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    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.

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    Jefferson Adams
    Celiac.com 05/19/2014 - A research team recently examined the effects of prednisolone and a gluten-free diet on mucosal epithelial cell regeneration and apoptosis in celiac disease.
    The team included Shalimar, P. Das, V. Sreenivas, S. Datta Gupta, S.K. Panda, and G.K. Makharia. They are with the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India.
    For their pilot randomized, controlled trial, the team looked at thirty-three untreated patients with celiac disease. They randomly assigned 17 of them to a gluten-free diet alone, and the other 16 to a gluten-free diet + prednisolone. Gluten intake was 1 mg/kg for 4 weeks.
    The team conducted duodenal biopsies at the start, and at 4 and 8 weeks following treatment. They recruited six patients with functional dyspepsia as control subjects.
    The team stained all biopsies for markers of intrinsic apoptotic pathway (AIF, H2AX, p53), common apoptotic pathway (CC3, M30), apoptotic inhibitors (XIAP, Bcl2), and epithelial proliferation (Ki-67). They then compared apoptotic (AI) and proliferation indices (PI).
    Initial duodenal biopsies showed the end apoptotic products H2AX and M30 to be markedly higher.
    In comparison with those treated with GFD alone, after 4 weeks of GFD + prednisolone treatment, some markers of both intrinsic and common apoptotic pathways showed rapid decline.
    After prednisolone withdrawal, there was overexpression of H2AX, CC3, and p53 in the latter group. In comparison with those treated with only GFD, patients treated with prednisolone showed suppression of mucosal PI, which started rising again after withdrawal of prednisolone.
    Apoptosis takes place in mucosal epithelium in celiac disease.
    The take away here is that a short course of prednisolone quickly suppresses apoptosis. However, it also suppresses epithelial regeneration, an so should be used only for a short time, if at all.
    Source:
    Dig Dis Sci. 2012 Dec;57(12):3116-25. doi: 10.1007/s10620-012-2294-1. Epub 2012 Jun 30.

    Jefferson Adams
    Celiac.com 01/16/2015 - Most people with celiac disease suffer from classic symptoms like weight-loss and diarrhea before diagnosis, right? Wrong. In fact, the most common medical issues for people with celiac disease might really surprise you.
    A team of researchers who recently looked at data on 770 celiac patients admitted to S. Orsola-Malpighi Hospital from January 1998 to December 2012, found that even though 80% of people with celiac disease have symptoms other than diarrhea, only 1 in 3 people with celiac disease shows classical malabsorption symptoms.
    Notably, two out of three people with celiac disease show non-classical symptoms. The majority of people have non-gastrointestinal symptoms. In fact, the top ten medical complaints of people with celiac disease are:
    Osteopenia/Osteoporosis—a full 52% of patients with celiac disease suffer from osteopenia/osteoporosis. Anemia—about one in three celiacs (34%) suffer from anemia. Cryptogenic hypertransaminasemia—nearly one-third (29%) of people with celiac disease, have what is called cryptogenic hypertransaminasemia. Diarrhea is, in fact, a common gastrointestinal symptom of celiac disease, but believe it or not, only 27% of people with symptomatic celiac disease experienced diarrhea. Bloating—20% of celiacs complained of bloating prior to diagnosis. Aphthous stomatitis—18% of people with symptomatic celiac disease had canker sores as one of their symptoms. Alternating bowel habit—15% of celiacs with symptoms have alternating bowel habit Constipation—13% of celiacs have constipation as a symptom. Gastroesophageal reflux disease—About 12% of people with celiac disease suffer from gastroesophageal reflux disease. Recurrent miscarriages—just over one in ten (12%) people with celiac disease experience recurrent miscarriages

    Jefferson Adams
    Celiac.com 04/10/2015 - Of course, a strict gluten free diet is still the only safe and effective treatment for celiac disease. However, new drugs in development, some of which are currently being tested on humans, might allow people with celiac disease to safely eat gluten again, at least in small amounts.
    To be fair, even if all goes smoothly, it will be a few years at least before we see such treatments on the market. Moreover, even though many early results have been encouraging, none have yet entered safety trials, the final step before Food and Drug Administration approval and commercial availability.
    Drugs currently under trial include an enzyme that splits the protein in wheat that triggers adverse reactions, into smaller harmless products, and another which promises to make the gut less leaky, and thus block potentially toxic substances from triggering inflammation.
    There are several other drugs in earlier stages of development aimed at suppressing the immune response to gluten and preventing intestinal inflammation:
    ALV003, which will protect people with celiac disease against gut damage from small amounts of gluten. BL-7010 is a novel co-polymer for the treatment of celiac disease, which significantly reduces the immune response triggered by gluten. ImmusanT’s therapeutic vaccine Nexvax2 combines three proprietary peptides that elicit an immune response in celiac disease patients who carry the immune recognition gene HLA-DQ2. Larazotide acetate (AT-1001) is Alba Therapeutics Corporation’s investigational product, a first-in-class tight junction regulator, intended for the treatment of patients with celiac disease. AVX176, from Avaxia Biologics, is an investigational oral antibody drug that is the subject of U.S. composition of matter patent 8,071,101, “Antibody Therapy for Treatment of Diseases Associated with Gluten Intolerance.” The patent, which expires on May 27 2029, provides broad coverage for treating celiac disease using orally administered antibodies produced by Avaxia’s proprietary platform technology [32]. ActoGenX is carrying out discovery research in celiac disease with its range of ActoBiotics™, which use Lactococcus lactis as an expression system to locally secrete bio-therapeutics such as cytokines, antibodies, hormones, etc. Chemocentryx’s CCR9, is also known as Traficet-EN, or CCX282B), and was originally intended for patients with moderate-to-severe Crohn’s disease. It has completed one Phase 2 trial in 67 patients with celiac disease. Meanwhile, in Europe, Dr. Falk Pharma and Zedira recently announced the start of phase I clinical trials for the drug candidate ZED1227, a direct acting inhibitor of tissue transglutaminase. The small molecule targets the dysregulated transglutaminase within the small intestine in order to dampen the immune response to gluten which drives the disease process.
    Some of these drugs may be taken right before eating gluten, while others might be more effective when taken on a regular schedule. If approved for use as intended, these drugs will likely allow people with celiac disease to eat gluten in small amounts. To my knowledge, there is no drug in current trial phases that is designed to permit unrestricted gluten consumption.
    So, the good news is that the next few years may see commercially available treatments that might actual help people manage celiac disease. The downside for people with celiac disease, at least for now, is that there is no treatment on the horizon that will allow safe, unlimited gluten-consumption. Moreover, there is no hint that a cure is coming anytime soon.
    Still, it’s good to know that researchers are working on providing helpful tools for treating celiac disease.
    Are you looking forward to seeing new treatment options for celiac disease? What kind of benefits should such treatments offer?
    Source:
    Gastroenterology Report

    Jefferson Adams
    Celiac.com 08/12/2015 - There are numerous pills, enzymes, and other products in development that are all designed to provide moderate protection against accidental gluten exposure to people with celiac disease to gluten-intolerance.
    Can a new pill, which uses egg yolk antibodies to coat gluten, allowing it to pass from the body without harm, find a place on the crowded roster of contenders?
    Driven by a desire to provide relief for people with celiac disease, Hoon Sunwoo, an associate professor of pharmaceutical sciences, has spent the last 10 years working on the proprietary pill.
    If Hoon has his way, people with celiac disease may soon be able to enjoy bread, pasta and other gluten products without suffering headaches, digestion problems and severe intestinal damage that come with the adverse gluten reactions of celiac disease.
    The pill works by using egg yolk antibodies to coat the gluten and allow it to pass from the body without doing any damage. While not a cure, Sunwoo's pill, now under development at the University of Alberta, may allow those people to join friends for a beer and pizza.
    Sunwoo makes it very clear that his pill is not a cure or long-term treatment solution, and the people with the disease should still follow a strict gluten-free diet.
    The pill is designed to be eaten by a person with celiac disease five minutes before eating or drinking, and would provide protection from an adverse gluten reaction for the next one or two hours.
    The pill completed safety clinical trials two months ago and is expected to begin efficacy clinical trials next year.
    Read more at CBC.CA.

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