The main objective of this
thesis is to improve the understanding of the role of helminth infections in
the development of insulin resistance, hence type 2 diabetes, and to gain
insight into the immunological mechanisms underlying this possible interaction.
To this end, we initiated a large scale cluster randomized controlled trial,
assessing the effect of anthelmintic treatment on insulin resistance and other
metabolic, as well as immunological parameters, in a rural area of Indonesia.
Deworming significantly reduced the prevalence of helminths, as well as
infection intensity. Although treatment did not lead to an increase of
whole-body insulin resistance at the community level, a significant increase in
insulin resistance was observed among helminth-infected subjects. Furthermore,
by comparing immune cells of helminth-infected Indonesians before and after
treatment, we gained insight into the specific cell populations that
participate in the type 2 and regulatory networks, and show that treatment
affects specific cell subsets in these networks. Altogether, the studies
described in this thesis show that helminth infections in humans, as well as
the administration of helminth molecules in obese mice, have a beneficial effect
on the insulin sensitivity, and have shed light on the immunomodulatory effects
of helminths. KNAWLUMC / Geneeskund
