Experimental Drug May Ease Gluten-Triggered Reactions in Celiac Patients
Researchers have developed an experimental drug that may ease gluten-triggered reactions in patients.
Celiac disease is an autoimmune disease that is characterized by the body’s immune system attacking the digestive tract. In celiac disease, the immune system assaults and destroys the villi of the small intestine. When these villi are damaged, the intestines can no longer absorb nutrients properly.
The small intestine is part of the digestive tract that connects the stomach and the large intestine. The small intestine contains small finger-like projections called villi, which contain specialized cells that transport nutrients into the bloodstream. Villi do not aid in the digestion of nutrients, but they are the key to nutrient absorption.
Gluten is the term for proteins contained in wheat, rye, barley, and triticale. Gluten gives foods their shape – it is almost like a paste that holds foods together. Gluten is found in many foods – even foods that you would not think contained gluten, like soy sauce.
The symptoms of celiac disease are painful. Over 200 known celiac disease symptoms occur in the digestive system and other parts of the body. Celiac disease can develop as a child or as an adult. The reasons for how celiac disease develops is still somewhat unknown.
Some symptoms of celiac disease include unexplained anemia, fatigue, bone or joint pain, and depression or anxiety. You may experience diarrhea, bloating, and extreme stomach discomfort.
The only treatment for celiac disease, which affects one in every 100 people, is a gluten-free diet. At the best of times, adhering to an entirely gluten-free diet is challenging. There are many gluten-free foods available, but it still is not an easy diet to keep.
The Mayo Clinic has studied celiac disease for years, and their studies reveal almost 70 percent of celiac patients who follow a gluten-free diet still have symptoms from low levels of contamination. Eating any amount of gluten causes intestinal damage no matter how strict you are with your diet.
According to researchers, if you avoid gluten, there are antioxidants you don’t get, and the lack of these elements can cause different health issues. You may experience anemia, brain fog, and bloating. Different symptoms make celiac disease a difficult condition to diagnose. Blood tests need to be performed to find specific celiac markers. You may also need an intestinal biopsy.
Once the immune system is activated by eating gluten, antibodies attack anenzyme in the body. It has been unclear how the interplay between antibodies and enzyme happens, but now research teams have found new details about how antibodies are formed and behave. Research has also discovered how enzymes react to different stimuli.
Thomas J.D. Jorgensen, one of the leading researchers of celiac disease, explains, "We now have an insight into how the antibodies react when they encounter the enzyme. We also know how the enzyme changes shape when exposed to different environmental impacts, such as the concentration of calcium ions changes.”
Is There Help for Those with Celiac Disease?
Scientists are continually researching new drugs and methods to help those with celiac disease. Researchers and scientists know it is not enough to maintain a gluten-free diet. So, more help is needed.
What type of help could there be for those with celiac disease? Pills that bind gluten before it gets into your system or maybe a medication that breaks down gluten helped by a beneficial enzyme? Perhaps there is a drug on the horizon that interrupts the immediate needs and delayed effects of gluten. Scientists are also experimenting with drugs that target the enzyme that causes celiac disease in the first place.
Help might come in the form of screening and DNA mapping to discover who is at risk and then using microorganisms that teach the body to tolerate gluten before it causes any harm. Perhaps a vaccine that can prevent the body from needing gluten. Many options are being considered.
Great strategies to help those with celiac disease and studies are being conducted to stop celiac disease from happening altogether. Dr. Fasano of MassGeneral Hospital for Children states, “It’s an almost impossible mission, but it’s the future of medicine.”
With this research and investigations, comes an experimental drug that helps celiac patients who inadvertently eat gluten.
Experimental Drug Details
Inadvertently eating gluten for those who have celiac disease leads to symptoms like pain in the gut, diarrhea, and intestinal damage. There is new hope, however, for celiac disease patients. During the Digestive Disease Week (DDW) 2018, an experimental drug was discussed.
Researchers discovered that AMG 714 antibody blocks interleukin15 or a mediator of celiac disease that triggers symptoms when minute gluten enzymes are ingested. In non-medical speak, a new drug has been discovered that can help you if you accidentally eat any form of gluten.
Francisco Leon MD, Ph.D., the study director and consultant for Amgen emphasizes, "It's important to note that this drug is being investigated for its potential to protect against modest contamination, not deliberately eating large amounts of gluten, like bread or pasta.” Dr. Leon goes on to say that polluting your body with gluten can happen during food processing, packaging, or cooking.
Contamination does frequently happen even though someone with celiac disease is following a gluten-free diet. When this inadvertent contamination occurs, and you eat the food prepared and infected, those with celiac disease suffer from diarrhea, stomach pains, and intestinal damage.
Dr. Leon hopes this new drug will allow celiac patients experience less gluten-triggered problems, when unknowingly exposed to gluten.
In the study, a double-blind, placebo-control phase 2a study compared the effects of AMG 714 at two doses to a placebo among celiac disease participants. The study was conducted for a 12-week period. The drug was given to participants via subcutaneous injections six times during the study.
One group of participants who experienced mucosal atrophy at the baseline, received high doses of gluten, about 2.5 grams per day, and were given the new drug. Another group with the same baseline were exposed to gluten contamination, without their knowledge, during their gluten-free diet and did not receive the drug.
The Results
AMG 714 was shown to reduce gluten symptoms in the group receiving the drug compared to the group that received a placebo. AMG 714 did not entirely prevent gluten symptoms, but a decrease in intestinal damage was observed. When the patient took the larger 300 mg dose, the reduction in symptoms was even higher.
"A gluten-free diet has been the only treatment option for celiac disease patients to date, yet it is nearly impossible for them to avoid gluten entirely and indefinitely," said Markku Maki, MD, PhD, the principal investigator and a professor for the Faculty of Medicine and Biosciences at the University of Tampere in Finland. "An average of half of all celiac disease patients on a gluten-free diet continue to have mucosal inflammation or damage, and a third have recurrent symptoms. That is why we have been investigating medications to help prevent the consequences of hidden gluten."
The discovery of AMG 714 is huge for those with celiac disease.
