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Showing results for tags 'intestinal permeability'.
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Celiac.com 06/29/2024 - Celiac disease is an autoimmune disorder where ingesting gluten leads to damage in the small intestine for those genetically predisposed. The standard treatment for celiac disease is a strict gluten-free diet, which, while effective, can be challenging to maintain and does not always completely prevent symptoms or intestinal damage. This has led researchers to explore new therapeutic approaches aimed at improving the lives of those with celiac disease. These novel therapies fall into five main categories: modulating the immune response to gluten, eliminating gluten before it reaches the intestine, inducing gluten tolerance, modulating intestinal permeability, and restoring a healthy gut microbiota. Modulating the Immune Response One promising area of research involves therapies that block the presentation of gluten peptides by HLA-DQ2 and HLA-DQ8, which are gene variants strongly associated with celiac disease. Three therapies in this category show significant promise: TPM502: This therapy uses three gluten-specific antigenic peptides that interact with T-cells associated with the HLA-DQ2.5 gene. A Phase 2a clinical trial is evaluating the safety and effects of TPM502 in adults with celiac disease. This trial is randomized, placebo-controlled, and involves multiple centers. Patients receive two infusions of TPM502 or a placebo, with the dose escalating through four cohorts to determine the optimal dosage. The study aims to monitor safety, tolerability, and pharmacodynamics. KAN-101: Designed to induce gluten tolerance, KAN-101 targets specific receptors in the liver. The study for KAN-101 is a three-part trial that includes an open-label, multiple ascending dose phase, followed by two double-blind, placebo-controlled phases. Part A of the study assesses the safety and tolerability of KAN-101, while Parts B and C focus on the response to gluten challenges and biomarker responses. This therapy has received Fast Track designation by the US Food and Drug Administration, highlighting its potential to address unmet needs in celiac disease treatment. DONQ52: This is a multi-specific antibody targeting HLA-DQ2. The ongoing clinical trial for DONQ52 involves two parts: a single ascending dose phase and a multiple ascending dose phase, both designed to evaluate the safety and tolerability of the drug in patients with well-controlled celiac disease. This trial aims to understand how the drug behaves in the body and its impact on biomarkers related to celiac disease. Eliminating Gluten Before It Reaches the Intestine Another approach is to prevent gluten from reaching the small intestine, thereby avoiding the immune response altogether. This strategy involves enzymes that break down gluten peptides in the stomach before they can cause harm. While specific therapies in this category are not detailed in the study, the concept is based on reducing the exposure of the small intestine to gluten, thereby preventing the autoimmune reaction. Inducing Gluten Tolerance Inducing gluten tolerance aims to retrain the immune system to tolerate gluten without triggering an autoimmune response. KAN-101 is a notable example in this category, as it seeks to create immune tolerance by targeting receptors in the liver. This approach could potentially allow people with celiac disease to consume gluten without adverse effects. Modulating Intestinal Permeability Celiac disease often increases the permeability of the intestinal lining, allowing gluten peptides to enter the bloodstream and trigger an immune response. Therapies that modulate intestinal permeability aim to strengthen the intestinal barrier. By doing so, these treatments can prevent gluten peptides from passing through the intestinal wall and reduce the overall immune response. Restoring Gut Microbiota Balance The gut microbiota plays a crucial role in overall health and immune function. In people with celiac disease, the balance of gut bacteria is often disrupted. Therapies in this category aim to restore a healthy balance of gut microbiota, which could help reduce symptoms and improve gut health. This approach includes the use of probiotics and other microbiota-modulating treatments. Conclusion The development of novel therapies for celiac disease offers hope for improved management and quality of life for those affected. These therapies, which range from immune modulation to restoring gut microbiota, are still in various stages of clinical trials but show promise in addressing the limitations of a gluten-free diet. For individuals with celiac disease, these advances could mean more effective treatment options and a better ability to manage their condition without the strict dietary restrictions currently required. The ongoing research and clinical trials are a crucial step toward finding more comprehensive solutions for celiac disease, potentially transforming the standard of care in the near future. Read more at: medscape.com sciencedirect.com nature.com
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Digestive System Care for those with Celiac Disease
Thora posted a blog entry in Gluten Free Mastery
Digestive Upset Causes Beyond Gluten When you have Celiac disease, you have a damaged digestive system. This requires that extra care should be taken to avoid foods and additives that are known to cause digestive side effects. Many of the people who successfully recover their health after going gluten free will speak about having to make other dietary changes. These additional changes generally involve removing other foods not thought of to have gluten. Some of these other foods do in fact contain gluten. Some of it will be in the various ingredients in packaged foods, or cross contamination during some point in the production line. But others will actually not contain gluten, but do contain other substances that further irritate the damaged digestive systems that those with Celiac Disease have. Some terms that are heard these days are: Leaky Gut Intestinal Permeability Microbiome Probiotics and Prebiotics These all relate to managing the digestive system. It can get a bit overwhelming when you start digging into these subjects, since there appears to be an endless amount of info to learn. Many of them don't directly speak about Celiac and gluten. Others will disregard gluten problems, and be disrespectful of Celiac sufferers. However, the core theories, and core research backed information coming out of these topics carry an extremely important message: Put good stuff into your diet, and take damaging stuff out. Groundbreaking Advances in Digestive Health Importance Research in the last few years is really starting to get the core understanding of how this works, and realizing it's much more important than anyone dreamed of. This research is really just the beginning. The research will continue, and much more will be learned over the coming years. Some core concepts that have come out so far are: The main part of the immune system resides in the stomach. The microbiome is the core of the immune system. The microbiome is the bacteria in our systems, with "ground zero" being the stomach and digestive tract. Modern life as lived for the last 100 to 150 years has seriously changed the composition of the microbiome, and not for the better. The microbiome can be "changed" via diet. (The details of this are still in their infancy, so much more will be learned in the coming years.) Every person has a unique microbiome, thus meaning solutions will be unique to every single person. (This is why some treatments, diets, etc. have such dramatically different results from person to person.) As people with Celiac disease, who still struggle with not feeling well, we can use this to tailor a truly unique diet plan for our life, and for our wellness. We all must start with removing gluten, ALL gluten, from our diets. Unfortunately, that does mean some dramatic lifestyle changes. If we all lived in Utopia, we could just snap our fingers and have a proper gluten free product available for everything we're used to eating. But we don't live in Utopia. We live in a culture that is obsessed with gluten. It's everywhere. As many of you are aware, first hand, eating gluten free is being treated like a fad. That means that your need for 100% gluten free foods are being disregarded, and not truly taken seriously. By restaurants, food manufacturers, your friends, your family, etc. Far too many people think "just a little is okay." If you REALLY want to get well, then you need to control your food 100%. That can be inconvenient. It involves a big learning curve. However, it's vital to understand that with practice, this truly will become second nature. But only if you take the initiative to educate yourself fully. If you rely on someone else to make some or all of these decisions, you will not get better. You will continue to be sick, and you will continue to suffer. As you learn about taking control of eating gluten free, you'll run across a lot of conflicting info. You'll just have to work through the conflicting info, to find what's actually true. A Core Step in Recovery A big first step in getting control is to eat only food. That may sound silly, but there's a ton of stuff in the products that we buy that isn't really food, and the vast majority of them can irritate various parts of our bodies. Manufacturers use a lot of additives to mimic the taste, texture and actions of more expensive food ingredients, and to allow them to sell items that if made with real foods would not be able to be packaged and sold long after they were made. If you're still struggling with feeling well, and feeling frustrated that you can't eat "normal" then it may be time to get back to basics for a while, until you can learn more. It really is better to feel well and have what you may think of as a restricted diet. When you feel well, you can make better decisions, plan more, get a bit more creative in your meal planning, etc. Change Our Attitudes, Change Our Destiny A change in our attitude about food will also go a long way to help us deal with the needed changes. For example, we may think we're being deprived by not being able to eat "normal." However, if you think the "Standard American Diet" (the SAD diet) is "normal," then it may be time to rethink the wisdom of that. The SAD diet has come to be known as one of the worst ways to eat that the world has seen. It causes severe chronic illness, and is massively contributing to decades of illness for many Americans. Earlier I said that our culture is obsessed with gluten. This is clearly seen when you look at the last several Food Guides that the USDA has put out. The current version recommends 5 to 8 servings per day of grain products (for adult women and men). That's a LOT of grain. That's a LOT of bread. We're being told that we must eat grains to provide the following (per current USDA MyPlate site): fiber some B vitamins - folate / folic acid; thiamin, roboflavin, niacin iron magnesium selenium When we cut out gluten containing grains, we pretty much cut out getting these above nutrients from grains. It's almost impossible to get these nutrients in the same quantities from non gluten grains. However, all is not lost. It's very easy to get these nutrients in other common foods in our diet (if we don't follow the USDA MyPlate recommendations). You can get a ton of fiber from adding leafy greens, vegetables, some fruits, nuts, and seeds. All of the B vitamins in the processed grains, those mostly used in the US and other developed countries, are added. The fact is that the processing of foods strips out most of the natural B vitamins. It's super easy to get these vitamins from meat, dairy, nuts, seeds, beans and vegetables. Be sure to eat all of those foods. If you have some other reason to exclude some of those foods, then get some proper advice from someone who properly understands eating gluten free AND your other limitations. Remember that part of the reason we think we must have these very high levels of grains is that's what the marketers have told us. Even the USDA is really just a group of growers in the US that grow mostly grains (along with a large portion raising livestock). The USDA's food guides have been shown repeatedly to NOT be based on truthful, valid research. Take a Step Back, Keep it Simple to Start So, when you're planning your gluten free diet, remember that you don't have to fill your plate with as many grains as you may be used to. Get back to the basics. Plan out some home cooked meals, made with pure, fresh foods. This may be something you haven't done much of, since our culture is so used to buying mostly prepared foods, but with some practice, and some basic planning, you'll be well on your way to making significant progress in getting well. Here's a super simple dinner plan, to get you started, when you have no idea how to start: Choose your favorite PROTEIN - meat, beans. Pick your favorite single herbs to prepare them with. Add some diced onions or garlic. Cook. Choose 2 different colored VEGGIES, steam them, or cut up and eat raw - have one be green, the other one be a nice vibrant color. Choose a STARCH - brown rice, potatoes, yams, etc. Boil and serve with butter. Make a SALAD, with a base of leaf lettuce, and at least 4 other veggies, all different colors. Make a salad dressing from scratch: 1 crushed garlic clove, 1/4 c apple cider vinegar, 1/2 c olive oil, 1 tsp raw honey, 1/4 tsp salt, 1/8 tsp pepper. Place in a container and shake. You can take this basic plan, and adjust one thing at a time by finding a recipe you like that fits the gluten free, processed food free criteria. Over time, you'll start to build a wonderful collection of recipes that suit you and your family. Be sure to let us all know in the comments below when you try this, how it went, and be sure to tell us what you ate! Bon Appetit! Thora Toft - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - References and further research: Time to Run - Recommended dietary allowance (RDA) USDA - Choose MyPlate website Excerpt from “Sugar Crush: How to Reduce Inflammation, Reverse Nerve Damage and Reclaim Good Health” by Richard Jacoby and Raquel Baldelomar
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