Toward a Cure for Celiac Disease

in Celiac
Published: August 27, 2010

From a vaccine to a pill to a wheat sheaf without gluten, Allergic Living explores the exciting research treatment around the world.

Building Tolerance

Dr. Bob Anderson, a gastroenterologist in Melbourne, Australia, is heading the research on a celiac vaccine. His work focuses on desensitizing patients by injecting them with gluten peptides, amino acids that gang up to produce the immune reaction. “The idea is if you give one injection, you will activate a response but if you repeat it, you can use it as a treatment,” he tells Allergic Living.

Anderson has focused on a treatment that would allow people to eat gluten because he knows it’s hard to avoid the protein, no matter how diligent you are. He points to research that suggests about half of patients who are following gluten-free diets still have substantial damage in their small intestines. Results from the Phase I safety trial with patients should be compiled and ready by the middle of this year.

Gluten-free Wheat

The effort to change the very makeup of wheat is centred at Washington State University. Dr. Diter von Wettstein, a professor in the department of crop and soil sciences is trying to neutralize the parts of gluten that cause the immune reaction in the first place. The goals are to produce a celiac-friendly wheat that contains lysine, an essential amino acid often deficient in the grain, which would help to maintain the wheat’s baking texture and elasticity when it was made into dough.

“Creating new cultivars of wheat, arguably the most important crop grown … will be of tremendous benefit not only for sufferers of celiac disease, but for all consumers of wheat and wheat products,” von Wettstein said.

Popping a Pill

Research to develop a celiac “pill” includes trials taking place at Leiden University in The Netherlands, where Dr. Frits Koning and his team are testing a drug derived from a common fungus that can be found on decaying vegetation. Known as an AN-PEP, it is thought to break down both the gluten proteins and the T-cell peptides in the small intestine, preventing an adverse reaction. They’ve found the enzyme to be safe in humans, but haven’t yet proved its effectiveness.

In Baltimore, Dr. Alessio Fasano and his team have developed a pill that, rather than break down gluten, prevents gluten particles from penetrating the lining of the small intestine. Fasano says to imagine the small intestine as a gated community, with a protein called zonulin opening and closing the gates. In people with celiac disease, the gate is left ajar. A person would take the drug before eating, to block the release of zonulin. Phase III clinical trials for the pill are on hold, as the biotech firm that was to conduct them is struggling with funding. Fasano may partner with a larger firm. “One of the best assets of a scientist is perseverance. This drug could potentially be the next blockbuster. You have to have faith.”