Now there’s a title to arouse one’s curiosity.

The training of the immune system so that it can distinguish “self” from “non-self” is something we take for granted. Maybe we shouldn’t. It begins to appear that for many, if not all people, exposure to worms in early life is a significant part of that training. Without it we may end up with autoimmune diseases such as Crohn’s, asthma, autism, MS, etc.

Many patients with Crohn’s disease are now being treated successfully with worms such as the whipworm, Trichuris trichiura. It’s a long story but excitingly told by Rob Dunn in “The Wild Life of our Bodies” and by Moises Velasquez-Manoff in “An Epidemic of Absence.” Evolution has a curious bag of tricks and we would do well to pay attention to the entire ecosystem of which we are only one small part. That includes all the microbes we are so familiar with but also our helminth friends that we tend to think so revolting. Maybe our exquisite public health and sanitation systems have given us a back-handed slap by eliminating these “parasites.”

Have you taken a worm to lunch lately? (They don’t eat very much.)

Gordon Short, MD