Harnessing the gut microbiome in the fight against anthelminthic drug resistance

Abstract

Intestinal helminth parasites present major challenges to the welfare of humans and threaten the global food supply. While the discovery of anthelminthic drugs empowered our ability to offset these harms to society, the alarming rise of anthelminthic drug resistance mitigates contemporary efforts to treat and control intestinal helminthic infections. Fortunately, emerging research points to potential opportunities to combat anthelminthic drug resistance by harnessing the gut microbiome as a resource for discovering novel therapeutics and informing responsible drug administration. In this review, we highlight research that demonstrates this potential and provide rationale to support increased investment in efforts to uncover and translationally utilize knowledge about how the gut microbiome mediates intestinal helminthic infection and its outcomes.

Figure 1.. Investigation of microbiome-parasite interactions holds potential to transform IHP infection prevention and treatment strategies.

Gut microbes may elicit probiotic effects that impact the success of infection, for example by affecting the environmental cues that induce egg hatching as well as by modulating host immunity to suppress IHP growth. Additionally, microbes may produce anthelminthic compounds that directly inhibit the growth of or kill IHPs, especially upon initial exposure of the worm in the gut. Microbial metabolites may also suppress the growth of other microorganisms in the gut that promote parasite infection. Relatedly, these microbes may influence a host’s sensitivity to IHPs with such effect that microbiomic information may be useful for predicting infection likelihoods and facilitating preventative infection strategies that ultimately decrease the frequency, duration, and dose of drug administration.