Trichuris suis ova in inflammatory bowel disease-clinical challenges and translational pathways

This article reviews the mechanisms and clinical trial findings of <i>Trichuris suis</i> ova (TSO) for inflammatory bowel disease (IBD).The results show TSO may exert potential effects on IBD via multiple pathways, yet no significant efficacy has been confirmed in clinical trials. Given its promising anti-inflammatory properties, further research is warranted. However, many knowledge gaps still exist in this field. Future trials should standardize study designs. Considering IBD complexity, priority should be given to precision medicine, with identifying TSO therapy's target populations as a core step. Additionally, enhanced safety monitoring is essential to fully assess short- and long-term risks of TSO treatment. Given the inherent uncertainties of live biotherapeutics, multi-omics and gene-editing tools should be adopted to clarify TSO's anti-inflammatory mechanisms and achieve its "artificial domestication", enabling stable therapeutic performance across diverse clinical settings. The breakthroughs will deepen insights into IBD pathogenesis and advance microbiome-based interventions from empirical practice to the precision medicine era.