A pill for celiac disease? Friend or foe?

So if there was a pill you could take to eat glu­ten again, celi­acs, would you do it?

Celiac dis­ease is a con­di­tion that the body attacks its own tis­sues in the pres­ence of wheat glu­ten (or a spe­cif­ic pro­tein in it, gli­ad­in). For those of us afflic­ted with the dis­ease, it means fatigue, an inab­il­ity to absorb nutri­ents, bloat­ing, weight loss, brain fog, rashes, B12 deficiency…and the list goes on. gfcp_logo

Last year, a study was pub­lished in the Journal of Gastroenterology where a tri­al was per­formed using a ALV003, a drug that has glu­ten-chop­ping enzymes called pro­teases, to digest glu­ten. Two groups were giv­en glu­ten; those with celi­ac dis­ease and those without, and both were giv­en ALV003. The group with celi­ac dis­ease did show react­iv­ity, but over the course of the six weeks, the immune sys­tem did show decreased react­iv­ity after ALV003 had been intro­duced each day, and there were no signs of dam­age in the intest­ine des­pite the 6 week chal­lenge.

Just last week, a report came out of the University of Alberta that col­leagues Hoon Sunwoo and Jeon Sim have developed a pill made from egg anti­bod­ies that are cap­able of bind­ing to glu­ten and pro­tect­ing against it by bind­ing to glu­ten. There are no tri­als yet, but Sunwoo has hopes that tri­als can begin shortly.

I’m sure this will not be the last we hear of these tri­als, which in many ways is good, to con­firm that what is being pro­duced for our con­sump­tion on the mar­ket does actu­ally work and is safe. The ques­tion is really, is it worth it?

The first study with ALV003 (the glu­ten-chop­ping enzymes) did reduce the body’s over­all pro­duc­tion of anti­bod­ies and cells against glu­ten, how­ever the react­iv­ity of the immune sys­tem was still present. While the dam­age was reduced, it wasn’t com­pletely elim­in­ated. Perhaps a nice option for expos­ure to glu­ten, but for most celi­acs the response is so intense to glu­ten that for most of us, tak­ing a few enzymes isn’t going to elim­in­ate hours or days of suf­fer­ing. It wouldn’t be worth eat­ing an entire pizza, but it might help reduce our expos­ure to trace glu­ten. I have seen sim­il­ar effects with some digest­ive enzymes that reduce but don’t elim­in­ate the response, which makes sense. The body, in autoim­munity, will find a way to voice its ‘dis­pleas­ure’.

As for the second prom­ising idea that glu­ten can be bound to by egg anti­bod­ies to elim­in­ate the expos­ure, this too can be lim­it­ing as many celi­acs have also mul­tiple oth­er foods that cause their tummy dis­pleas­ure, includ­ing egg at times, as well as oth­er aller­gies.

In gen­er­al, the immune sys­tem in celi­acs should in truth con­tin­ue to be the focus of our well­ness, and as much as I hate to say it because I too miss being able to eat glu­ten, a quick fix may not be a fix at all.

I’d love to hear your thoughts, celi­acs and friends and fam­ily of celi­acs! Is it worth it?

To your health!

Dr Aoife

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