What’s On the Horizon: Nondietary Therapies

So far, all this blog has touched on is how to eat gluten free.  As of now, eating gluten free is the only known and safe cure for celiac disease.  While some drugs may be out on the market claiming to help celiacs and your gut, they are not safe, not tested, and not to be trusted.  Please, don’t take them.  The good news is, there are some nondietary therapies that are still being tested out.  It is likely that in the future celiacs could have another cure for their disease that doesn’t involve just the strict diet.  Here’s what they are, according to the book “Gluten Exposed” by Peter H.R. Green, MD and Rory Jones, MS.

Gluten vaccine: ImmusanT’s Nexvax2

This would be an injectable vaccine to help people become immune to gluten.  This would be similar to an allergy shot. This vaccine would potentially work for 90 percent of those who have celiac disease, because approximately 90 percent of those with the disease have HLA-DQ2-associated celiac disease.  The other 10 percent of people have the -DQ8 gene. Currently the vaccine has undergone phase one testing in Australia and appears to be safe. However, experts are now looking to test the vaccine for its effectiveness in protecting the intestine from damage, since as we all know that just because someone can tolerate eating gluten without the discomfort and symptoms this doesn’t mean they aren’t harming their gut. If this vaccine goes through, celiacs would be able to eat gluten with regular shots, like someone with an allergy.

Gluten removal from intestine: BioLineRX Ltd.’s BL-7010

This approach would use polymers that bind with gluten to remove it from the GI  tract. Testing is being done to see if the polymers would be able to prevent absorption of the gluten while doing so.  The idea is that the gluten would be removed from the intestinal tract and still come out in the stool. So far, this U.S. study has only been done in animals, but seems to be effective.   Some concern surrounds this method that the polymers would bind with vitamins and minerals as well as gluten and prevent their absorption, so it must be proven safe, but things are looking up as this kind of treatment is similar to drugs prescribed for those with diarrhea and high cholesterol.

Gluten blocking: Larazotide Acetate

Another drug being tested is one that would prevent the toxic peptides from entering the intestine.  However, an issue is that gluten is also absorbed through the epithelial cells, not just in between them, and so far this drug would not be able to block this. The drug is in phase two trials where it seems to be effective but more testing needs to be done relating to absorption.

Blocking Tissue Transglutaminase

The tTG inhibitor may be a familiar term to those with celiac disease: it is the enzyme that changes gluten into toxic molecules in celiacs. There has been talk of attempting to inhibit the action of this enzyme, but this is risky because tTG also is an enzyme used in the body for wound binding.  Additionally, there are concerns that the therapy could block tTG in another organ or interact with metabolic pathways. For these reasons the test has not been conducted on humans.

Wheat Modification

Scientists are also looking at modifying wheat strains to remove the peptides.  However, this a challenge because it is difficult to remove the peptides, all known peptides that cause a reaction are still not known, and costs would go up significantly even more, among other challenges.

Bugs

See if this will gross you out: an idea is being tested that would inject parasites including hookworms into the intestinal tract via the bloodstream.  The bugs would grow in the gut and exert an immune response. Similar therapies have been used in Crohn’s disease and asthma treatment.  However, studies that have occurred have so far not shown any benefit and did not reduce symptoms.  Another concern is that hookworms can cause anemia, an already present risk for celiacs.

Antibodies

This is an option that scientists have been considering for a while. Some animals may be able to be immunized to gluten and produce antibodies that could be administered to people with celiac disease. The potential options have looked at cow’s milk and another recent one with hen’s eggs.

Probiotics

We  have all heard how probiotics help our gut health.  While they currently do not act as a treatment for celiac disease, they could potentially be enriched with other drugs and ingested to the intestine.  There is so far not much research into this option. So far they are under the category of a dietary supplement, not a drug.

Clearly there is still some ways to go with finding other therapies to celiac disease, as it takes a long time for drugs to be approved.  If something like this ever did come out, it would be revolutionary in the celiac world, as it would be the first of its kind, and possibly mean a different kind of life for celiac patients.

Chloe Dyer

About Chloe Dyer

Chloe is a senior at University of Maine Orono studying Mass Communication and Political Science. In addition to writing for BDN, she is the Editor-in-Chief of Her Campus UMaine and Contributing Editor for Odyssey UMaine. She has known about her Celiac Disease for a little over a year and has been eating gluten free as well as sometimes dairy-free. She is from Chebeague Island, Maine, where she grew up, but has also lived in Cleveland, Ohio and Blagoevgrad, Bulgaria in addition to Orono.