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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