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Celiac.com January 2025 - Explore expert insights, research updates, and practical tips on celiac disease, gluten-free living, and emerging treatments in our video library. Stay informed and empowered with the latest developments to manage celiac disease effectively. Follow our videos and stay up to date on our video content, which is designed to help you navigate a gluten-free lifestyle with confidence. Whether you’re newly diagnosed or seeking advanced strategies for managing celiac disease, our videos provide valuable resources tailored to your needs. All Celiac.com Videos - January, 2025: Gluten-Free on a Budget: How to Save Money on Specialty Foods (Live on 01/17/2025): Study Examines the Nutritional Deficiencies and Challenges of a Gluten-Free Diet for Celiac Disease Patients: Navigating Low-Gluten Hosts for Catholics with Celiac Disease: FDA's Inaction on Gluten Labeling Fails to Protect Celiac Patients: Exploring the Connection Between Alopecia Areata and Celiac Disease: Navigating Allergen-Free Dining Options at the University of Pennsylvania: A Focus on Gluten-Free Choices:

Celiac.com December - Explore expert insights, research updates, and practical tips on celiac disease, gluten-free living, and emerging treatments in our video library. Stay informed and empowered with the latest developments to manage celiac disease effectively. Follow our videos and stay up to date on our video content, which is designed to help you navigate a gluten-free lifestyle with confidence. Whether you’re newly diagnosed or seeking advanced strategies for managing celiac disease, our videos provide valuable resources tailored to your needs. All Celiac.com Videos - December, 2024: Breakthrough Study on Gluten-Dependent Activation of T-Cells Offers Hope for Celiac Disease Treatment (Live on 12/30): Understanding the Link Between Psychological Traits and Dietary Adherence in Adolescents with Celiac Disease (Live on 12/26): Understanding Celiac Disease Autoimmunity in Nigerian Children with Type 1 Diabetes (Live on 12/23): Hidden Sources of Gluten and Unexpected Products That May Contain Gluten (Live on 12/19): Understanding the Link Between Blood Pressure Medications and Celiac Disease Complications (+Video): Exploring Links Between Autoimmune Diseases and Schizophrenia: Understanding Gluten-Free Certification in Healthcare Facilities: Exploring Gluten-Free Baking: Tips for Perfecting Your Favorite Recipes: Theories on the Growing Prevalence of Celiac Disease and Gluten Sensitivity Over the Last Half-Century: 6 Research Breakthroughs in Celiac Disease You Should Know About: The Role of Allergies and Autoimmune Diseases Including Celiac Disease in Chronic Rhinosinusitis:

Explore expert insights, research updates, and practical tips on celiac disease, gluten-free living, and emerging treatments in our video library. Stay informed and empowered with the latest developments to manage celiac disease effectively. Follow our videos and stay up to date on our video content, which is designed to help you navigate a gluten-free lifestyle with confidence. Whether you’re newly diagnosed or seeking advanced strategies for managing celiac disease, our videos provide valuable resources tailored to your needs. All Celiac.com Videos - November, 2024: What Parents Need to Know About Raising a Child with Celiac Disease: Are Prawn Crackers Gluten-Free?: Exploring the Connection Between Celiac Disease and Anal Diseases: How to Transition to a Gluten-Free Diet: A Step-by-Step Guide: Debunking Common Myths About Gluten Sensitivity (Coming on November 28th): Hidden Gluten in Everyday Products: What You Need to Avoid (Coming on November 30th):

Celiac.com 12/23/2023 - Celiac disease, an autoimmune condition triggered by gluten consumption, has seen remarkable progress in recent research endeavors. This article delves into the latest breakthroughs, ongoing clinical trials, and the prospective landscape of celiac disease treatments. From innovative therapies to promising drug developments, the aim is to unravel the potential impact of these advancements on the lives of individuals with celiac disease. Understanding Celiac Disease: A Brief Overview Celiac disease stands as a multifaceted autoimmune condition triggered by the consumption of gluten, a protein found in wheat, barley, and rye. With a prevalence reaching approximately 1% of the global population, this chronic disorder poses unique challenges to individuals whose immune systems react adversely to gluten ingestion. At its core, celiac disease is characterized by an abnormal immune response that targets the small intestine. Gluten consumption sets off an inflammatory reaction, leading to damage to the lining of the small intestine and impairing its ability to absorb nutrients. This often results in a range of symptoms, from gastrointestinal distress and malabsorption issues to fatigue, joint pain, and neurological complications. Diagnosis is a multifaceted process involving a combination of blood tests, genetic testing, and, often, confirmation through an intestinal biopsy. It's crucial to recognize that celiac disease can manifest in diverse ways, making diagnosis challenging and underscoring the importance of comprehensive medical evaluation. For those diagnosed with celiac disease, the primary and only effective treatment is strict adherence to a gluten-free diet. By eliminating gluten-containing foods, individuals can manage symptoms, allow the small intestine to heal, and prevent complications associated with ongoing inflammation. As we embark on the exploration of recent research advances, it is paramount to grasp the fundamental aspects of celiac disease. This understanding lays the groundwork for appreciating the significance of breakthroughs, clinical trials, and emerging treatments in the dynamic landscape of celiac disease research. Genetic Research and Personalized Medicine Genetic research has emerged as a cornerstone in unraveling the complexities of celiac disease. The strong genetic component of the condition is underscored by the association with specific human leukocyte antigen (HLA) genes, particularly the HLA-DQ2 and HLA-DQ8 variants. Individuals carrying these genetic markers are more predisposed to developing celiac disease when exposed to gluten. Advancements in genetic research not only enhance our understanding of celiac disease's hereditary nature but also pave the way for personalized medicine approaches. Genetic testing allows for the identification of at-risk individuals, enabling targeted screening and early intervention. This precision in diagnosis is pivotal, as it empowers healthcare providers to tailor their approach based on an individual's genetic predisposition, optimizing the efficacy of interventions and improving overall patient outcomes. Moreover, ongoing genetic research delves into the intricate interplay of various genetic factors that contribute to the diverse manifestations of celiac disease. Unraveling these genetic intricacies holds the promise of unveiling novel therapeutic targets and refining risk prediction models. The integration of genetic insights into the realm of personalized medicine marks a paradigm shift in celiac disease management, steering us towards more nuanced and individualized approaches to diagnosis, treatment, and long-term care. As genetic research continues to unfold, the potential for groundbreaking discoveries that shape the future of celiac disease care becomes increasingly apparent. Breakthrough Therapies on the Horizon The quest for innovative and effective therapies for celiac disease has ushered in a new era of research and development. Breakthroughs on the horizon promise transformative approaches that go beyond the conventional reliance on a gluten-free diet. These pioneering therapies aim to address the underlying immune response and inflammation characteristic of celiac disease, providing new avenues for individuals seeking relief and an improved quality of life. One notable breakthrough involves the exploration of enzyme therapies designed to break down gluten in the digestive system, rendering it less immunogenic. These enzymes, often referred to as glutenases, hold the potential to mitigate the impact of accidental gluten exposure and offer individuals with celiac disease a degree of dietary flexibility. Immunomodulatory therapies represent another frontier in celiac disease research. By targeting specific components of the immune system responsible for the aberrant response to gluten, these therapies aim to modulate immune activity and alleviate the inflammatory cascade triggered by gluten ingestion. These approaches hold promise in not only managing symptoms but also addressing the root cause of celiac disease. Additionally, advancements in the realm of nanotechnology and drug delivery systems contribute to the development of novel strategies for gluten detoxification. Nanoparticle-based approaches seek to encapsulate gluten, preventing its interaction with the immune system and reducing its harmful effects on the intestine. While these breakthrough therapies are in various stages of preclinical and clinical development, their potential to revolutionize celiac disease management is evident. As research progresses, the prospect of a more diversified therapeutic landscape offers hope to individuals with celiac disease, signaling a future where effective treatments extend beyond dietary restrictions. Clinical Trials: Navigating the Path to Approval Clinical trials stand at the forefront of translating scientific discoveries into tangible treatments for celiac disease. These rigorous investigations represent a critical phase in the development of new therapies, assessing their safety, efficacy, and overall impact on patient outcomes. Navigating the path to approval involves a systematic and regulated approach, encompassing various phases that rigorously evaluate the intervention's viability and potential benefits. The journey begins with Phase 1 trials, where the focus is primarily on the therapy's safety profile. Small groups of participants are enrolled, and the treatment's tolerability and potential side effects are closely monitored. Following successful Phase 1 outcomes, researchers progress to Phase 2 trials, expanding the participant pool to assess both safety and initial efficacy in a larger and more diverse cohort. Phase 3 trials constitute a pivotal stage, involving a more extensive participant population to provide robust data on the therapy's effectiveness, safety, and optimal dosage. These trials often employ a randomized and controlled design, comparing the investigational therapy against a placebo or standard treatment to ensure statistically significant results. Upon completion of successful Phase 3 trials, researchers compile comprehensive data for regulatory submissions seeking approval from health authorities. Regulatory agencies meticulously review the evidence to ascertain the therapy's safety and efficacy, with the potential for market approval if deemed beneficial and safe for patient use. Engaging in clinical trials requires collaboration between researchers, healthcare professionals, and individuals with celiac disease who voluntarily participate in these groundbreaking studies. Their contributions play a pivotal role in advancing the field, bringing us closer to a future where novel therapies offer renewed hope and improved outcomes for the celiac community. Innovative Drug Developments In the dynamic landscape of celiac disease research, innovative drug developments are catalysts for transformative change. The pursuit of novel pharmaceutical interventions goes beyond traditional dietary restrictions, offering a spectrum of therapeutic possibilities. These groundbreaking developments aim to address the intricate immunological and inflammatory processes at the core of celiac disease, providing hope for enhanced management and improved quality of life for those affected. Monoclonal antibodies represent a forefront in innovative drug development for celiac disease. These antibodies are designed to specifically target and neutralize key components of the immune response associated with gluten-induced inflammation. By modulating immune activity, monoclonal antibodies hold promise in mitigating the damaging effects of gluten ingestion and preventing the cascade of events leading to intestinal damage. Small molecule drugs tailored to interrupt specific pathways involved in the immune response to gluten also feature prominently in ongoing research. These compounds, often designed to be orally administered, aim to provide a systemic impact on celiac disease, offering an alternative to dietary restrictions. As these drugs progress through clinical trials, their potential to revolutionize the therapeutic landscape becomes increasingly apparent. The exploration of microbiome-based therapies adds an additional layer of innovation to celiac disease drug development. Leveraging the intricate relationship between gut microbes and the immune system, these therapies seek to restore balance and tolerance to gluten. Manipulating the microbiome holds promise in creating a more resilient and tolerant gut environment, potentially reducing the severity of celiac disease symptoms. While these innovative drug developments are in various stages of research and clinical testing, their emergence signifies a paradigm shift in how we approach celiac disease. By expanding the therapeutic toolkit, researchers aim to provide individuals with celiac disease options that align with their unique needs and contribute to a future where effective pharmaceutical interventions coexist with dietary management. The Role of Diet and Nutritional Therapies Diet remains a cornerstone in managing celiac disease, and ongoing research continues to refine nutritional strategies to optimize health outcomes for individuals with this autoimmune condition. Understanding the intricate relationship between diet and celiac disease is crucial for effective symptom management, promoting gut healing, and ensuring overall well-being. Gluten-Free Diet: A Necessity for Celiac Disease Management The foundation of celiac disease management lies in the strict adherence to a gluten-free diet. Eliminating gluten-containing grains such as wheat, barley, and rye is essential to prevent immune-mediated damage to the small intestine. A gluten-free diet requires vigilance in scrutinizing food labels, choosing naturally gluten-free foods, and adopting gluten-free cooking practices to avoid cross-contamination. Beyond Gluten: Exploring Nutritional Support While the removal of gluten is non-negotiable for those with celiac disease, attention to overall nutritional support is equally vital. Deficiencies in key nutrients such as iron, calcium, vitamin D, and B vitamins are common in individuals with celiac disease due to malabsorption issues. Nutritional therapies focus on addressing these deficiencies through dietary modifications, supplementation, and monitoring. Potential of Microbiome Modulation Recent research highlights the dynamic interplay between the gut microbiome and celiac disease. The composition of gut bacteria influences immune responses and may play a role in the development and progression of the disease. Exploring nutritional strategies to modulate the microbiome, such as probiotic supplementation and prebiotic-rich foods, holds promise in promoting gut health and optimizing the nutritional status of individuals with celiac disease. Personalized Nutrition: Tailoring Dietary Approaches Recognizing the diverse presentations of celiac disease, researchers delve into the realm of personalized nutrition. Tailoring dietary approaches to individual needs considers factors such as symptom severity, coexisting conditions, and nutritional requirements. Personalized nutrition aims to enhance dietary compliance, address specific nutritional deficiencies, and improve the overall quality of life for those managing celiac disease. As our understanding of the intricate relationship between diet and celiac disease evolves, nutritional therapies continue to play a pivotal role in comprehensive management strategies. Balancing the strict requirements of a gluten-free diet with personalized nutritional support contributes to the holistic care of individuals with celiac disease, fostering optimal health and well-being. Challenges and Considerations in Celiac Disease Research As the landscape of celiac disease research expands, researchers face various challenges and considerations that shape the trajectory of scientific inquiry and impact the translation of findings into tangible advancements for patients. Navigating these complexities is crucial for fostering progress, ensuring the validity of research outcomes, and addressing the multifaceted nature of celiac disease. Heterogeneity in Celiac Disease Presentations Celiac disease exhibits a diverse spectrum of clinical presentations, ranging from classic gastrointestinal symptoms to atypical or silent forms. This heterogeneity poses a challenge in both diagnosis and research, as individuals may present with varying degrees of symptom severity and associated conditions. Researchers grapple with the need to account for this diversity in study cohorts, considering the implications for generalizability and personalized treatment approaches. Diagnostic Limitations and Evolving Criteria Accurate diagnosis is fundamental to celiac disease research, yet diagnostic criteria and tools continue to evolve. Serological tests, histological analysis, and genetic markers contribute to diagnosis, but challenges persist in cases of seronegative celiac disease and potential overlap with other gastrointestinal conditions. Researchers must navigate the nuances of diagnostic criteria, considering advancements and potential limitations in standardizing assessments across studies. Long-Term Implications and Outcomes Understanding the long-term implications of celiac disease, including its impact on quality of life, comorbidities, and associated complications, requires longitudinal research. Tracking outcomes over extended periods presents logistical challenges, including participant retention, data accuracy, and the dynamic nature of patient experiences. Longitudinal studies are essential for unraveling the multifaceted nature of celiac disease progression and its consequences. Interplay of Genetics, Environment, and Microbiome Celiac disease's etiology involves a complex interplay of genetic predisposition, environmental factors, and the gut microbiome. Untangling these interconnected elements presents a formidable challenge, as researchers strive to elucidate the role of specific genes, environmental triggers, and microbiome dynamics in disease onset and progression. Collaborative and interdisciplinary approaches are essential for comprehensively addressing these multifactorial influences. Translation of Research Findings into Clinical Practice Bridging the gap between research findings and clinical practice is a critical consideration in celiac disease research. Successful translation requires effective communication between researchers, healthcare providers, and individuals with celiac disease. Implementing evidence-based recommendations, disseminating research outcomes to diverse stakeholders, and fostering awareness are integral aspects of ensuring that advancements in research positively impact patient care. Addressing these challenges and considerations requires ongoing collaboration, innovation, and a commitment to advancing our understanding of celiac disease. As research endeavors continue, the collective efforts of the scientific community play a pivotal role in overcoming obstacles, refining diagnostic and therapeutic approaches, and ultimately improving outcomes for individuals living with celiac disease. Patient Perspectives: Voices from the Celiac Community In the realm of celiac disease research, the voices and experiences of individuals living with the condition provide invaluable insights that complement scientific findings. Patient perspectives offer a nuanced understanding of the challenges, triumphs, and day-to-day realities faced by those navigating life with celiac disease. These firsthand accounts contribute to the broader dialogue surrounding the condition and enrich both research initiatives and the broader celiac community. Navigating Diagnosis and Treatment Journeys Patients with celiac disease often encounter a labyrinthine journey in obtaining an accurate diagnosis and navigating subsequent treatment paths. Sharing personal stories illuminates the diverse pathways individuals take in seeking answers to their health concerns, from initial symptoms to the diagnostic process and the subsequent initiation of a gluten-free lifestyle. These narratives underscore the need for improved awareness, timely diagnosis, and accessible support networks. Quality of Life and Daily Challenges Understanding the impact of celiac disease on individuals' quality of life requires an exploration of the daily challenges they face. Patient perspectives shed light on the intricacies of managing a gluten-free diet, coping with social and emotional aspects, and addressing the broader implications of the condition on mental and physical well-being. Capturing these nuanced experiences informs research priorities, emphasizing the holistic needs of individuals with celiac disease. Advocacy and Community Engagement The celiac community is characterized by a strong spirit of advocacy and mutual support. Patient perspectives highlight the role of individuals in advocating for improved awareness, research funding, and policy changes that benefit the broader community. Engaging with patient advocacy groups, sharing success stories, and mobilizing collective efforts amplify the impact of patient voices in shaping the trajectory of celiac disease research and fostering a sense of community. Challenges and Triumphs in Gluten-Free Living Living gluten-free entails a myriad of challenges, from navigating restaurant menus to deciphering food labels and managing potential cross-contamination risks. Patient narratives capture the triumphs and tribulations of gluten-free living, offering practical insights into coping strategies, favorite recipes, and innovative approaches to enhancing the gluten-free lifestyle. These stories resonate with others facing similar challenges and provide a platform for shared learning and support. Collaboration Between Patients and Researchers The synergy between patients and researchers is integral to advancing celiac disease research. Patient perspectives contribute to research prioritization, study design, and the development of patient-centered outcomes. Collaborative initiatives that involve individuals with celiac disease in research endeavors foster a sense of shared ownership and promote research that is reflective of the diverse needs and experiences within the community. In amplifying the voices of the celiac community, patient perspectives serve as a powerful catalyst for positive change. By integrating these narratives into the fabric of celiac disease research, we honor the lived experiences of individuals, foster a more empathetic and informed approach to patient care, and collectively work towards a future where the journey with celiac disease is understood, supported, and empowered. The Future Landscape of Celiac Disease Treatment As the field of celiac disease research advances, the prospect of innovative and targeted treatments heralds a transformative era for individuals living with the condition. The future landscape of celiac disease treatment holds promise, with ongoing research endeavors exploring novel therapeutic avenues and potential interventions. This section delves into the evolving landscape of celiac disease treatment, highlighting key areas of exploration and envisioning the potential trajectory of future interventions. Immunomodulatory Therapies Immunomodulatory therapies represent a forefront area of investigation in celiac disease treatment. Researchers are exploring strategies aimed at modulating the immune response to gluten, thereby mitigating the inflammatory cascade that characterizes the condition. From targeted immunotherapies to interventions that induce gluten tolerance, the goal is to develop treatments that allow individuals with celiac disease greater dietary flexibility while maintaining immune balance. Enzyme Therapies and Gluten Digestion Enzyme therapies designed to enhance gluten digestion are emerging as a potential avenue for celiac disease management. These therapies involve the use of enzymes that break down gluten into non-immunogenic fragments, reducing the likelihood of triggering an immune response. While challenges exist in achieving complete gluten degradation, ongoing research explores the feasibility and safety of enzyme-based approaches as adjuncts to a gluten-free diet. Microbiome Modulation The gut microbiome's intricate role in celiac disease pathogenesis has sparked interest in microbiome modulation as a potential therapeutic strategy. Research aims to understand how specific microbial compositions influence gluten metabolism and immune responses. Modulating the microbiome through probiotics, prebiotics, or fecal microbiota transplantation represents a novel frontier in addressing the dysbiosis associated with celiac disease and fostering a gut environment conducive to tolerance. Personalized and Precision Medicine Advancements in personalized and precision medicine offer a tailored approach to celiac disease treatment. Genetic profiling, biomarker identification, and individualized treatment plans based on specific patient characteristics are integral components of this evolving paradigm. Tailoring interventions to address the heterogeneity of celiac disease presentations enhances treatment efficacy and aligns with the broader trend toward precision medicine in autoimmune conditions. Therapeutic Vaccines Therapeutic vaccines designed to induce immune tolerance to gluten are under investigation as potential interventions for celiac disease. These vaccines aim to reprogram the immune system's response to gluten, allowing individuals to consume gluten-containing foods without triggering an adverse reaction. While challenges related to vaccine design and long-term efficacy persist, ongoing research holds promise for a future where therapeutic vaccines become a viable treatment option. Patient-Centered Approaches and Shared Decision-Making The future landscape of celiac disease treatment emphasizes patient-centered approaches that prioritize individual preferences, values, and goals. Shared decision-making between healthcare providers and individuals with celiac disease becomes paramount in tailoring treatment plans to align with patients' lifestyle, dietary choices, and overall well-being. Empowering individuals with information and involving them in treatment decisions fosters a collaborative and patient-centric care model. While these potential avenues offer glimpses into the future of celiac disease treatment, ongoing research, clinical trials, and collaborative efforts will determine the feasibility, safety, and efficacy of these interventions. As the scientific community continues to unravel the complexities of celiac disease, the prospect of transformative treatments brings hope for enhanced quality of life and improved management strategies for individuals living with this autoimmune condition. Conclusion In navigating the intricate terrain of celiac disease research, this exploration reveals a landscape marked by significant strides, promising breakthroughs, and a collective commitment to transforming the lives of individuals affected by gluten intolerance. From the realms of genetic insights guiding personalized medicine to the forefront of innovative therapies and ongoing clinical trials, the journey towards effective celiac disease treatment is unfolding. As we envisage the future, a convergence of multidisciplinary approaches, patient-centered care, and cutting-edge pharmaceutical developments emerges. The synergy of researchers, healthcare professionals, and the resilient celiac community propels us towards a horizon where the burdens of celiac disease are lightened, and individuals can embrace a life unrestricted by the constraints of gluten intolerance. Yet, this journey is not without its challenges. Regulatory intricacies, the need for increased research funding, and the imperative for sustained patient advocacy underscore the complexity of the path ahead. In the face of these challenges, however, the resilience and determination witnessed in the celiac community serve as a beacon of hope, propelling research forward and fostering an environment where breakthroughs become a reality. The evolving narrative of celiac disease research paints a picture of optimism, collaboration, and a shared vision for a future where effective treatments abound. As we reflect on the progress made and anticipate what lies ahead, let us remain steadfast in our pursuit of alleviating the impact of celiac disease and championing a future where individuals can thrive without the constraints of gluten intolerance. Together, we stride towards a horizon where the promises of research translate into tangible improvements in the lives of those navigating the challenges of celiac disease. Further reading: Celiac Disease Foundation - Celiac Disease Foundation Research National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Celiac Disease Research at NIDDK Clinical Trials Beyond Celiac - Research and Innovation Gluten Intolerance Group - Research and Education American College of Gastroenterology (ACG) - Celiac Disease Overview PubMed - Celiac Disease Research Articles

Celiac.com 12/13/2023 - Celiac disease is a common autoimmune disease affecting more than 1% of the population. In celiac disease, the ingestion of gluten, a protein found in wheat, barley, and rye, triggers an immune response targeting the small bowel. In susceptible individuals, this immune reaction leads to both gastrointestinal and systemic symptoms. Unlike some other autoimmune diseases, the specific immunogenic antigens responsible for the immune response in celiac disease have been identified and extensively characterized. Consequently, a gluten-free diet has long been established as an effective treatment. This is not an easy task, partly due to a lack of awareness of the gluten content in foods, and the extensive incorporation of gluten into many processed foods. Furthermore, a gluten-free diet can impose a sense of limitation, and can be associated with decreased quality of life, in some celiac disease patients. This contributes to gluten contamination in the diets of four out of five celiacs trying to follow a gluten-free diet. Furthermore, one in three adult celiac patients will report persistent symptoms, while two in three will not achieve full histological recovery when on a gluten-free diet. In recent years, extensive research has fueled a quest for a pharmacological treatment for celiac disease, the development of which represents a sort of a Holy Grail for many researchers and patients. A new review presents a concise description of the current rationale and main clinical trials related to celiac disease drug therapy. The review is the work of by Professor Mariana Verdelho Machado, with the Gastroenterology Department, Hospital de Vila Franca de Xira, Nª 2, Vila Franca de Xira, Portugal; and the Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Universidade de Lisboa, Avenida Prof. Egas Moniz, Lisbon, Portugal. Estimates suggest that over 1% of the global population, roughly 80 million people, is affected by celiac disease. The classical presentation involves symptoms of malabsorption, such as diarrhea, weight loss, and nutritional deficits. However, a significant portion of patients either remains asymptomatic or experiences non-specific and extra-intestinal symptoms. Despite the challenges posed by the strict dietary regimen, achieving mucosal healing through a gluten-free diet is crucial, particularly given the increased mortality observed in some cohorts of celiac patients. Challenges with the Gluten-Free Diet The gluten-free diet is currently the only proven effective treatment for celiac disease. However, its implementation presents various challenges. Adherence rates to a strict gluten-free diet fluctuate widely, ranging from 42% to 91%. Moreover, even among those who claim adherence, up to 80% might inadvertently consume gluten due to contamination or non-compliance. Additionally, achieving mucosal healing, a critical aspect of managing celiac disease, appears to occur in less than half of adults following a gluten-free diet. Rationale for Drug Development In the past decade, there has been a concerted effort to explore pharmacological treatments for celiac disease. The endeavor is particularly challenging as a well-established, non-pharmacological therapy— the gluten-free diet—already exists. For a new drug to be a viable alternative, it must demonstrate efficacy, lack significant adverse effects, be simple to administer (preferably orally), and be cost-effective. Pharmacological Treatments in Focus Efforts in drug development for celiac disease have focused on three main scenarios: maintenance therapy, rescue therapy after acute gluten exposure, and mitigation of chronic inadvertent gluten exposure. Larazotide: One drug in clinical research is larazotide, designed to stabilize enterocyte tight junctions, thereby reducing intestinal permeability. While phase 2 studies showed promising results in decreasing symptoms and serological markers, a phase 3 trial in 2022 was suspended after an interim analysis revealed no meaningful effects. Latiglutenase: Another promising drug is latiglutenase, a mix of glutenases. Phase 2 studies demonstrated its efficacy in preventing mucosal degradation and symptom development resulting from gluten contamination. Latiglutenase is considered a strong candidate for becoming a standard adjunctive therapy in celiac disease treatment. IL-15 Pathway Inhibition: For patients unresponsive to a gluten-free diet or those with refractory celiac disease (RCD), research has focused on the IL-15 pathway. While blocking IL-15 with PRN15 showed disappointing results, tofacitinib, a pan-JAK inhibitor acting on the IL-15 receptor signaling pathway, appears promising. Immune Tolerance Induction: Inducing immune tolerance to gluten is an appealing strategy to avoid systemic immune suppression. Strategies like therapeutic vaccines and hookworm infestation, despite initial disappointment, have not been entirely ruled out. Future Prospects and Considerations The ongoing research prompts questions about the role these emerging drugs might play in treating extra-intestinal manifestations associated with celiac disease, such as neuropsychiatric and autoimmune conditions. While these drugs offer hope, they must surpass the effectiveness and safety of the existing dietary therapy, a high bar given the complexity of celiac disease and the challenges posed by gluten exposure. The researchers conclude that celiac disease patients need effective and practical treatment options beyond the stringent gluten-free diet. They also note that ongoing developments in pharmacological treatments bring hope for improved management, especially for patients facing challenges with dietary adherence and inadvertent gluten exposure. However, the complexity of celiac disease demands a meticulous approach to drug development, ensuring not only efficacy and ease of use, but also safety and accessibility. As research progresses, the landscape of celiac disease management may witness transformative changes, offering a brighter outlook for those living with this autoimmune condition. Read more in the Int. J. Mol. Sci. 2023, 24(2), 945.

Celiac.com 06/03/2023 - This article first appeared in the Australian Coeliac newsletter, and is reprinted here by permission of the Australian Coeliac Society. By Robert Anderson, MD, Peter Gibson, MD and Finlay Macrae, MD. In 2002, the diagnosis of celiac disease means an end to delicious French pastries and the casual approach to diet that most people in the community enjoy. Today, strict adherence to a gluten free diet is the only effective treatment for celiac disease. A Vaccine for Celiac Disease? The good news is that new research in celiac disease suggests a "vaccine" may be feasible! Such a development has come from a greater understanding of the cause of celiac disease. You might say that we have known the cause of celiac disease for decades—"something" in gluten. But, there is more! We are all exposed to gluten but only some of us get celiac disease. This other factor is the characteristic of the immune system that makes the small intestine a "battleground" when it is exposed to gluten. The exciting advances are twofold. First, we have now identified the "something" in the gluten that makes the immune system angry (that is, the target of the immune response). Secondly, we now understand why only some people's immune system gets angry with gluten—it is all about the genes we carry that control the immune response. How the Advances were Made Almost all individuals with celiac disease have one of two genes involved in the immune response, HLA-DQ2 (90%) or HLA-DQ8 (5%). In the general population only 30% have one of these genes, let's call them A and B. These genes are also very common in early onset diabetes and thyroid disease (both quite commonly associated with celiac disease). A and B have the task of latching on to chunks of proteins (peptides) and carrying them to certain cells in the immune system called T cells. In celiac disease, we know that gluten peptides are indeed taken ("presented") to T cells via A and B. Gluten peptides attached to A and B then activate a proportion of the T cells present in the gut and cause the flattening of the intestinal villi known as villous atrophy— the pathologist's hallmark for diagnosing the disease. Ever since it was shown that gluten causes celiac disease, the challenge faced by researchers was to prove whether there are many, a few, or just one component of gluten that is "toxic"—that is capable of causing this damage. Most researchers thought that a wide range of components of gluten (peptides) were involved in causing celiac disease, and indeed a range of T cells reacting against various gluten peptides were found. This would have meant that the idea of a vaccine to abort this immune process to gluten (a process technically called "tolerance") was impractical. However, these early experiments with T cells were unable to show what really happened when gluten was exposed to the immune system in "real people" with celiac disease. Our work performed in Oxford, and to continue at The Royal Melbourne Hospital, Box Hill Hospital and Walter and Eliza Hall Institute in Melbourne, utilizes T cells from celiac subjects that have recently eaten gluten-containing bread. T cells induced by eating gluten could be measured in blood. To our surprise, these T cells initially targeted only one small component of gluten (a small peptide) in the most toxic fraction of wheat gluten (alpha-gliadin). Whether different peptides in the other components of wheat, rye and barley gluten are targets to which T cells react in patients with celiac disease is currently under investigation. How a Vaccine Might Work In animal diseases, the understanding of how T-cells respond is much further advanced than in humans. In fact, it has been possible to prevent and even treat animal diseases caused by T cells by "vaccinating" with T-cell target peptides. For example, nasal administration of peptide can prevent a mouse disease similar to multiple sclerosis. It "blocks" the subsequent immune response which is the hallmark of the disease. Why can't we do this in celiac disease? Celiac disease is the first human condition for which there is a clear understanding of the T-cell targets—a peptide in gluten. In work that is now planned in Melbourne, the possibility of a "vaccine" for celiac disease will be tested. The first stage of this project will begin in the next six months. But even if successful, it is still likely to be ten years or more before a "treatment" is ready for general use. These studies may provide celiac disease with its first alternative to a gluten free diet. Welcome back French pastries and crusty bread!

Celiac.com 11/21/2022 - Following a gluten-free diet for life can be difficult, Most celiacs on a gluten-free diet get exposed to gluten on a regular basis, especially if they eat in restaurants. Currently, a gluten-free diet is the only effective treatment for celiac disease. Because of this, there is substantial interest in drug therapies that can help to protect celiacs on a gluten-free diet, and, ideally, free them from a strict gluten-free diet. There are a number of drugs still in the pipeline that promise the former, at least. So what's the status of the multiple new therapies that are under investigation? To answer this question, a team of researchers recently set out to review existing and upcoming clinical trial programs for pharmacologic agents for celiac disease. The team conducted a narrative review using searches of MEDLINE, Embase, the Cochrane CENTRAL Library and clinicaltrials.gov. In their review, the team summarizes the pathophysiology of celiac disease, and the specific steps that might help to speed pharmacologic treatment. They also assess the evidence in support of current and future drug targets, including trials of peptidases, gluten sequestrants, tight junction regulators, anti-transglutaminase 2 therapies, immune tolerizing agents, advanced biologics and small molecules, and microbiome-targeted strategies. The team also spotlights the special challenges of conducting celiac disease trials, including identifying appropriate study populations, assessing results in the context of a gluten challenge, and interpreting celiac disease-specific clinical and histologic outcomes. Understanding these factors is crucial for accurately appraising the evidence. Finally, they outline what the future of celiac disease therapy may hold with the introduction of viable drug treatments. There is a definite need for drug options for treating celiac disease, either for accidental or intentional gluten exposures, as part a gluten-free diet, or for refractory disease. The big takeaway, is that, according to the team's reading of the data, multiple promising celiac disease drug therapies are in development, and these trials are likely to lead to approvals for the first generation of pharmacologic agents for celiac disease within the next 5 years. Color us skeptical, but that seems a pretty bullish view, especially given the crowded graveyard of once seemingly promising celiac drug therapies, especially the very recent demise of the highly touted Larazotide. Basically, we'll believe in successful drug treatments for celiac disease when we see a successful product make it to celiacs. Meanwhile, stay tuned for more on this and related stories. Read more in Aliment Pharmacol Ther. 2022;55(10):1277-1296 The research team included Michael Klonarakis, Christopher N. Andrews, Maitreyi Raman, Remo Panaccione and Christopher Ma. They are variously affiliated with theDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada; the Division of Gastroenterology & Hepatology, University of Calgary, Calgary, Alberta, Canada; the Alberta's Collaboration of Excellence for Nutrition in Digestive Diseases, Calgary, Alberta, Canada; and the Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

Celiac.com 10/11/2022 - Enzymes that can break down gluten in the stomach before it gets to the gut are a potentially important therapy tool for people with celiac disease. In people with celiac disease, the digestion of gluten creates peptides, including the strongly immunogenic proline-rich 33-mer from wheat α-gliadin, that trigger auto-immune reactions in the gut, along with associated villi damage, when untreated. Having a therapy that could reduce the abundance of the 33-mer in the small intestine could be very helpful to many people with celiac disease. Neprosin is the latest candidate. A team of researchers recently set out to test a glutamate-class prolyl-endopeptidase for celiac disease therapy. The research team included Laura del Amo-Maestro, Soraia R. Mendes, Arturo Rodríguez-Banqueri, Laura Garzon-Flores, Marina Girbal, María José Rodríguez-Lagunas, Tibisay Guevara, Àngels Franch, Francisco J. Pérez-Cano, Ulrich Eckhard & F. Xavier Gomis-Rüth. They are variously affiliated with the Proteolysis Laboratory at the Department of Structural Biology, Molecular Biology Institute of Barcelona (CSIC), Barcelona Science Park in Barcelona, Catalonia, Spain; the Section of Physiology; Department of Biochemistry and Physiology; Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Catalonia, Spain; and the Research Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona in Barcelona, Catalonia, Spain. Neprosin from the pitcher plant is a reported prolyl endopeptidase. As part of their effort, the team produced recombinant neprosin, along with several mutants, and revealed that full-length neprosin is a zymogen, which is self-activated at gastric pH by the release of an all-β pro-domain via a pH-switch mechanism featuring a lysine plug. The team describes the catalytic domain, in which the action occurs, as an atypical 7+8-stranded β-sandwich, with an extensive active-site cleft holding an unprecedented pair of catalytic glutamates. The researchers found that neprosin quickly and effectively breaks down both gliadin and the 33-mer in vitro under gastric conditions. The action can be reversibly inactivated above pH 5. Moreover, administering gliadin and the neprosin zymogen together at the ratio 500:1 reduces the abundance of the 33-mer in the small intestine of mice by up to 90%. A 90% reduction in the 33-mer means that a substantial reduction in the ability of the protein to trigger an immune response in people with celiac disease. Neprosin therefore represents a family of eukaryotic glutamate endopeptidases that meets the parameters for an effective therapeutic glutenase. The development of effective therapeutic glutenase products remains a top priority for many researchers, with the potential to benefit huge numbers of people with celiac disease, many of whom are subject to accidental gluten ingestion on a regular basis. Read more in Nature Communications volume 13, Article number: 4446 (2022)

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

Celiac.com 03/27/2017 - A number of researchers are looking to provide alternative or adjunct treatments to the gluten-free diet in celiac disease. Meanwhile, a number of companies are currently developing a wide variety of such options, ranging from various kinds of enzyme therapies, to treatments that eliminate celiac disease reactions, even to vaccines to inoculate celiac sufferers against their condition, perhaps allowing for full recovery and a return to non-gluten-free eating habits, as desired. At least, that's one dream. More likely will be the development of enzymes or other treatments that offer celiacs varying degrees of protection from gluten ingestion. Most likely, such treatments would be designed to augment an existing gluten-free diet, and to provide protection against moderate gluten-contamination when eating out. One particular enzyme that shows strong potential in breaking down toxic peptides in A-gliadin, the main culprit in celiac reactions, is caricain. A recent paper discusses the scientific principles behind the use of caricain for enzyme therapy. The paper is based on a recent study, in which a team of researchers set out to review the structures of the toxic peptides in A-gliadin for key sequences of amino acids or motifs related to toxicity, especially with respect to digestive difficulties, or immunogenicity. The research team included Hugh J. Cornell and Teodor Stelmasiak. They are affiliated with the RMIT University, School of Applied Sciences, Melbourne, Australia, and with Glutagen Pty Ltd, Maribyrnong, Victoria, Australia. For their study, they first evaluated structures of synthetic A-gliadin peptides shown to be toxic in the fetal chick assay, both before and after digestion with duodenal mucosa from patients in long remission. They also measured synthetic peptides corresponding to the undigested residues, and compared the key amino acid sequences, to see if they might be related to direct toxicity and immunogenicity of the peptides. They found that the smallest toxic peptides from celiac mucosal digestion were octa-peptides, which they found in greater amounts than similar products from normal digestion. One of those peptides corresponded to residues 12-19 of A-gliadin and contained the key motifs PSQQ and QQQP of De Ritis et al., while the other corresponded to residues 72-79, and contained the key motif PYPQ (extending to PYPQPQ). These key motifs have been noted by other workers, especially those investigating immunological activity over the past two decades. They are present in undigested residues from celiac mucosal digestion These motifs, along with the greater prevalence of these residues, as compared with residues from normal digestion, supports the basic notions underpinning enzyme therapy for celiac disease. This study also supports the basic scientific merits of research and development of the enzyme caricain to break down gliadin peptides with two different types of toxicity, and thus to potentially benefit people with celiac disease. Source: International Journal of Celiac Disease. Vol. 4, No. 4, 2016, pp 113-120. doi: 10.12691/ijcd-4-4-2 Previous study: NCBI

Celiac.com 09/18/2015 - That old saw about death and taxes might need a bit of amending to include complaints about pharmaceutical companies working on celiac drug treatments. One interesting facet of our coverage of the development of various drugs to treat and/or cure celiac disease has been the regular presence of comments questioning the motives,and actions of the companies involved. It's funny, but no one complains that companies still make money selling aspirin, and that no one has cured a headache, and that there must be some conspiracy to profit off of those who suffer a headache. There's no doubt that there's money to be made producing drugs that treat disease. But, if a company can develop and produce a safe drug to protect celiacs against contamination, or to help reduce symptoms, what's wrong with that? Just like an aspirin, I can take it or not take it. In the old days, ten years ago or more, people with celiac disease generally suffered in silence, with scant gluten-free food choices, and little information. However, in just a decade, we've got a wealth of information, and multi-billion dollar gluten-free foods market and a number of companies developing drugs to treat or cure celiac disease. To me, that's a good thing. Still, there are naysayers. Here's a rundown of comments by readers who seem less than enthused about celiac drugs in development. Our recent article, An Update on Every Celiac Disease Drug Currently in Development included the comment: "Article's fine. Concept's disturbing. Eating a gluten-free diet is the free, already-proven cure for celiac and gluten-intolerance. They don't have to torture mice and likely other animals to find a 'cure' for something that there already is a cure for. I imagine there is $$ for the researchers here and $$ for the animal labs and $$ for the pharmaceuticals." Of our article entitled, How Close Are New Celiac Disease Treatments? one reader wrote: "I would be very cautious about taking any of these until it was proven absolutely to have no side effects. There always are some and history has shown some to be deadly." Commenting on our article ALV003 Reduces Gluten Damage in Celiac Disease Patients, one reader commented: "I only want to know: how long until random internal organs begin to fail or malfunction as a result of yet another new mystery drug? I'd rather starve to death than be a guinea pig for big pharma again." Our article on NexVaxx, entitled Is a Vaccine for Celiac Disease Just Around the Corner? included the following comments: "Totally agree with vhill seems like a ploy to poison people with GMO foods that come up with a supposed "'cure'. Eat healthy whole foods this is not a curse its a wake up call to be healthy if you didn't have celiac you'd probably be eating processed crap." Balm wrote: "Thanks but no thanks. I'll remain a celiac and continue to eat healthy. While trying to fix one problem, some will end up with far worse problems." Jonnys wrote: "Stupid idea! Just another way to make more money off of people." These are but a few of the largely positive comments we receive, and we hope you enjoyed them as much as we do.

Celiac.com 09/19/2017 - Hookworms. Intestinal parasites. They sound gross. The thought of having one's gut infected with a parasitic worm generally makes people's skin crawl. Indeed, intestinal worms, like hookworm, have a bad reputation among health experts, and have been the subject of fierce public health campaigns seeking their eradication. However, researchers have also documented the gut healing abilities of parasites like hookworm. In fact, part of how hookworms seem to work in nature is to promote an optimal gut environment in which they can thrive. In nature, the guts of people infected with hookworm are generally healthy. Could hookworms and other intestinal parasites prove key to treating and possibly eliminating diseases like celiac, and asthma? A number of clinicians and researchers feel that if they can just get the right strain of hookworm, at the right levels, they can basically eradicate celiac disease, and possibly asthma and other inflammatory diseases. When hookworms are introduced into the gut of people with celiac disease in the right amount, and kept at therapeutic levels, patients see their celiac symptoms disappear and their guts return to a healthy, normal condition. In fact, hookworms do not reproduce once inside the human gut, so if doctors put , say, 10 hookworms into a gut to treat celiac disease, there will be 10 there later, not more. In nature, the way humans build up dangerous levels of hookworm is via unsanitary environmental conditions and repeated exposure to more hookworms. Done clinically, the hookworm would present little or no danger to the human who was hosting it. While still very much in the experimental phase, researchers hope to investigate a number of strains to determine the best therapeutic levels for such disease treatments. For that, they will need FDA approval. Remember, the fecal transplant was first described in the 1950s, but took decades to catch on as a conventional treatment for gut disorders, such as c-dif bacteria, partly because it was seen as crude and somehow objectionable. But it proved to work. Really well. So much so that it's now a fairly conventional treatment. Could the hookworm follow a similar path from crude and weird to cool and effective? Could hookworms be used to cure celiac disease? Only close study will tell us for sure, and that's why the move to get FDA approval is an important one. For that, special strains of hookworm must be approved. "One of the big roadblocks is having the parasites that the FDA will allow you to infect people with," says John Hawdon, vice president of the American Society of Parasitologists and a researcher at the George Washington University. He and his colleagues are applying for permission to grow hookworm larvae to standards fit for testing in humans, which is not currently permitted in the United States. Hawdon says he anticipates a lengthy application process. Stay tuned for news on efforts to develop hookworm as a potential cure to celiac disease, asthma, and more. Sources: popsci.com iflscience.com

Celiac.com 02/17/2017 - In recent tests, researchers found that microwave treatment (MWT) of wet wheat kernels caused a striking reduction in R5-antibody-based ELISA gluten readings, reducing the readings to under 20 ppm, so that wheat could theoretically be labeled as gluten-free. However, the actual gluten content of the wheat remained unchanged. Just the test reading changed. The research team included C Gianfrani, G Mamone, B la Gatta, A Camarca, L Di Stasio, F Maurano, S Picascia, V Capozzi, G Perna, G Picariello, A Di Luccia. They are variously affiliated with the Institute of Protein Biochemistry, CNR, Naples, Italy, the Institute of Food Sciences, CNR Avellino, Italy, the Department of the Sciences of Agriculture, Food and Environment at the University of Foggia, Italy, the Institute of Food Sciences, CNR Avellino, Italy; Department of Agriculture, University of Naples, Portici (Na), Italy, the Department of Clinical and Experimental Medicine, University of Foggia, Foggia (Italy) and National Institute of Nuclear Physics, Section of Bari, Italy, and the Department of the Sciences of Agriculture, Food and Environment, University of Foggia, Italy. The failure of R5 Elisa to register gluten in MWT stands in stark contrast to analysis of gluten peptides by G12 antibody-based ELISA, mass spectrometry-based proteomics, and in vitro assay with T cells of celiac subjects, all three of which gave consistent results both before and after MWT. As to what caused the R5 Elisa to misread the MWT samples, an SDS-PAGE analysis and Raman spectroscopy showed that MWT reduced the alcohol solubility of gliadins, and altered the access of R5-antibody to the gluten epitopes. Thus, MWT neither destroys gluten nor modifies chemically the toxic epitopes, this contradicts claims that MWT of wheat kernels detoxifies gluten. This study provides evidence that R5-antibody ELISA alone is not effective to determine gluten levels in thermally treated wheat products. Gluten epitopes in processed wheat should be monitored using strategies based on combined immunoassays with T cells from celiacs, G12-antibody ELISA after proteolysis and proper molecular characterization. Source: Food Chem Toxicol. 2017 Jan 12;101:105-113. doi: 10.1016/j.fct.2017.01.010.

Celiac.com 05/14/2014 - A team of Canadian researchers have discovered a key molecule that could lead to new treatments for celiac disease. The molecule, called elafin, protects the lining of the intestine, says Elena Verdu, associate professor of medicine, and head of the McMaster University research team. When people with celiac disease consume gluten, tiny proteins called gliadins cross the intestinal lining and cause inflammation. There are also other proteins in wheat grain that may contribute to the common complaint of abdominal pain, such as ATIs which help grains be resistant to pests. Low levels of elafin in the intestinal lining can increase inflammation. According to Verdu, treatment with elafin could strengthen the intestinal lining, protect it from accidental gluten ingestion or contamination, and help to speed recovery. The Canadian Institute of Health Research is providing $400,000 over four years to fund the research. Stay tuned for more reporting on their efforts. Source: http://www.cbc.ca/news/canada/hamilton/news/mcmaster-researchers-find-possible-treatment-for-celiac-disease-1.2593106

Celiac.com 10/17/2013 - A gluten-free diet is till the only treatment for celiac disease, but a number of companies are working on pharmaceutical treatments. However, very little information exists bout the level of interest among patients in using a medication to treat celiac disease. A research team set out to assess interest levels among patients in medical treatments for celiac disease. The research team included Christina A. Tennyson, Suzanne Simpson, Benjamin Lebwohl, Suzanne Lewis and Peter H. R. Green. For their study, the researchers submitted a questionnaire to celiac disease patients and collected data on demographics, presentation, and interest in medication. The questionnaire included three validated celiac disease-specific instruments: Celiac Disease Associated Quality of Life, the Celiac Symptom Index, and the Celiac Dietary Adherence Test. The team received 365 responses from people with biopsy-proven celiac disease. A total of 276 women and 170 men over 50 years of age responded to the study. Of these respondents, 154 experienced classic, diarrhea predominant celiac disease. In all 339 people responded to the question asking if they were interested in using a medication to treat celiac disease, 66% of whom indicated that they were interested. The questionnaire responses broke down as follows: Older people showed the greatest interest, with 71% of people over 50 years of age saying they were interested, compared with 60% of people under 50 years of age, (p = 0.0415). More men (78%) than women (62%) women were interested (p = 0.0083). People who ate out frequently (76%) showed a greater interest than those who did not (58%), p = 0.0006). People dissatisfied with their weight showed greater interest (73%) than those satisfied with their weight (51%), (p = 0.0003) Lastly, those concerned with gluten-free diet costs (77%) showed greater interest than those not concerned about gluten-free diet costs (64%), (p = 0.0176). Interestingly, the list of factors that did not seem to influence interest included length of time since diagnosis, education, presentation, and symptoms with gluten exposure. Overall, celiacs with lower quality of life scores showed a higher interest in medication (celiac disease-QOL 69.4 versus 80.1, p < 0.0001). This survey shows a fairly strong interest among people with celiac disease in non-dietary, medical treatments. Interest was highest among men, older individuals, frequent restaurant customers, individuals dissatisfied with their weight or concerned with the cost of a gluten-free diet, and those with a worse quality of life. Just how well any drugs developed to treat celiac disease might be received will likely depend on many factors, including efficacy, side-effects, cost, ease of use, etc. Source: Ther Adv Gastroenterol. 2013;6(5):358-364.

Celiac.com 12/08/2010 - A team of researchers recently compiled an overview of prevention measures and exploratory pharmacological treatments of celiac disease. Maud Pinier, Gregor Fuhrmann, Elena Verdu and Jean-Christophe Leroux comprised the research team. First, a bit of background. Human leukocyte antigens (HLAs) is the name scientists give to the major histocompatibility complex (MHC) in humans. HLAs are host to a group of genes that influence human immune system function. The HLA group of genes on chromosome 6 encodes cell-surface antigen-presenting proteins, along with numerous other genes. The proteins encoded by certain genes are also known as antigens. The major HLA antigens are key components of immune function. HLA DP,DM, DOA,DOB,DQ, and DR present antigens from outside of the cell to T-lymphocytes. Celiac disease is common worldwide, and 90–95% of people with celiac disease exhibit HLA-DQ2 molecules and the rest exhibit HLA-DQ8. Celiac disease affects about 1 in 100 individuals in the general population, but recent studies show a substantial increase in American and Finnish populations in the recent years. This rise in celiac disease rates cannot be explained by better screening methods, and other factors have been suggested including environmental factors such as breast-feeding, time of gluten introduction, and infections. Celiac disease patients can present a wide variety of pathological and clinical symptoms, ranging from severe to subtle, and the clinical expression is not always indicated by the presence of intestinal atrophy. Classic celiac symptoms include diarrhea, abdominal bloating, and discomfort. However, numerous people with celiac disease go undiagnosed because their symptoms are not apparent, as in cases of silent celiac disease, or because their symptoms are atypical. Complications of celiac disease include refractory celiac disease, a rare, but complex disorder with severe and recurrent symptoms, in which patients remain unresponsive after at least 6 months on a strict gluten-free diet. It's rare for patients with non-responsive celiac disease to develop enteropathy-associated T-cell lymphoma, a complication of celiac disease that requires drug-based therapies. Only about 0.5–1/1.000.000 celiac patients develop this rare disorder. Other autoimmune disorders, such as autoimmune thyroiditis and type 1 diabetes, are also more common in people with celiac disease. Among siblings of children with type I diabetes, rates of celiac disease have been shown to correlate with the prevalence of celiac disease-associated HLA-DQB1 alleles. Moreover, the risk of celiac disease is significantly higher in children with type 1 diabetes who also carry the HLA-DQB1*02–DQA1*05 genotype. A recent genotyping study comparing 8,064 people with type 1 diabetes with 9,339 control subjects showed that patients with type 1 diabetes and celiac disease share seven common alleles that regulate autoimmune responses. Recent data also confirm an elevated risk of mortality in individuals with mild gluten-induced inflammation who show no villous atrophy. The team concludes by noting that, due to the high prevalence of celiac disease, and its rising numbers, early prevention may represent a cost-effective strategy. Source: The American Journal of Gastroenterology , (28 September 2010) | doi:10.1038/ajg.2010.372