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Celiac.com 04/24/2014 - Though some celiacs will tell you they’re content to remain gluten-free for life, being able to freely consume gluten is the dream of many a person with celiac disease. ImmusanT is one of the few companies working on an actual vaccine for celiac disease. Over the next few months, ImmusanT is likely to begin reporting data from two separate early-stage clinical trials for NexVax2, a celiac disease vaccine. That data will offer the first glimpse into the potential for ImmusanT to treat celiac disease, and into the viability of the company’s peptide immunotherapy platform. The current two studies are Phase 1b trials, designed to confirm the safety of NexVax2, and to find a range of potential doses for the company’s next trials. Success at this stage still means a very long process for ImmusanT, as numerous clinical hurdles remain. Meanwhile, several other companies trying to find non-vaccine treatments for celiac disease. Both San Carlos, CA-based Alvine Pharmaceuticals and Baltimore, MD-based Alba Therapeutics, for instance, are developing drugs to supplement an existing gluten-free diet. Rather than being full-blown vaccines, these drugs are intended to reduce or eliminate adverse gluten-reactions due to simple gluten-contamination. Another company, Sitari Pharmaceuticals, fueled by $10 million in capital, and a joint venture with GlaxoSmithKline and Avalon Ventures, is also looking to pursue treatments for the digestive disorder. For its part, ImmusanT remains committed to its goal of developing a vaccine that will allow celiac patients to eat all the gluten they want. The company says its drug is currently the only treatment in development “focusing on disease modification so patients can resume an unrestricted diet.” Source: Xconomyc.com -
Celiac.com 09/19/2016 - At the time of diagnosis, some celiac patients suffer also from what is called celiac hepatitis, which is liver damage in patients with celiac disease that resolves after a gluten-free diet. A team of researchers recently set out to evaluate predictive factors of celiac hepatitis at the celiac disease diagnosis stage. To do so, they conducted a retrospective study that included 46 adult patients with clinically diagnosed celiac disease. The research team included Andreia Albuquerque, Susana Rodriguesa, and Guilherme Macedoa of the Department of Gastroenterology at Centro Hospitalar São João, in Porto, Portugal. Of the 46 patients, eighty-seven percent were women, with an average age of 33 ± 11 years, 87% showed Marsh 3, and 21 patients (46%) had celiac hepatitis. At the time of diagnosis, these patients had average Immunoglobulin A anti-tissue transglutaminase antibody (TTG-IgA) levels of 208.0 U/ml (p25–p75: 89–1316 U/ml), a mean aspartate aminotransferase of 42 ± 24 U/L, alanine aminotransferase 50 ± 28 U/L, alkaline phosphatase 111 ± 64 U/L. One year after diagnosis, the median average TTG-IgA was 9U/ml (p25–p75: 4.5–30.5 U/ml) and one-third of the patients had normal values. At diagnosis, patients without celiac hepatitis had an average TTG-IgA of 77U/ml (p25–p75: 24–288 U/ml), average aspartate aminotransferase of 23 ± 4 U/L, alanine aminotransferase 20 ± 6 U/L, alkaline phosphatase 69 ± 17 U/L. One year after diagnosis, median TTG-IgA was 6 U/ml (p25–p75: 3–19 U/ml) and nearly half of the patients showed normal values. At diagnosis, patients with celiac hepatitis had higher values of TTG-IgA (p = 0.007). Also, at diagnosis, there was a statistically significant positive correlation between TTG-IgA and alanine aminotransferase (r = 0.324, p = 0.028). For patients with a TTG-IgA level higher than 310 U/ml (OR = 4.8, 95%CI = 1.213–18.781, p = 0.025), the risk of having celiac hepatitis was nearly 5-times higher. From this, the team concludes that higher TTG-IgA levels can help predict celiac hepatitis in adult patients with celiac disease at diagnosis. Source: Scandinavian Journal of Gastroenterology. DOI:10.1080/00365521.2016.1203017 -
Poorer Celiac Kids More Likely to Remain Undiagnosed
Jefferson Adams posted an article in Latest Research
Celiac.com 03/09/2015 - When you hear estimates saying that celiac disease has a prevalence of about 1% of then general population of a given place, it is important to remember that there are still significant variations in rates of certain subgroups within those general populations. That is illustrated by a a recent UK study that shows that poor UK children with celiac disease are far more likely to remain undiagnosed, compared their non-poor counterparts. In fact, rich and middle-class children are 80% more likely to receive proper medical diagnosis for celiac disease, compared to poor children, according to results from a recent UK study. So even though serological studies indicate that celiac disease affects about 1% of all UK children, current estimates of diagnostic patterns among children do not indicate how disease rates might vary by socioeconomic group. A research team in the UK recently looked into socioeconomic variation in the incidence of childhood celiac disease. The research team included Fabiana Zingone, Joe West, Colin J. Crooks, Kate M. Fleming, Timothy R. Card, Carolina Ciacci, Laila J. Tata. They are variously affiliated with the Division of Epidemiology and Public Health, City Hospital Campus of University of Nottingham in Nottingham, UK, and the Department of Medicine and Surgery at the University of Salerno in Salerno, Italy. For their study, the team identified all children aged 0–18 years between 1993 and 2012 treated by general practices nationwide that are part of a large population-based patient health database. They assessed the incidence of celiac disease in each quintile of the Townsend index of deprivation and stratified by age, sex, country and calendar year. From information on 2,063,421 children, they found 1,247 celiac disease diagnoses, for an overall celiac rate of 11.9 per 100 000 person-years, which was similar across the UK countries, and higher in girls than in boys. Interestingly, they found a range of celiac diagnosis across socioeconomic groups, with the rate of diagnosis being 80% higher in children from the least-deprived areas than in those from the most-deprived areas (incident rate ratio 1.80, 95% CI 1.45 to 2.22). This pattern held for both boys and girls and across all ages. Across all four countries of the UK, they found similar associations between celiac disease and socioeconomic status. While celiac incidence up to age 2 remained stable over the study period, diagnoses at older ages have almost tripled over the past 20 years. Children living in less socioeconomically deprived areas in the UK are more likely to be diagnosed with celiac disease. Increased implementation of diagnostic guidelines could result in better case identification in more-deprived areas. Source: Arch Dis Child. doi:10.1136/archdischild-2014-30710 -
Gluten-free Growers Likely to Benefit from New Farm Bill
Jefferson Adams posted an article in Additional Concerns
Celiac.com 02/17/2014 - Efforts to promote increased acreage for gluten-free crops, such as sorghum, will likely increase now that the farm bill has been signed into law. That's partly because acreage for big crops such as corn and soybeans have run well over their historic levels, and prices are falling, and partly because target prices in the farm bill set higher prices for sorghum than for corn. Until now, corn had been eating steadily into sorghum’s old base of 11.6 million acres. However, new markets in China and the growing sales of gluten-free products at home are raising demand for sorghum. Still, corn and beans alone accounted for nearly half of all 2012 receipts, basically matching the revenues of all other program crops plus the revenue-rich fruit and vegetable market. "We compete against corn and soybeans in the North. We compete against cotton in the South,” says Tim Lust, CEO for the National Sorghum Producers in Lubbock, Texas. He adds that losing acres can mean losing capital investment. Thankfully, crops like sorghum have a formidable champion in Senate Agriculture Committee chair Debbie Stabenow (D-Mich.), who has worked to help strengthen specialty crops in the face of major cuts from existing commodity programs. Says Robert Guenther, senior vice president for policy with the United Fresh Produce Association, “Stabenow has been a champion for specialty crops, fruits and vegetables since she has been in Congress. She has been a strong proponent of our issues.” Given the success of Stabenow and her supporters, at least one of the results of the legislation signed by the president will likely be slightly better market conditions for growers of gluten-free crops. Source: Politico.com -
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Celiac.com 09/09/2011 - A team of researchers recently set out to assess the effects of milk-feeding behavior and the HLA-DQ genotype on intestinal colonization of Bacteroides species in infants with a risk of developing celiac disease. The research team included E. Sánchez, G. De Palma, A. Capilla, E. Nova, T. Pozo, G. Castillejo, V. Varea, A. Marcos, J. A. Garrote, I. Polanco, A. López, C. Ribes-Koninckx, M. D. García-Novo, C. Calvo, L. Ortigosa, F. Palau, and Y. Sanz. They are affiliated with the Ecofisiología Microbiana y Nutrición, Instituto de Agroquímica y Tecnología de Alimentos (CSIC) in Valencia, Spain. The team studied 75 full-term newborns with at least one first-degree relative who suffered from celiac disease. They classified the newborns according to milk-feeding practice (breast-fed or formula fed) and HLA-DQ genotype, which indicates high or low genetic risk. The team used PCR and denaturing gradient gel electrophoresis (DGGE) to analyze stools at 7 days, 1 month, and 4 months. They found that formula-fed infants showed greater Bacteroides species diversity than did breast-fed infants. Breast-fed infants showed a higher prevalence of Bacteroides uniformis at 1 and 4 months of age, while formula-fed infants had a higher prevalence of B. intestinalis at all sampling times, of B. caccae at 7 days and 4 months, and of B. plebeius at 4 months. Infants with low genetic risk showed greater colonization of B. ovatus, B. plebeius, and B. uniformis, while those with high genetic risk showed a greater colonization of B. vulgatus. Among breast-fed infants, those with low genetic risk had greater colonization of B. uniformis than those with high genetic risk, who showed higher rates of B. vulgatus. Among formula-fed infants, the prevalence of B. ovatus and B. plebeius was increased in those with low genetic risk, while the presence of B. vulgatus was greater in those with high genetic risk. The results indicate that both the type of milk feeding and the HLA-DQ genotype influence the types of Bacteroides that colonize in the intestinal tract, and possibly also influence risk for developing celiac disease. Source: Appl Environ Microbiol. 2011 Aug;77(15):5316-23. Epub 2011 Jun 3. -
Celiac.com 05/27/2008 - People with celiac disease know all too well that the only effective treatment at present is faithfully following a gluten-free diet. There’s been a lot of talk about various therapies and enzyme treatments that would allow people with celiac disease to return to a normal diet. Talk to anyone who suffers from celiac disease and they’ll likely have a personal horror story about a time when they had an unhappy episode of cross-contamination. So, the idea of a drug that would prevent such symptoms is appealing, and the goal, desirable. The chief cause of recurring symptoms in celiac disease is accidental gluten exposure, usually through cross-contamination. Cross-contamination doesn’t always mean food. Gluten is a common ingredient in many medicines and vitamins, and exposure in celiacs can cause diarrhea, weight loss, abdominal pain, anemia and oral ulcerations in the short-term, and myriad other problems in the long-run. The drug AT-1001 is a good example of how the realities are playing out on the front-lines of science. AT-1001 is an enzyme therapy that has promised some degree of protection from gluten exposure in people with celiac disease. A team of researches recently set out to assess the effectiveness of AT-1001 in preventing gluten from crossing the gut barrier by reversing the defective barrier mechanism. This required evaluating intestinal permeability between those exposed to gluten after taking AT-1001, those exposed without AT-1001, and control groups. The of intestinal function is done by gauging the absorption rates of various sugars. Early testing of AT-1001 showed some progress and a significant rate of protection of celiac patients exposed to wheat proteins. The research team looked at 86 subjects with celiac disease. The patients were divided into three groups. The first group was given placebo AT-1011 and challenged with gluten, the second group was given either active or placebo AT-1001, while the third group was given gluten and active AT-1001. After the first week, all subjects showed improvement, possibly due to closer adherence to a gluten-free diet. At three weeks, those given AT-1001 showed substantial improvement over the group given gluten and placebo AT-1001, including reduced intestinal permeability and fewer symptoms of gluten toxicity. The problem is that while AT-1001 shows a degree of promise, the results are so far underwhelming. The research team noted that the degree of improvement did not match the primary study. The results are, however, strong enough to encourage researchers to conduct a larger trial of AT-1001, which is currently underway. It’s important to remember that celiac disease is an immune disorder and no immune disorder has ever been fully cured. So, the idea of people with celiac disease being able to take a pill and head out for a night of pizza and beer without the standard celiac-related reactions is far-fetched at best. At best, such drugs would likely help to prevent cross-contamination, rather than conveying immunity to gluten proteins. Until then, stay tuned…best of luck with the gluten-free diet! Presented by Dr. Leffler at the 2009 Digestive Disease Week on Tuesday, May 20 at 10:45 a.m. Pacific Time in room 10, San Diego Convention Center.
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Pediatrics 2002;109:833-838. Celiac.com 06/06/2002 - The results of a study conducted by Dr. Graziano Barera and colleagues from the Scientific Institute H San Raffaele, Milan, Italy and published in the May issue of Pediatrics indicate that those with type 1 diabetes are 20 times more likely to also have celiac disease. The researchers collected data on 274 consecutive newly diagnosed type 1 diabetes patients with a mean age of 8.28 years. These patients were studied for the following 6 years. At the time of their diagnosis 10 of them (3.6%) already had celiac disease, and over the next 4 years an additional 12 children tested positive for antiendomysial antibodies, and 7 underwent biopsies and were confirmed to have celiac disease. The overall prevalence of biopsy confirmed celiac disease in the group was 6.2%, and most of the cases were asymptomatic and the children showed no obvious signs of the disease. The researchers conclude that greater than 10% of children with newly-diagnosed type 1 diabetes had developed serological markers for celiac disease within the first 6 years of diagnosis, and they recommend that children in this category be screened annually for celiac disease for several years following their type 1 diabetes diagnosis. -
JAMA 2002;287:1413-1419. Celiac.com 04/12/2002 - According to a report published in the March 20th issue of the Journal of the American Medical Association, people with celiac disease are three times more likely to develop non-Hodgkin lymphoma (NHL) than the normal population. Dr. Carlo Catassi and colleagues from the University of Maryland in Baltimore compared the prevalence of celiac disease in 653 NHL patients with more than 5,000 healthy control subjects to determine the NHL-celiac disease occurrence rate. The results indicate that 1% of NHL patients also have celiac disease, in comparison with 0.42% of the healthy controls. Adjustments were made for age and sex, and the final results indicate that the odds ratios for a patient with celiac disease of developing NHL are: 3.1 for all types of NHL, 16.9 for gut NHL, and 19.2 for T-cell NHL. The overall risk, however, for someone with celiac disease developing NHL is only 0.63%. The researchers do not feel that their findings support mass screening for celiac disease, but they do feel that selected NHL patients should be screened for celiac disease. We would also like to add that these findings support the screening of people with celiac disease for NHL, which was not directly addressed by the report.
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