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Celiac.com 01/04/2017 - Ever since I was a young girl I have always had a bad stomach. Last year, when I was 16, I decided to move to London. Circumstances became difficult, and I ended up becoming physically and mentally ill, which included anorexia nervosa and then onset depression and trauma, as well as almost crippling anxiety. Things led to me getting so ill that I went to a doctor who noticed that I had serious mouth ulcers—and this is what finally led them to diagnose me with celiac disease, after what seemed to be months of suffering. At the time my diagnosis seemed to make a lot of sense because of the stomach pains I had, especially after eating certain foods. My symptoms included much confusion, dire pains, and resulted in my having a phobia of food. As most celiacs know, currently there is no medicine available to treat celiac disease, and the only treatment is a strict gluten-free diet. I got diagnosed in late January 2016, and have been on a strict gluten-free diet ever since, and although I believe this has helped me a lot, more than nine months later, I still often have the same symptoms. They vary in levels and are sometimes uncomfortable and very painful. Sometimes I have migraines, stomach bloating, churning, etc., all of which are not very nice. Let me explain a little about what celiac is. It is an autoimmune disease where the immune system kills off tissue in the small intestine in response to ingesting gluten. This can make eating more difficult, and a lot of the time I am left in pain with nothing to do but sit in agony and wait for it to stop. But what if there was something else out there that could help with ongoing symptoms? I recently discovered that thousands are being helped by using cannabis to treat their celiac disease symptoms. Marijuana is gluten-free and for some, can ease the painful symptoms. Special note: This approach is NOT meant as a substitution for a guten-free diet, but for some people, like myself, it can offer additional symptom relief for those who need it. Reset.me has this posted: "Marijuana 'cools the gut,' in which it slows down the muscle contractions that move food through the stomach and intestines and reduces the secretion of liquid into the intestines associated with diarrhea (one of the most severe symptoms of the disease)," Deno writes. "Marijuana also controls the muscle spasms associated with diarrhea. It also increases appetite and can offset the inefficiency in the Celiac's ability to absorb nutrients from the food you eat." "People with celiac in some states in America are able to get access to to medical marijuana if they have chronic pain. The rest of us [celiacs] are left with buying illegally or simply avoiding this one plant that may be the most effective celiac treatment of all!" HelloMD.com states: "Inflammation can be suppressed by activating the cannabinoid receptors, CB2, on immune cells. Though there have not yet been clinical human trials, this study opens up new avenues to investigate as possible treatment options for autoimmune diseases. Though this study only looked at THC, CBD is also known to help the immune system. CBD helps repair the bodies [sic] ability to recognize the difference between normal internal body functions and foreign entities, keeping the body from attacking itself." Remember, Marijuana is not a cure, but is a natural anti-convulsant and can suppress seizure activity. It is also anti-inflammatory, and has helped people with other autoimmune diseases such as rheumatoid arthritis, psoriasis, Type 1 diabetes, multiple sclerosis, and many others. I smoked cannabis even before I was diagnosed, and I always found that it settled my stomach. I have since spoken to many other people with celiac disease online and face to face, and I've done a fair amount of research to find out if there are other celiacs who experience the same relief from their symptoms. While doing my research, I came across an interesting post on Medhelp.org by Betherie Mommi about a girl with celiac who also suffers with IBS and has a history of chronic pain, nausea and, just like me, eating disorders. With such a weak stomach it's always hard to eat things without discomfort. She goes on to say that she uses medical marijuana becuase the meds that the doctors gave her have not helped with the pain and side effects of the medications, and the marijuana has also helped her appetite. She goes on to give one of the best descriptions of stomach pains, which I also get, but had difficulty explaining: "like velcro made out of razor blades being pulled apart in certain parts of your belly." She goes on to say that it also gave a sense of community back to her life, as you do sometimes feel excluded as a celiac, because there's a lot you have to miss out on. Betherie Mommi was a medical marijuana patient. I really notice the effects it has on me, and how it relieves my stomach pains, including providing relief from the confusion and anxiety that I've experienced. I feel that other people shouldn't have to go through what I've had to experience, and I really do believe that this is an exceptional way forward for some people. You can find CBD only "vapes", liquids, and waxes, which are also supposed to help, but in my case the THC, even if it is a low dosage, was essential to get rid of the pain. What I have described in this article is only what has helped me, after much suffering, and I urge all celiacs to do their own research and speak to their doctors before making a decision. I really believe that this approach could be helpful to so many others, but I also realize that it may not be for everyone. Sources: Can Cannabis Help Autoimmune Disease Sufferers?
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Celiac.com 11/30/2016 - Trials using hookworm as a possible treatment for celiac disease are already underway in Australia, but they latest hookworm news indicates that they might also be useful for treating asthma. The New World hookworm, aka necator americanus, is long and slender as an angel hair noodle. Adults are large enough to be seen with the naked eye. Seen up close, they look more like the sand worms in the movie Dune than anything people are used to seeing here on earth. Researchers are reporting that a protein produced by hookworms reduces the symptoms of asthma in mice, and could one day be used to treat asthma in humans, says the journal Science Translational Medicine. These parasites are some of the most maligned creatures in the animal kingdom. They chew into the human intestinal wall and suck blood to survive, but they just might be the key to making millions of people healthier. Says Severine Navarro, the paper's lead author and a senior research fellow at James Cook University in Australia, data from immunological studies shows that populations with no parasites also have "the highest incidence of autoimmune diseases and allergies." The data in this study arose from an effort by Navarro and her fellow researchers to look for a connection between success of de-worming programs around the world and the rise of immune system problems like asthma and celiac disease. Among other things, when hookworms infect humans, they secrete chemicals that turn off the immune alarm bells and repair the tissue around it. The worms limit blood consumption to a few drops a day and keeps its own numbers in check by plants offspring in the host's poop to ensure an orderly exit from the body. Navarro and her team wonder if the hookworm's stealthy adaptations also benefit their host by controlling in adverse immune reactions. The team's initial small study of one dozen trial participants showed that the hookworm did improve their tolerance of gluten. Since infecting large numbers of patients directly with hookworm might lead to other issues, the team isolated the active ingredient in hookworm spit - a compound called AIP-2 - and injected it into asthmatic mice on a daily basis for five days. Results showed a sharp decline in asthma symptoms, and reduced inflammation in airways. These benefits persisted for 10 weeks after the mice stopped getting the treatment. The researchers also noticed that AIP-2 seemed to have a calming effect on the body's dendritic cells - a part of the immune system responsible for processing threats. According to Navarro, the drug works by "basically rewiring the cells in that tissue into promoting very efficient regulatory T cells." This suggests that AIP-2 might also help humans, since dendritic cells have the same function in us that they do in mice. Navarro said the team's next step is a phase one clinical trial, which would test the effectiveness of an AIP-2 pill. Successful phase one trials will lead the way toward a safe drug that could help tens of millions of asthma sufferers. As seen in earlier studies using hookworm, the compound might be useful in treating autoimmune disorders, like celiac disease, inflammatory bowel disease and multiple sclerosis. Read more on hookworms and celiac disease. Source: ChicagoTribune.com.
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Celiac.com 08/30/2017 - The human gut is home to a huge and diverse number of microorganisms that perform various biological roles. Disturbances in a healthy gut microbiome might help to trigger various inflammatory diseases, such as multiple sclerosis (MS). Human gut-derived commensal bacteria suppress CNS inflammatory and demyelinating disease. Can they improve the treatment of multiple Sclerosis (MS)? A team of researchers recently set out to evaluate evidence that gut commensals may be used to regulate a systemic immune response and may, therefore, have a possible role in treatment strategies for multiple Sclerosis. The research team included Ashutosh Mangalam, Shailesh K. Shahi, David Luckey, Melissa Karau, Eric Marietta, Ningling Luo, Rok Seon Choung, Josephine Ju, Ramakrishna Sompallae, Katherine Gibson-Corley, Robin Patel, Moses Rodriguez, Chella David, Veena Taneja, and Joseph Murray. In a recent article, the team reports on their identification of human gut-derived commensal bacteria, Prevotella histicola, which can suppress experimental autoimmune encephalomyelitis (EAE) in a human leukocyte antigen (HLA) class II transgenic mouse model. P. histicola suppresses disease through the modulation of systemic immune reactions. P. histicola challenge caused a reduction in pro-inflammatory Th1 and Th17 cells and an increase in CD4+FoxP3+ regulatory T cells, tolerogenic dendritic cells, and suppressive macrophages. This study indicates that gut commensals may regulate a systemic immune response, and so may have a role in future treatments for multiple Sclerosis, and possibly other autoimmune diseases such as celiac disease. Source: Cell.com. DOI: http://dx.doi.org/10.1016/j.celrep.2017.07.031
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Celiac.com 06/14/2017 - Some data have suggested a connection between celiac disease and eosinophilic oesophagitis (EoE)/oesophageal eosinophilia (EE). Any potential relationship has implications for treatment. Should the two conditions be treated together, or separately? To better understand any possible connection, and the implications for treatment, a team of researchers recently set out to characterize children with celiac disease+EE in-depth and assess the contribution of each condition to the clinical presentation and treatment response. The research team included Anne Ari, Sara Morgenstern, Gabriel Chodick, Manar Matar, Ari Silbermintz, Amit Assa, Yael Mozer-Glassberg, Firas Rinawi, Vered Nachmias-Friedler, Raanan Shamir, and Noam Zevit. They are variously affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel, the Pediatrics Center at Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel, the department of Pathology at Rabin Medical Center in Petach Tikvah, Israel, and the Sackler Faculty of Medicine at Tel Aviv University in Tel Aviv, Israel. The research team conducted a retrospective review of medical records of children with both celiac disease+EE, or isolated EoE diagnosed between 2000 and 2014. They then compared these records with those of patients with isolated celiac disease or epigastric pain. To calculate the frequency of EE, they used endoscopy results of patients with suspected celiac disease or epigastric pain between 2011 and 2014. They used a telephone questionnaire to gather missing data. At a single large, tertiary pediatric center, the team assessed 17 patients with celiac disease+EE, 46 with EoE, 302 with isolated celiac disease, and 247 with epigastric pain. The patients with celiac disease+EE shared characteristics of both individual conditions. While age at diagnosis, family history of autoimmunity/celiac disease and anaemia were similar to most celiac patients, other characteristics such as male gender, personal/family history of atopy, peripheral eosinophilia and oesophageal white papules more closely resembled those of patients with EoE. Most patients with celiac disease+EE tended to present with celiac-associated symptoms, and 63% went on to develop typical EoE symptoms. In celiac disease+EE patients, only 21% saw their EE resolve after a gluten-free diet; another 21% saw their EE normalize after proton pump inhibitor treatment. The rest required EoE-specific treatment. Patients with celiac disease found to have EE share characteristics similar to both isolated celiac disease and EoE. This study indicates that celiac patients with concurrent EE are actually suffering from two separate conditions, rather than celiac-associated eosinophilia. Therefore, in such patients, doctors should consider treating each condition separately. Source: Archives of Disease in Childhood Published Online First: 12 April 2017. doi: 10.1136/archdischild-2016-311944
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Celiac.com 10/21/2016 - Researchers at Boston University's Henry M. Golden School of Dental Medicine have identified a metabolic enzyme that alerts the body to invading bacteria, which may lead to new treatments for celiac disease. A research team that set out to isolate and identify the enzymes and evaluate their potential as novel enzyme therapeutics for celiac disease, reports that the enzymes exhibit exceptionally high gluten-degrading enzyme activities, and are "naturally associated with bacteria that colonize the oral cavity." Rothia bacteria, found in human saliva, can break down gluten compounds that cause an exaggerated immune response and that are typically resistant to the digestive enzymes that mammals produce. The team was able to isolate a new class of gluten-degrading enzymes from Rothia mucilaginosa, an oral microbial colonizer. The Rothia enzymes in question belong to the same class as food-grade Bacillus enzymes. The researchers noted that "B. subtilis is food safe and has been consumed for decades, e.g. in a product called natto, a Japanese fermented soy bean dish." B. subtilis and its products have been safely consumed by humans for many hundreds of years, with very few problems reported. They add that the "…food-grade status of B. subtilis, and the already widely consumed natto products, open new avenues for potential therapeutic applications of the subtilisin enzymes." The Rothia subtilisins and two subtilisins from Bacillus licheniformis, subtilisin A and the food-grade Nattokinase, efficiently degraded the immunogenic gliadin-derived 33-mer peptide and the immunodominant epitopes recognized by the R5 and G12 antibodies. This study identified as promising new candidates for enzyme therapeutics in celiac disease. Based on these results, the research team concludes that gluten-degrading Rothia and food-grade Bacillus subtilisins are the "preferred therapy of choice for celiac disease," and that their exceptional enzymatic activity, along with their connection to natural human microbial colonizers, make them "worthy of further exploration for clinical applications in celiac disease and potentially other gluten-intolerance disorders." Their study appears in the American Journal of Physiology—Gastrointestinal and Liver Physiology.
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Celiac.com 12/28/2015 - Immune-mediated cerebellar ataxias include gluten ataxia, paraneoplastic cerebellar degeneration, GAD antibody associated cerebellar ataxia, and Hashimoto's encephalopathy. Despite the identification of an increasing number of immune-mediated cerebellar ataxias, there is no proposed standardized therapy. Recently, a research team set out to develop guidelines for treatment of immune-mediated cerebellar ataxias. The research team included H. Mitoma, M. Hadjivassiliou, and J. Honnorat. They are variously associated with the Department of Medical Education at Tokyo Medical University in Tokyo, Japan; the Academic Department of Neurosciences at Royal Hallamshire Hospital, Sheffield, UK; the University Lyon 1; INSERM, UMR-S1028, CNRS, UMR-5292, Lyon Neuroscience Research Center, Neuro-Oncology and Neuro-Inflammation Team, 7; and the National Reference Centre for Paraneoplastic Neurological Diseases, Hospices Civils de Lyon, Hôpital neurologique in Bron, France. For their study, the team evaluated the efficacies of immunotherapies in reported cases using a common scale of daily activity. Their resulting analysis focuses on the importance of removing autoimmune triggers (e.g., gluten or cancer), evaluating immunotherapy (e.g., corticosteroids, intravenous immunoglobulin, immunosuppressants), and adjusting according to each sub-type. Source: Cerebellum Ataxias. 2015 Nov 10;2:14. doi: 10.1186/s40673-015-0034-y. eCollection 2015.
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Can Steroids Help Treat Celiac Disease?
Jefferson Adams posted an article in Diagnosis, Testing & Treatment
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.- 2 comments
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Celiac.com 07/13/2015 - Gluten-free students at two elite liberal arts colleges in suburban Philadelphia, Pennsylvania, are now able to enjoy exclusive gluten-free dining areas. Both Haverford College and Bryn Mawr College have created dedicated, exclusively gluten-free dining areas for their students with celiac disease or gluten intolerance, according to a report by Campus Reform. Bryn Mawr opened their gluten-free dining area in 2013, and Haverford followed in 2014. The exclusive eating areas are the brainchild of Bernie Chung-Templeton, executive director of dining services at both schools. Each of the gluten-free dining areas has signage clearly warning students to refrain from bringing in food from outside, including the main school cafeteria. What do you think? Do students with celiac disease or gluten intolerance deserve dedicated, exclusively gluten-free dining options? Read more in Campus Reform.
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Blocking Interleukin-15 May Treat Celiac Disease Symptoms
Jefferson Adams posted an article in Latest Research
Celiac.com 03/18/2011 - By blocking an inflammatory protein called interleukin-15 (IL-15), doctors may be able to treat and prevent symptoms of celiac disease in some people, according to a new study in the journal Nature. The data suggest that the inflammatory response to gluten in people with celiac disease may be triggered by interleukin-15 and retinoic acid, which is a derivative of vitamin A. The team notes that researchers previously thought that retinoic acid would lessen the inflammation in the intestine. Instead their study showed that it might actually worsen inflammation. According to Bana Jabri, MD, PhD, a member of the Celiac Disease Center and Comprehensive cancer Center at the University of Chicago, the team results showed that "elevated levels of IL-15 in the gut could initiate all the early stages of celiac disease in those who were genetically susceptible, and that blocking IL-15 could prevent the disease in our mouse model. It also demonstrated that in the treatment of inflammatory intestinal diseases, vitamin A and its retinoic acid metabolites are likely to do more harm than good.” The researchers found that by blocking IL-15 in mice that were genetically engineered to have celiac disease, they were able to reverse the symptoms, and the mice were able to eat gluten without suffering the symptoms of celiac disease. One reason this is good news, is that a number of medicines designed to block IL-15 are already being developed for other inflammation related diseases, such as rheumatoid arthritis. Source: Nature. 2011 Mar 10;471(7337):220-4.- 9 comments
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Can Mind and Body Techniques Help Treat Celiac Disease?
Jefferson Adams posted an article in Additional Concerns
Celiac.com 01/14/2010 - Most people with celiac disease will tell you that faithfully maintaining a gluten-free diet can be very challenging, especially for those who enjoy dining out or in the homes of friends. "Going to restaurants or dinner at a friend's house can pose dangers to a person with celiac disease," says said Dr. Ali Keshavarzian, vice chairman of medicine and gastroenterologist at Rush University Medical Center. "It can really impact a person's quality of life." For most people, maintaining a gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further damage, along with potentially preventing numerous associated conditions, such as diabetes. But setting up and sticking to a gluten-free diet can be a challenge. A team of Gastroenterologists at Rush have designed a new study to determine if mind and body techniques could help people with celiac disease adhere to the very strict diet. "Eating even a small amount of gluten can damage the small intestine," says Dr. Ali Keshavarzian, vice chairman of medicine and gastroenterologist at Rush. "The damage will occur in anyone with the disease, including people without noticeable symptoms." Hidden sources of gluten are sometimes additives such as modified food starch, preservatives and stabilizers made with wheat. Also, numerous corn and rice products made in factories that also make wheat products can be contaminated with wheat gluten. "The purpose of this study is to determine whether participation in one of two mind/body courses can help patients cope with the restricted diet," says Keshavarzian. "It can be very hard and stressful for people with celiac disease to stick to a gluten-free diet." Healing existing intestinal damage and preventing further damage means that people with celiac disease must go on a lifelong gluten-free diet. Patients must be trained by health professionals on how to understand safe and unsafe ingredient on food labels, and to spot foods containing gluten in order to make safer, more effective choices when grocery shopping or eating out. People with celiac disease or gluten intolerance usually begin to feel better within days of starting a gluten-free diet. The small intestine usually heals in three- to six-months in children, but can take several years in adults. A healed intestine means a person now has healthy intestinal villi that can properly absorb nutrients from food into the blood. Patients enrolled in the study on Celiac disease and mind/body techniques at Rush will be randomly assigned to two course assignments for eight weeks. To be eligible for the study, patients must be over 18 years of age, have received a diagnosis of celiac disease in the past four weeks or within two weeks of starting a gluten-free diet, and have not previously attempted a gluten-free diet. Source: ScienceDaily (Jan. 11, 2010)- 5 comments
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Aliment Pharmacol Ther 18(5):487-494, 2003. M. S. Goerres*, J. W. R. Meijer, P. J. Wahab*, J. A. M. Kerckhaert, P. J. T. A. Groenen, J. H. J. M. Van Krieken, C. J. J. Mulder Celiac.com 11/18/2003 - This very important Dutch study demonstrates a new and effective way of treating a subgroup of refractory celiac disease patients, those with normal intraepithelial T-lymphocytes (IELs). Considering the very poor outcome for those in the study with abnormal IELs (phenotypically immature intraepithelial T-lymphocytes defined by a lack of characteristic T-cell markers), we must hope that future research will soon yield an equally effective treatment. Here is the abstract of the study: "Introduction: Refractory coeliac disease (RCD) is a rare syndrome with a poor prognosis, defined by malabsorption due to gluten-related enteropathy after initial or subsequent failure of a strict gluten-free diet and after exclusion of any disorder mimicking coeliac disease. Patients and methods: Nineteen patients were included and treated. Based on intraepithelial T-lymphocyte(IEL) phenotyping, patients were recorded as having RCD type I with normal IELs, or RCD type II with phenotypically immature IELs defined by a lack of characteristic T-cell markers. Treatment consisted of azathioprine combined with prednisone for 1 year, which was tapered and, if possible, stopped. Results: Clinical improvement was seen in nearly all patients in both groups. Eight of 10 RCD type I patients responded histologically, and complete normalization of villi was seen in four patients. In RCD type II, 6/8 patients developed enteropathy-associated T-cell lymphoma (EATL) and 7/8 patients died. Conclusions: For the first time we report a promising therapeutic treatment option for RCD type I. In RCD type II, azathioprine and prednisone therapy (APT) is not effective, therefore we suggest that other (chemo)therapeutic agents are considered. Not all RCD type II patients presented with a monoclonal TCR?-gene rearrangement and immunohistological changes as is currently reported in the literature. Therefore, immunophenotyping seems mandatory in the work-up of RCD."
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