For decades, celiac disease has been treated solely by a gluten-free diet. This proof-of-concept paper shows that a digestive enzyme engineered to specifically break down gluten proteins seems to be effective at preventing damage of the intestine.
Normally, patients with celiac disease on a gluten-free diet are challenged with gluten. The challenge induces inflammation or irritation of the intestine and symptoms. This study from Finland uses a novel preparation of two, custom designed enzymes that break down the particular damaging parts of the gluten proteins. The two enzymes combine in a way to increase the maximum efficiency of breaking down the parts of gluten that drive the disease.
In this clinical study, patients with well-treated celiac disease on gluten-free diet and healed intestines were challenged with gluten at a dose that would induce injury. In the group that received the placebo, there was significant injury seen. The patients that received the drug were protected from this damage to a significant degree.
What does this mean for people with celiac disease? This is an experimental agent being studied in a large international study, including North America, in patients with symptomatic celiac disease. The hope is that it can improve the damage or inflammation to the intestine while also improving symptoms. There are many challenges before this drug, or other drugs, can reach the marketplace. There are more studies underway with other agents and it's an exciting time to be involved with celiac disease.
Read the full study online here.
For more information on celiac disease, visit mayoclinic.org/celiacdisease.
Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.