By Tracy Hampton, PhD, BIDMC Correspondent

Celiac disease is one of the most common autoimmune gastrointestinal disorders—its prevalence is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Experts say that the majority of cases are undiagnosed due to a lack of awareness and education of the disease among primary care physicians, as well as the atypical symptoms that patients tend to present.

(Photo: iStockphoto)

(Photo: iStockphoto)

An abnormal immune response in patients with celiac disease damages the lining of the small intestine and prevents it from absorbing certain nutrients from food, which can lead to reduced bone mineral density, impaired quality of life, and even an increased risk of premature death. In some affected individuals, even small amounts of gluten in the diet can cause the body to mount an immune reaction that leads to abdominal pain and diarrhea.

Because gluten is found in so many foods—from bread to soups to salad dressings—researchers have been working to find treatments for Celiac disease that do not require patients to drastically alter their diet.

“There are three drugs in clinical testing: one tightens the barriers between the cells of the intestine to not let gluten in, one degrades gluten in the stomach like a lactaid, and one is an allergy shot–like approach to re-induce gluten tolerance by the immune system,” explains Dr. Daniel Leffler, Director of Research at Beth Israel Deaconess Medical Center’s Celiac Center, the only multidisciplinary center in New England specializing in the care of patients with celiac disease and gluten-related disorders. “BIDMC has been a major site for work done on the first two therapies, both in phase 2 clinical trials,” Dr. Leffler adds.

The first agent, called larazotide acetate, prevents the opening of cell-to-cell connections triggered by bacterial proteins, gluten fragments, and other stimuli. The second, called ALV003, is an orally administered mixture of two recombinant proteases (cysteine endoprotease B-isoform 2 and prolyl endopeptidase) engineered to degrade gluten into non-immunogenic fragments by targeting certain components common in gluten. The third, called NexVax, is a vaccine that is designed to reprogram gluten-specific immune cells.

BIDMC’s Celiac Center offers a web site called CeliacNow as a resource for people living with Celiac disease and other gluten-related disorders. In addition to offering tips on nutritional management, the site also includes a section that highlights research efforts on treatments and other aspects of Celiac disease.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted September 2013