Navigating the wheat free, gluten free diet

If you, like me, have settled into the gluten free diet, have learned (or are starting to learn) to navigate its healthy highs and frustrating lows, then an alternative treatment to Celiac Disease might not be at your top list of priorities.  But for some celiacs (and, studies have shown, maybe for all celiacs), a GF diet isn’t good enough.  Luckily, according to the December/January issue of Living Without magazine, there is a hope for supplementary treatment for CD and a full-on cure may not be too far in the future.

celiac pill

Photo from Living Without

Here’s some interesting tidbits of the article (in purple).  To read it in its entirety, subscribe to Living Without here.

“‘There’s growing evidence in the medical literature and in clinical experience that if a repeat endoscopy is performed, many adults on the gluten-free diet have persistent damage to the small intestine,’ reports Alessio Fasano, MD, medical director of the University of Maryland Center for Celiac Research.

“A 2007 study found that some degree of intestinal damage was observed in approximately 25 percent of children and over 80 percent of adults with celiac disease when follow-up biopsies were performed.”

In the back of my mind, I knew this was probably true, given the risks of cross contamination and the fact that I still feel gluten-sick at least once a month.  Still, it’s disheartening to hear that the only treatment for the condition you have isn’t all that effective.

One of the new drugs the article mentioned is ALV003, being developed by Alvine Pharmaceuticals.  It’s designed to prevent an immune response to gluten.

“’No humans fully digest gluten,’ explains Daniel C. Adelman, MD, senior vice president of development and chief medical officer of Alvine Pharmaceuticals, located in San Carlos, California. ‘When we eat gluten, we digest it down to a protein comprised of about 33 amino acids.’ But that large a protein can be immunogenic—capable of stimulating an immune response in those with celiac disease. ALV003 chops up the gluten protein further than the digestive system does naturally, with the hope of rendering it harmless.

“‘If you can degrade gluten into smaller fragments, fewer than nine amino acids in length, you can destroy its immunogenic potential,’ says Adelman.”

Pretty fascinating stuff.  It should be noted that these drugs are designed to collaborate with a gluten free diet, to prevent if not eliminate the effects of cross contamination.  They are not cures.  However, a cure may be on the horizon.

“Australian researchers just completed the first clinical trial on a peptide-based vaccine known as Nexvax2, which exposes the immune system to very specific, small amounts of gluten fragments (peptides) with the idea that repeated small exposures will help induce the immune system to once again tolerate gluten. It’s a concept not unlike allergy shots.”

“’The long-term ambition of Nexvax2 is to replace the need for the gluten-free diet and to prevent celiac disease,’ says Bob Anderson, PhD, director of Nexpep, the biotechnology company that developed Nexvax2 and is running the clinical trial.”


It is unclear, as of yet, how long it would take for a Celiac’s body to begin tolerating gluten again, but the findings  and animal-based studies do seem promising.  How amazing would it be to be able to order a gourmet sandwich, an artisan pizza, or even a big mac?  Unfortunately, this miracle drug won’t be hitting pharmacies tomorrow.

“’There’s a real possibility that in the next 10 to 15 years, we will be able to offer celiac disease patients an alternate treatment for the gluten-free diet,’ says [Bana] Jabri [MD, PhD, co-director of the University of Chicago Digestive Disease Research Core Center]. “We can even dream today of being able to identify a preventive cure for individuals at high risk of developing celiac disease. This is something we wouldn’t have said even five years ago. There’s been lots of progress.”

But before getting too disheartened over what seems like a long way away, remember how far the gluten free diet has come just in the last few years.  The market is huge and is continuing to grow.  Eating out is easier than ever.  Until the day comes when there is another treatment out there, it is up to no one but us to prevent cross contamination, not take risks, and keep coming up with delicious gluten free foods.



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