Developing Therapies for Celiac Disease

    Published: 06-16-2009
    Views: 9,372
    Alice Bast discusses the latest research and developing therapies for celiac disease.

    Alice Bast: Hi! I am Alice Bast, President and C.

    E.

    O of the National Foundation for Celiac Awareness, where as part of our mission we advance celiac disease research and give hope to our community.

    A strict 100% gluten-free diet is the only treatment currently known to be effective for celiac disease, a genetic autoimmune disease triggered by the protein gluten. Unfortunately, the gluten-free diet is not perfect. Completely eliminating gluten is virtually impossible since it's found in so many foods, less than of crumb of gluten containing food can cause an immune reaction which makes dining outside the home very difficult.

    Many people with celiac disease never completely heal their small intestine and continue to experience symptoms, because celiac disease is on the rise. It's important that researchers look at new ways to treat this common condition.

    Dr. Anthony J. DiMarino Jr.

    : Well several therapies are in development across the world. In the United States I know of at least three major clinical trials in progress with more on the way. Some of the research both in the United States and abroad is focused on breast-feeding practices and that timing of introduction of foods that contain gluten into infant feeding.

    These studies would suggest that introducing gluten between the fourth and seventh month while breast-feeding, appears to delay or lessen the risk of the subsequent developments of celiac disease. Well other trials are using peptidases to predigest gluten before it reaches the small intestine and therefore prevent its absorption.

    And then third method focuses on tightening the junctions between intestinal cells where most of the gluten is absorbed which would also limit absorption. Finally, immunotherapy attempts to reprogram the cells that cause celiac disease and therefore prevent the autoimmune response in people with the HLA-DQ gene.

    Alice Bast: Some of the clinical trials are focused on adult patients who continue to have symptoms despite following a gluten-free diet while others are focused on genetically at risk individuals. The therapy is focused on pre-digesting gluten molecules or preventing intestinal permeability are intended to supplement the gluten-free diet.

    If these therapies were to come to market, the gluten-free diet would still be necessary, but patients would have a safety net in case of the exposure to gluten.

    Dr. Anthony J. Dimarino Jr.

    : One of the immune approaches to therapy uses a vaccine to desensitize the body to the toxic peptides that have been identified in the gluten protein. This therapy is focused solely on those who carry the HLA-DQ2 gene and if successful would enable those with celiac disease who are DQ2 positive, to eventually return to a normal gluten containing diet. This approach is similar to the allergy shots which worked to prevent an immune reaction from occurring in the first place. Alice Bast: 70% of those with celiac disease remain exposed to gluten despite following a life-long gluten-free diet resulting in alleviated antibody levels that put their long-term health at risk. While the therapies we have outlined are each at different stages in the clinical trial process, there are promising developments for those with celiac disease.

    Patient participation in scientific research is essential to helping these and other drugs complete their clinical trial processes. Steps needed for new therapies to be approved by the FDA getting a proper diagnosis is the first step to participating in clinical trials.

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