Exposure to worm infection in the womb may protect against eczema

A large trial in Uganda, funded by the Wellcome Trust, showed that treating a pregnant woman for worm infections increased the risk of her child developing eczema. This research supports the hygiene hypothesis, which maintains that exposure to infections early in development can modify the immune system and protect against allergies in later life.

The allergy epidemic is now no longer restricted to the developed countries of the world, and declining incidence of infection from worms (helminths) is widely considered to be a contributory factor. Helminth infection very often has no symptoms at all, but they can range from mild anaemia to vomiting and, stomach pain.

The study carried out at the MCR/UVRI Uganda Research Unit on AIDS in Entebbe showed a reduced instance of eczema among infants whose mothers had worms, and an increased incidence among infants whose mothers had been treated with albendazole to kill the worms.

In a follow up study involving just over two and a half thousand pregnant women, the researchers carried out a randomised, double-blind trial comparing those treated with albendazole or praziquantel against those issued a placebo, and found that treatment increased risk of eczema by a factor of 1.8 and 2.6 respectively in the off-spring of treated women.

These findings have led the authors, headed by Professor Alison Elliott, The London School of Hygiene and Tropical Medicine, to suggest that the routine de-worming of pregnant women, in a setting where the infection has mild symptoms, may not be beneficial for the child, and may cause problems with allergy.

Professor Elliott stressed that further studies need to be done before any changes in treatment policy are recommended.

Source: Wellcome Trust 

January 2011

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