s well worth the price. “There’re no words to describe it. It’s like giving me my son back,” he says. “or in many ways, like giving me a son that I didn’t ever have.”

Since seeing the positive effects of TSO on Lawrence’s worst behaviors, Stewart has launched a Web site, autismtso.com, to share his family’s experience and inform other parents of current research and the progress of the clinical trial at the Seaver Center. He also wrote a chapter about his experience with TSO treatment in the recently published Textbook of Autism Spectrum Disorders.9

Even given the remarkable contributions he’s made in the field of helminthic therapy, Stewart remains realistic about his continued contribution. “am I the one who’s going to find out the underlying mechanism by which helminths interact with the immune system?” he asks. “No. I am definitely not that person. But I got us to this point, and now hopefully others can figure that out, and hopefully there is a connection and this will help other people.”

Correction (2nd February): When originally posted, this article conflated irritable bowel syndrome with inflammatory bowel diseases. The Scientist regrets the error.

Tuberculosis, known as the white plague in Victorian England, is returning to London at an alarming rate, according to a set of studies and reports due to be released this weekend. London now is the only major European city where the rate is actually rising, according to one report.

TB was once thought to be a factor of Charles Dickens’s times, and was virtually banished through most of the last century. Last year, however, some 9,000 cases were reported in the UK, 40 per cent in the capital.

These represent a 50 per cent increase in reported cases in London over the past decade – up from 2,309 in 1999 to 3,450 last year. this, say authors of the reports to be released in the coming days, is certainly an underestimate – because they have evidence that only 70 per cent of all Tuberculosis cases are being picked up and treated.

At least 250 of the cases, according to one of the experts, have proved resistant to the usual antibiotic treatments. Another worry is that the disease is now in Britain’s jails. In 2000 TB swept through New York jails and spread among jail staff. it was when a white jailer died that the authorities released $80 million to tackle the outbreak.

this led experts in infectious diseases on both sides of the Atlantic to warn the British government that the same sort of outbreak might be imminent in Britain – particularly as a rise in TB cases was being reported across eastern and central European.

However, the assumption that TB is being spread by recently arrived immigrants in London is erroneous, according to one frontline medical practitioner in the East end I spoke to. “Most of the cases occur in people who have been here at least three years,” he said.

this suggests that what’s behind the rise in TB cases is poverty, insanitary conditions and overcrowded housing, particularly in London’s East end.

TB is likely to strike most in so-called ‘high risk’ groups in the capital – the homeless and vagrants, drug users and HIV-positive groups. some may carry the illness and not realise they have it all, and pass it on unwittingly.

though the government declined to fund any special measures, in 2000 the King’s Fund gave a grant of £250,000 for a study on the resurgence of TB in the capital. One of the studies was carried out by Professor Griffiths, an expert in community hygiene and medicine who has continued to practice as a GP in Hackney.

One of the measures undertaken in the research was to brief 30 out of a group of 61 GPs in the East end with a one-day course on how to identify TB. The 30 doctors who received the training showed a dramatic increase of ‘pick up rate’ in identifying early symptoms of the disease compared with the 31 doctors who had not been given the tutorials.

One of the problems, a health worker explained to The First Post, is that it so difficult to