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    Jefferson Adams

    A Breath Test for Celiac Disease? Yes Please!

      Scientific paper has more than a few people excited about a breakthrough breath test to help manage diabetes, celiac disease and other conditions.

    Caption: Image: CC--Bread for the World

    Celiac.com 05/20/2019 - A stuffy and obscure-sounding scientific paper has more than a few people excited about a breakthrough breath test to help manage diabetes, celiac disease and other conditions.

    Celiac is one of the most common and misdiagnosed disease. The process of getting a proper diagnosis can be long and convoluted. In part, that's because people with celiac disease may have few or no symptoms. In fact, these days, most people diagnosed with celiac disease report few or no symptoms.

    In fact, it's not at all uncommon for a person with celiac disease to suffer for up to 10 years before getting a proper celiac diagnosis.

    In diabetes, glucagon increases blood glucose levels. In diabetes treatment, DPP-4 inhibitors are used to reduce glucagon and blood glucose levels.  According to Wikipedia, they do this by increasing levels of incretin, GLP-1 and GIP, "which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels."

    The excitement arrises because a team of scientists has developed a selective, non-invasive breath test that could be used to diagnose and treat celiac disease and Type-II diabetes.

    The development team set out to develop a selective, non-invasive, stable-isotope 13C-breath test that can detect dipeptidyl peptidase-4 inhibitors (DPP4i), a class of orally available, small molecule inhibitors for the management of Type-II diabetes. 

    The team included Roger Yazbeck, Simone Jaenisch, Michelle Squire, Catherine A. Abbott, Emma Parkinson-Lawrence, Douglas A. Brooks & Ross N. Butler. The team's paper carries the very weighty title: Development of a 13C Stable Isotope Assay for Dipeptidyl Peptidase-4 Enzyme Activity A New Breath Test for Dipeptidyl Peptidase Activity.

    If you read that title, and understood only the words "breath test," you are not alone. The title and the paper are highly scientific. The takeaway is that the test they developed could be useful in diagnosing, treating, and managing diabetes and gastrointestinal diseases, including celiac disease.

    The team's paper describes in detail their development process for the stable-isotope 13C-breath test for DPP4. The test could potentially help to treat and manage diabetes, celiac disease, and other conditions, including certain cancers.

    "Furthermore," the paper reads "the significant pool of DPP4 in the small bowel and in inflammatory conditions suggests that a DPP4 breath test could also have potential application as a non-invasive method to measure intestinal function/integrity and immune status. Certain cancers also exhibit high expression of DPP4 as exemplified by the adenocarcinoma cell line in this study and this may provide a measure of cancer activity and response to therapy."

    Imagine a quick non-invasive breath test that can do all that. That's exciting stuff. Among other things, it could mean better treatment, and less unnecessary suffering. We say: Yes, please!

    Do you find the idea of a breath test for diabetes and celiac disease an exciting prospect? Share comments below.

    Read more in Nature.com Scientific Reports; volume 9, Article number: 4906 (2019.

    Also of interest is D Detel, M Persic, & J Varljen's paper titled "Serum and intestinal dipeptidyl peptidase IV (DPP IV/CD26) activity in children with celiac disease," and published in the Journal of Pediatric Gastroenterology and Nutrition; 45, 65–70


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    I have been diagnosed with Celiac with an endoscopy testing.  There is no cure ! It’s diet! 

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    First- by making it easier and less invasive to test for Celiac or diabetes- it will  lead to more diagnoses of Celiac - that can then be treated.  And It sounds like they could use it to help check compliance and healing of Celiac.  It doesn’t say it replaces a gluten-free diet or insulin in a diabetic.  

    Edited by kareng

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    45 minutes ago, kareng said:

    First- by making it easier and less invasive to test for Celiac or diabetes- it will  lead to more diagnoses of Celiac - that can then be treated.  And It sounds like they could use it to help check compliance and healing of Celiac.  It doesn’t say it replaces a gluten-free diet or insulin in a diabetic.  

    Aren't the antibody tests more specific for Celiac? What would this test add to them?

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    The breath test would be done to diagnose not treat according to the article above I am curious however ,whether it could diagnose celiac without eating the foods.I am a recently retired nurse and diagnosed with an allergy to gluten not sensitivity by an ENT specialist .It affected my sinuses severely .The bloating only came once i was eating high carbs while I was on a very high dose of oral steroids .I have a picture where I look ready to deliver a child full term.I have one sibling with a wheat allergy another with a gluten sensitivity and as well  2  distant cousins with wheat allergies.My siblings and I were off gluten before we had testing done as things were  too bad to continue eating it

    So we have no way of knowing if we all have celiac disease.Here's hoping!

     

     

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    The article does say to diagnose and treat celiac disease.

    Quote / "The excitement arrises because a team of scientists has developed a selective, non-invasive breath test that could be used to diagnose and treat celiac disease and Type-II diabetes."  // Unquote

    I assume they mean to diagnose and monitor celiac disease though.

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    Monitoring if a treatment works is part of "the treatment".   If you break your leg, part of "treating" the leg is repeat xrays (to see how its doing in the cast).  By the logic that this one "guest" keeps repeating, then a followup xray to decide to take off the cast is not part of the treatment?

      Seems a silly thing to quibble about if there is an easier way to diagnose any disease.  

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    Guest ANTHONY COLATRELLA

    Posted

    Mr. J.A. erred in his explanation of the test---it was developed to detect DPP enzyme activity---NOT DDPi(inhibitor) activity---DPPi is the class of drugs used to treat type2Diabetes---it would seem the main use of this test would be to measure DPP activity AFTER ingestion of DPPi to see if the drug would be effective, since that is how the drug works by inhibiting DPP so it does not inactivate GLP and GIP allowing these hormones to counteract glucagon. I cannot see how it applies to Celiac disease---either diagnostically or therapeutically---in fact the other article referenced which is from 2006--found no difference in intestinal levels of DPP in patients with celiac disease or other malabsorption syndromes---and presumably this is what the breath test is measuring-- intestinal levels of DPP.  There also was no difference in serum levels of DPP among the Celiacs, the MAS, and controls    Interestingly most of the OTC so called "digestive enzymes" which claim to digest gluten and advertised to help people with problems with gluten( but with the disclaimer--"NOT INTENDED TO TREAT CELIAC DISEASE"-since that would make it a drug and subject to FDA regulations instead of a "SUPPLEMENT" which is unregulated----most of these contain DPP as their active ingredient---DPP=dipeptidyl protenase---an enzyme that can digest proteins like gluten--------  unfortunately when subjected to legitimate scientific testing DPP does NOT effectively digest gliadin peptides which initiate celiac disease--so such products are of no help to celiacs.  Maybe after further work other applications of this test will become clearer 

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    Guest ANTHONY COLATRELLA

    Posted

    As an addendum to my prior comments above, I went back and read the entire article describing this test---I am not at all sure how well versed in celiac disease the authors are----they state that DPP has recently been implicated in the pathogenesis of celiac disease!------the 2 references they give #s 27 and 28 are from 1990 and 1994---we have certainly found out a great deal about the pathogenesis of celiac disease since then and it has nothing to do with DPP! Then seemingly in support of their test they refer to the same article(#29) from 2006 that was referenced by JA at the end of his article reporting on the test---which as I already stated above did NOT seem to find DPP levels helpful.   The one area where I can see it may potentially be helpful would be in a patient with KNOWN celiac disease after being on a GFD for 1-2yrs to check for DPP levels---if WNL it would indicate mucosal recovery----you would need to get a baseline when first diagnosed and then the repeat later to see if the DPP had recovered---this would be in place of repeating the SB biopsy.  It would seem to me this would still require much work to see if such measurements accurately correlate with mucosal recovery.

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Scott Adams
    Scand J Gastroenterol. 2003 Jul;38(7):727-31.
    Effectiveness of the sorbitol H2 breath test in detecting histological damage among relatives of coeliacs.
    Tursi A, Brandimarte G, Giorgetti GM, Inchingolo celiac disease.
    Dept. of Emergency, L. Bonomo Hospital, Andria (BA), Italy.
    Celiac.com 08/07/2003 - An Italian study conducted by Dr. L. Bonomo and colleagues and published in the July 2003 edition of Scandinavian Journal of Gastroenterology concludes that A significant proportion of coeliacs may be missed if relatives are screened by serology only, while the efficacy of sorbitol H2-BT in screening relatives is confirmed. This study confirms that neither a breath test nor serology can replace intestinal biopsy, which remains the gold standard for the diagnosis of celiac disease, thus confirming the continued importance of performing biopsies for diagnosing celiac disease. The studys goal was to determine the diagnostic capabilities of serological tests (antigliadin (AGA), antiendomysium (EMA) and anti-tissue transglutaminase (anti-tTG)) and sorbitol H2 breath test (H2-BT) in the detection of celiac disease in first-degree relatives. The study screened 111 first-degree relatives of 37 celiac families using both test methods to determine candidates for small bowel biopsy. First-degree relatives with abnormal test results underwent a small bowel biopsy, as did those with negative serological and H2 breath test results who had clinical complaints or suspected that they may have celiac disease.
    The biopsy results were expressed using the Marsh classification system, and celiac disease was diagnosed in 49 of the 111 screened relatives of celiacs, or in 44.14%. A breakdown of the results is as follows: 5 showed Marsh IIIc, 8 Marsh IIIb, 16 Marsh IIIa, 13 Marsh II and 7 Marsh I lesions. 19 relatives showed the classical form of celiac disease, 20 showed the sub-clinical form, and 10 showed the silent form. The serological test results indicated an overall positivity of only 36.73%, with strong positive results only in those with severe intestinal damage and Marsh IIIb-c lesions. The sorbitol H2-BT breath test results showed an overall positivity of 83.67%, and showed strong positivity in patients with slight histological damage (Marsh I-IIIa).

    Roy Jamron
    New, Simple 13C-Sucrose Leaky Gut Breath Test Now Available
    Celiac.com 05/06/2013 - After a diagnosis of celiac disease, it is unlikely a gluten-free diet alone will provide expeditious relief from its various associated symptoms and health problems.  Additional steps and remedies to restore the integrity of the damaged intestinal mucosal barrier are often needed, at least, to hasten the process.  The first step all patients should take after a celiac disease diagnosis is to establish a "baseline" measurement of the intestinal damage which can be used to assess how well the gut is healing over time.  Assessing the status of the gut via multiple endoscopic biopsy procedures is not a very practical choice of method. It is expensive, invasive, uncomfortable, subject to possible risks and complications, and only assesses the intestinal mucosa at the sites biopsied.[1]  The downsides of biopsies can be avoided by using a low-cost, non-invasive leaky gut or intestinal permeability test to provide a useful baseline measurement and following up with future periodical testing for comparison.   
    A new, simple and easy-to-use home Carbon-13 or 13C-Sucrose Breath Test to assess for leaky gut is now available.  The 13C-Sucrose Breath Test takes only 90 minutes, requiring drinking a sucrose (20 grams) solution and collecting 4 breath samples 30 minutes apart following an 8 hour fast.  13C-Sucrose Breath Test samples, collected in 4 small screw-capped glass tubes, are simply mailed to the laboratory within 14 days in the original shipping box that also serves as a pre-paid U.S. Postal Service First Class Mailer.  13C-Sucrose Breath Test results are emailed back within 24 hours after the breath test samples are received.[2] 
    In comparison, the better known and established Lactulose/Mannitol Intestinal Permeability Test requires an 8 hour overnight fast, collecting a pretest urine specimen, drinking a Lactulose(5 grams)/Mannitol(1 gram) solution, drinking water every 2 hours, and sampling and collecting all the urine excreted over a 6 hour period.  The Lactulose/Mannitol Test urine specimens must be kept refrigerated and shipped to and received by the laboratory within 24 hours in a special frozen gel pack shipper via FedEx overnight delivery.  Lactulose/Mannitol Test results are emailed around 7 days after the specimens are received.[3]
    The 13C-Sucrose Breath Test is based on the level of sucrase activity in cells of the intestinal mucosa.  Sucrase enzymes break down sucrose into its constituent components, fructose and glucose, which, when metabolized in the liver, produce carbon dioxide (CO2) exhaled in the breath.  Sucrase enzymes are synthesized and embedded in the "brush border" of cells comprising the villi of the intestinal mucosa.  The brush border is composed of numerous microvilli which extend into the intestinal lumen from the face of the villus cells.[1,4,5]
    Natural sucrose from cane sugar contains 2 forms of carbon atoms, carbon-12 (12C) and the stable, non-radioactive isotope, carbon-13 (13C).  12C and 13C carbon dioxide can be detected and measured using an isotope ratio mass spectrometer (IRMS).  By using natural 13C-enriched sucrose in which the ratio of 13C to 12C has been previously measured, measurement and analysis of the relative amounts of 13C and 12C in the carbon dioxide exhaled by an individual after ingesting a known quantity of the 13C-enriched sucrose provides an indicator of the sucrase activity in the brush border.  Damage to villus cells and the brush border results in both a decrease in sucrase activity and an increase intestinal permeability.  This forms the basis for a leaky gut test where low carbon-13 measured in the breath means the intestinal villi are damaged.[1,4]
    The Metabolic Solutions, Inc. 13C-Sucrose Breath Test is taken after a minimum 8 hour fast.  No sleep or exercise is allowed during the test.  A baseline breath sample is first collected.  Then a 20 gram packet of 13C-enriched sucrose is stirred into an 8 ounce glass of water and ingested.  Breath samples are then collected at 30, 60, and 90 minutes after sucrose ingestion.  Breath samples are collected into 4 small labeled 10 ml glass tubes with color-coded screw caps by simply unscrewing the cap, taking a full breath, and blowing into the tube through an ordinary straw.  Breath will be felt escaping out of the tube as it is blown through the straw.  That is normal.  All that is required is to screw the cap back on the tube, finger-tight, within 5 seconds.  If screwing the cap back on takes more than 5 seconds, one can simply take another breath and blow again.  After the test, the 4 tubes and the instruction sheet, filled-in with the test taker's name, email address, date of birth, sex, height and weight, are repacked into the original shipping box and dropped into any U.S. mail box within 14 days.  A prepaid U.S. Postal Service First Class mailing label is printed on the box.  Test results are emailed back within 24 hours after receipt by Metabolic Solutions, Inc.  If the percentage cumulative dose of 13C recovered from the sucrose at 90 minutes is less than 5.10% 13C for females or less than 3.91% 13C for males, the test is considered positive for intestinal damage.[2,4]
    The percentage cumulative dose of 13C recovered from sucrose over 90 minutes is calculated from the area under the curve formed by plotting the amount 13C carbon dioxide measured in each 10 ml breath sample against time, the ratio of 13C to 12C in the 20 grams of sucrose ingested, and a formula where age, sex, height and weight are used in a to compute the total amount of carbon dioxide (both 12C and 13C) that would be expirated by the test subject during the test time period.  Together, these considerations yield the desired test result expressing how much of the 20 grams of sucrose ingested has been metabolized by brush border sucrase enzymes and the liver and expelled in the breath within 90 minutes.[6,7]
    The 13C-Sucrose Breath Test was invented and developed by scientists at The Centre for Paediatric and Adolescent Gastroenterology, Children, Youth and Women’s Health Service, University of Adelaide, North Adelaide, SA Australia.  U.S. Patent 7338454 (March 4, 2008) and U.S. Patent Application 20080160504 (July 3, 2008) are assigned to Children, Youth and Women's Health Service Incorporated, North Adelaide, AU.[7,8]  Development of the 13C-Sucrose Breath Test began prior to 2002, the year an international patent application for the test was filed.[9]  Only recently has the test become available in the United States.  Because of limited published clinical studies, the 13C-Sucrose Breath Test has not yet become fully established as a standard for intestinal permeability testing, but has advantages over other tests and appears to be reliable.  Except in cases of intestinal damage, sucrase levels generally remain consistent thoughout life and across differing ethnicities.  Only 0.2% of the population has a genetic sucrase deficiency.[1,4,7]
    In only one study concerning zinc absorption in children with celiac disease has the 13C-Sucrose Breath Test been compared against Marsh scores of celiac disease patients.  That study recruited 51 children, aged 2 to 18 years, who underwent routine endoscopy for the diagnosis or exclusion of celiac disease.  There were no significant differences in 13C-Sucrose Breath Test results between children with a Marsh score of 0 and Marsh scores of 3a, 3b, and 3c.  All participants, including those with Marsh score 0, had a mean percentage cumulative dose of 13C recovered from sucrose at 90 minutes slightly below the 5.06% cut-off for a normal 13C-Sucrose Breath Test.  In a prior study, the average test result for normal healthy children (aged 11.2 +/- 0.8 years) was 8.5%.  Since all recruited children had bowel symptoms prompting an endoscopy, those children with March scores of 0, while not diagnosed with celiac disease, were not normal and healthy.  The study shows the 13C-Sucrose Breath Test is potentially useful to monitor gut integrity in celiac disease children.[10]
    Lactulose/Mannitol and the similar Lactulose/Rhamnose dual-sugar permeability tests have been studied since 1979.   Mannitol and rhamnose are small sugar molecules which normally cross the intestinal barrier via absorption through healthy intestinal cell membranes.  Lactulose is a large sugar molecule that crosses the intestinal barrier by passing between intestinal cells through the "tight junctions".  These sugars are non-metabolizable, and, therefore, the molecules which cross the intestinal barrier are excreted unchanged in the urine.  Loss of tight junctions elevates lactulose urinary levels.  Damage to intestinal cell membranes compromises absorption of mannitol or rhamnose molecules, and, thus, lowers mannitol or rhamnose urinary levels.  A high urinary lactulose to mannitol or lactulose to rhamnose ratio, therefore, indicates intestinal damage.[1]
    Lactulose/Mannitol permeability tests have been studied in celiac disease patients with mixed results as to whether the test is suitable as a screening test for celiac disease.[11-15]  Like the 13C-Sucrose Breath Test, the Lactulose/Mannitol test is probably best used to monitor the progress of gut healing by first testing intestinal permeability at the time of celiac disease diagnosis to establish a baseline for subsequent follow-up tests.
    The two tests are available online at competitive prices.  Metabolic Solutions Inc. currently offers the 13C Sucrose Breath Test for $129 which includes shipping.  The Genova Diagnostics Lactulose/Mannitol Intestinal Permeability Test is available at similar discounted prices from several online sellers.
    13C-Sucrose Breath Leaky Gut Test Kits are available directly from:
    Metabolic Solutions, Inc.
    460 Amherst Street
    Nashua, NH 03063
    866-302-1998
    For Health Professionals:
    http://www.metsol.com/leaky-gut-syndrome
    To Order Home Test Kits:
    http://www.breathtestingathome.com/leaky-gut/
    Lactulose/Mannitol Intestinal Permeability Test Kits are available (through retail website sellers) from:
    GDX/Genova Diagnostics
    63 Zillicoa Street
    Asheville, NC 28801
    800-522-4762
    http://www.gdx.net/product/10122
    I have personally taken the Metabolic Solutions, Inc. 13C-Sucrose Breath Leaky Gut Test.  A kit ordered online on a Monday was picked up from my post office box on Friday of the same week.  The test was taken on the following Monday, and the prepaid shipping box was dropped off at the U.S. Post Office the next day, Tuesday.  The test result was received in an email sent from Metabolic Solutions, Inc. Thursday evening, only 2 days later.  The test result was normal, 6.97% cumulative dose of 13C recovered, well above the cut-off of 3.91% for males. 
    Since no such simple and easy leaky gut test existed more than a dozen years ago when leaky gut was first suspected, no baseline was ever established for test result comparison.  Following years of diet and supplements targeted to heal leaky gut and treat its symptoms, a general indication of current gut status was desired.  Some  symptoms still remain.  A normal test result suggests the symptoms are likely due to other factors occurring before or during the leaky gut healing process, such as inflammation due to the continued presence of previously "leaked" environmental toxins accumulated in adipose tissue.   
    Sources
    1. Mucositis and non-invasive markers of small intestinal function.
    Tooley KL, Howarth GS, Butler RN.
    Cancer Biol Ther. 2009 May;8(9):753-8.
    http://www.landesbioscience.com/journals/cbt/article/8232/01-TooleyCBT8-9.pdf
    2. Instructions for Leaky Gut Breath Test.
    Metabolic Solutions, Inc.
    http://www.breathtestingathome.com/leaky-gut/instructions-leaky-gut/
    3. GDX Lactulose/Mannitol Intestinal Permeability Test Kit Instructions.
    Genova Diagnostics.
    http://www.gdx.net/core/domestic-kit-instructions/Intestinal-Permeability-Instructions.pdf
    4. 13C-Sucrose Breath Test for Leaky Gut Syndrome.
    Metabolic Solutions, Inc.
    http://www.metsol.com/leaky-gut-syndrome
    5. Small Intestine: Brush Border Enzymes.
    R. Bowen.
    Pathophysiology of the Digestive System, Colorado State University.
    http://www.vivo.colostate.edu/hbooks/pathphys/digestion/smallgut/bbenzymes.html
    6. Recent Results of the Development and Application of 13C–Breath Tests.
    Klaus Wetzel and Heinz Fischer.
    Fischer ANalysen Instrumente GmbH (FAN), Leipzig, December 1999, Page 33.
    http://www.fan-gmbh.de/docs/13c_recent_results.pdf
    7. Breath Test.
    Butler RN, Tivey D, Davidson GP, Pelton N.
    U.S. Patent 7338454, March 4, 2008.
    http://www.google.com/patents/US7338454
    8. Breath Test.
    Butler RN, Tivey D, Davidson GP, Pelton N.
    U.S. Patent Application 20080160504, July 3, 2008.
    http://www.google.com/patents/US20080160504
    9. Breath test.
    Butler RN, Tivey D, Davidson GP, Pelton N.
    International Application No.: PCT/AU2002/001666, December 9, 2002.
    10. Zinc homeostasis and gut function in children with celiac disease.
    Tran celiac disease, Katsikeros R, Manton N, Krebs NF, Hambidge KM, Butler RN, Davidson GP.
    Am J Clin Nutr. 2011 Oct;94(4):1026-32.
    http://ajcn.nutrition.org/content/94/4/1026.long
    11. Follow-up of adult celiac patients: which noninvasive test reflects mucosal status most reliably?
    Vecsei AK, Graf UB, Vogelsang H.
    Endoscopy. 2009 Feb;41(2):123-8.
    http://www.ncbi.nlm.nih.gov/pubmed/19214890
    12. Intestinal permeability in long-term follow-up of patients with celiac disease on a gluten-free diet.
    Duerksen DR, Wilhelm-Boyles C, Parry DM.
    Dig Dis Sci. 2005 Apr;50(4):785-90.
    http://www.ncbi.nlm.nih.gov/pubmed/15844719
    13. Lactulose-mannitol intestinal permeability test: a useful screening test for adult coeliac disease.
    Johnston SD, Smye M, Watson RG, McMillan SA, Trimble ER, Love AH.
    Ann Clin Biochem. 2000 Jul;37 ( Pt 4):512-9.
    http://www.ncbi.nlm.nih.gov/pubmed/10902869
    14. Lactulose-mannitol intestinal permeability test: a useful screening test for adult coeliac disease.
    Johnston SD, Smye M, Watson RG, McMillan SA, Trimble ER, Love AH.
    Ann Clin Biochem. 2000 Jul;37 ( Pt 4):512-9.
    http://www.ncbi.nlm.nih.gov/pubmed/10902869
    15. Is the sugar intestinal permeability test a reliable investigation for coeliac disease screening?
    Catassi C, Fabiani E, Rätsch IM, Bonucci A, Dotti M, Coppa GV, Giorgi PL.
    Gut. 1997 Feb;40(2):215-7.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1027051/
     

    Jefferson Adams
    Celiac Disease Research Could Lead to Diabetes Vaccine
    Celiac.com 10/19/2018 - Work to develop a vaccine for celiac disease could soon lead to a vaccine for diabetes.
    After successful phase 1 studies of Nexvax2, their peptide-based therapeutic vaccine for celiac disease, ImmusanT has seen a significant investment from venture philanthropy organization JDRF T1D. ImmusanT's peptide therapy program for celiac disease may provide lessons for a similar therapeutic treatment for Type 1 diabetes.
    The investment will support ImmusanT as it attempts to develop a vaccine to prevent Type 1 diabetes, based on the early success of its peptide immunotherapy program for celiac disease, the two entities announced in a press release.
    ImmusanT’s celiac peptide therapy program works by identifying antigens that trigger an inflammatory responses in people with autoimmune diseases. Once identified, the peptide therapy is used to neutralize the autoimmune response. This celiac disease program goes back to 1998, when Anderson first began his efforts to find and identify the peptides. 
    The findings were published in 2010, and the company was founded shortly afterward by Leslie Williams, BS, RN, MBA, director, president and CEO of ImmusanT. 
    From there, ImmusanT conducted five phase 1 trials for its celiac therapy. Those trials have proven very promising, and the latest investment into a similar drug for diabetes is proof of that promise. In the case of celiac disease, the drug works by “targeting T cells in patients. Those T cells that are engaged as peptides are distributed throughout the body after the injection, and we see evidence that the T cells are being activated about 2 hours later,” Robert Anderson, BMedSc, MB, ChB, PhD, FRACP, chief scientific officer for ImmusanT, told Endocrine Today. “We found that if we gradually increase the dose in patients building up to a maintenance dose level, they become non-reactive to those peptides.”
    With much of the early research targeted towards demonstrating the drug’s safety, and getting the right dose and dose regimen, the development of a version targeted at diabetes, says Anderson, “should be more streamlined due to the lessons learned during the celiac disease program.
    That’s partly because the team knows “a lot more going into Type 1 diabetes about how peptide therapy works and how to optimize it than we did when we started celiac disease, where it was a blank slate.”
    This is really exciting news. A vaccine for celiac disease is exciting, to be sure, but a viable vaccine for diabetes would be a major development in disease prevention. Stay tuned for more news as the story develops. 
    Read more at Healio.com

    Jefferson Adams
    Celiac Vaccine Nexvax 2 Could Be a Big Deal for Disease Sufferers
    Celiac.com 02/20/2019 - Pharmaceutical company ImmusanT is developing a celiac disease vaccine called Nexvax 2. Many vaccines provide long-term or permanent protection against disease after just one, or several doses. Because celiac disease is not caused by a virus, like polio, but is a response to the presence of an antigen (similar to an allergen that triggers an allergy), the approach to creating a vaccine like Nexvax 2 is different and, in some ways, easier, than creating a traditional vaccine, like the HPV vaccine. Nexvax 2 is a vaccine in much the same way that allergy shots are, but not in the way the polio vaccine is.
    Celiac Vaccine is Similar to Allergy Shots
    Unlike traditional vaccines, such as the polio vaccine, or the measles vaccine, Nexvax 2 does not inject a small dose of dead or weakened virus, or any virus fragment, into the patient to achieve disease immunity. 
    Allergy shots work by desensitizing the body’s reaction by strengthening the immune system, thereby reducing or eliminating reactions to certain allergens. Nexvax 2 would work in a similar manner to allergy shots. It would build tolerance levels until there was little or no immune reaction to gluten exposure.
    Anyone who’s ever had allergy shots knows that their effectiveness can range from person to person. Some people get minimal relief, though most see good to excellent results. Many experience tremendous relief, and see their symptoms disappear.
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    Because Nexvax 2 works less like a traditional vaccine, and more like allergy therapy, the process for testing and approval is potentially easier and shorter; several years, rather than a decade or more.
    The hope is that, once treated with Nexvax 2, “the immune system, now seeing these fragments of gluten in a different way, might learn to tolerate gluten," said Benjamin Lebwohl, director of clinical research at the Celiac Disease Center at Columbia University.
    Certainly, the ability to reduce or neutralize the body’s reaction to gluten in people with celiac disease would be a major breakthrough in the treatment of celiac disease. Benefits for celiac patients could include a reduction in severity of gluten contamination symptoms, and potentially an elimination of symptoms entirely. Nexvax 2 treatment, if successful, could allow some people with celiac disease to safely consume wheat. That is potentially huge news.
    Phase two clinical trials of the Nexvax 2 are slated for completion by the end of 2019. 
    Read more: Promising Celiac Vaccine Nexvax 2 Begins Phase Two Trials

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