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Can Some Celiac Disease Be Treated with More than Just a Gluten-free Diet?


Photo: CC--Brett Jordan

Celiac.com 08/05/2016 - Currently, a gluten free diet is the only option for treating celiac disease. Still, there are numerous patients who follow the diet, but do not respond fully clinically or histologically.

What options do doctors have to treat celiac disease beyond a gluten-free diet? A team of researchers wanted to find out. The research team includes S. Kurada, A. Yadav, and DA Leffler of the Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, and the Celiac Research Program at Harvard Medical School, and the Department of Medicine at Boston Medical Center’s Boston University School of Medicine in Boston, Massachusetts.

The team conducted a search of PubMed and clinicaltrials.gov to highlight celiac disease articles that use keywords including 'celiac disease' and 'refractory celiac disease' and focused on articles conducting pathophysiologic and therapeutic research in/ex-vivo models and human trials.

They then zeroed-in on developing therapies that influence these processes, including tight junction regulators, glutenases, gluten sequestrants and immunotherapy using vaccines, nanoparticles that may serve as adjuncts to a gluten-free diet, or maybe even allow for gluten consumption.

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Their subsequent paper also highlight the role of anti-inflammatories, immunosuppressants and monoclonal antibodies in refractory celiac disease.

According to the commentary of their expert, "therapies including tight junction regulators and glutenases have the potential to be approved for non-responsive celiac disease, or as gluten adjuncts."

The team expect results of various phase 1/2 trials using AMG 714, BL 7010, IgY antibodies to be published. In the interim, They plan to treat refractory celiac disease with off-label use of 5 amino-salicylates, budesonide, nucleoside analogues and newer biologics developed for other inflammatory diseases.

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3 Responses:

 
Lynn Holtmeyer
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said this on
18 Aug 2016 6:43:27 AM PDT
I am currently facing a decision: Diagnosed with celiac in 2009. Last endoscopy in 2013 showed healing of small intestines, some duodenal scalloping still present.
I developed psoriasis vulgaris over 15% of my body. I am presently being offered Stelara as a treatment. How will this affect my celiac ...positive or negative?

 
Leaky gut
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
07 Nov 2016 5:53:40 AM PDT
A huge piece of the puzzle for me was reducing dairy and sugar consumption to minimal AND eliminating NSAIDs and other drugs that promote leaky gut.

 
Altinoy Kamilova
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said this on
20 Mar 2017 9:25:14 AM PDT
Very interesting information.




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@cyclinglady thanks for checking in Restricted diet didn't do much. Still had some VA last time they checked. Heath still otherwise fine, so RCD remains unlikely. My sxs kick in lockstep with life stress, so that kind of points to some general IBS stuff on top of celiac disease. Very doubtful I'm getting any gluten in, but fingers crossed my system is just a little hyper-vigilant, as I ponder on this thread.

I have always noticed that the table wine in Europe is pretty damn good! I am a wine lover and so is my husband but he does like his Green's beer.

The reason they set the limit at 20ppms is that through scientific study, they have proven that the vast majority of people with Celiac Disease do not have an autoimmune reaction to amounts below that......it is a safe limit for most. Also, just because that limit is set at 20ppms, does not mean that gluten-free products contain that amount of gluten. Testing for lower levels becomes more expensive with each increment down closer to 0-5ppms, which translates into higher priced products. Unless you eat a lot of processed gluten-free food, which can have a cumulative affect for some, most people do well with the 20ppm limit.

I'm in the Houston area so I'm assuming there are plenty of specialists around, though finding one that accepts my insurance might be hard. This might sound dumb, but do I search for a celiac specialist?? I'm so new to this and want to feel confident in what is/isn't wrong with my daughter. I'm with you on trusting the specialist to know the current research.

Hi VB Thats sounds like a good plan. Would it help to know that a frustrating experience in seeking diagnosis isn't unusual With your IGG result I'm sure a part of you is still wondering if they are right to exclude celiac. I know just how you feel as I too had a negative biopsy, but by then a gluten challenge had already established how severely it affected me. So I was convinced I would be found to be celiac and in a funny way disappointed not to get the 'official' stamp of approval. Testing isnt perfect, you've already learned of the incomplete celiac tests offered by some organisations and the biopsy itself can only see so much. If you react positively to the gluten free diet it may mean you're celiac but not yet showing damage in a place they've checked, or it may be that you're non celiac gluten sensitive, which is a label that for a different but perhaps related condition which has only recently been recognised and for which research is still very much underway. We may not be able to say which but the good news is all of your symptoms: were also mine and they all resolved with the gluten free diet. So don't despair, you may still have found your answer, it just may be a bit wordier than celiac! Keep a journal when you're on the diet, it may help you track down your own answers. Best of luck!