New hope for coeliacs

A new therapy being developed at Stanford University in the US may allow coeliacs to follow a more normal diet.

Researchers have found that a combination of enzymes, which could be taken as a tablet, may reduce or even prevent an inflammatory reaction to the gluten in foods that contain wheat, barley and rye.

The study, reported in the June 2006 issue of the journal Chemistry and Biology, focused on two enzymes.

Firstly, a form of the enzyme EP-B2, a substance found in barley seeds, which specifically targets a component of gluten called glutamine and, secondly, the enzyme propyl endopeptidase (PEP), a well-studied enzyme that breaks up proline, another gluten component.

Separately, these enzymes do not completely dampen the immune response to gluten but, together, they create what the researchers refer to as an enzyme 'tag-team' which completely detoxifies gluten within ten minutes under the conditions found in the stomach and duodenum.

In parallel research being conducted at the Leiden University Medical Centre in the Netherlands, enzymes are also the focus of attention.

So far, the work of both teams has been confined to the test tube and the next step is to conduct human trials. The scientists say, however, that there is no reason why this approach should not work and side effects are not expected.

Currently, the only effective therapy for coeliac disease is the complete exclusion of all gluten from the diet. However, gluten is used in so many foods (to 'glue' paprika and other spices to potato crisps, for example) that it is very difficult to avoid, and most coeliacs who adopt a restricted diet still exhibit damage to their small intestine caused by the continuing gluten-induced inflammatory reaction.

If the enzyme treatment proves to be successful, this will give coeliacs the option of at least occasionally following a normal diet - on social occasions, or at other times when it is difficult to adhere to a strictly gluten-free diet.

Read more here.

First published, 2006.

Click here for more research on the management of coeliac disease


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