Archive for the ‘Research into Coeliac Disease’ Category

In 2008 a trial which involved reintroducing hookworms into patients with coeliac disease was commenced in Brisbane, Queensland. The first phase was completed in 2009. While 2010 has seen the trial roll over into a second extended phase. The results have been presented at several national and international meetings and publication of the results is pending. 

The trial is based around the theory of the “hygiene hypothesis” which in brief, suggests that as we’ve become cleaner (or more hygienic) we have effectively removed parasites from our bowel. These are organisms with which humans have co-evolved with over tens of thousands of years, and to which our immune system may have developed a symbiotic dependent relationship – i.e. each helping the other to ensure their normal function and survival. By effectively removing these parasites we may have allowed our immune system to be overactive in certain areas which may have predisposed us to certain “autoimmune conditions” such as coeliac disease. This theory is supported by the observation that as we have improved our “cleanliness” and availed ourselves of better medical care we have not only seen a dramatic decrease in traditional infectious diseases such as rheumatic fever, hepatitis and tuberculosis, but over the same period of time we have witnessed a dramatic corresponding increase in “autoimmune diseases” such as Coeliac disease, Crohn’s disease, Multiple Sclerosis and Type I diabetes.

In this trial which was supported by the Broad Medical Research Program in Los Angeles, twenty people with coeliac disease in remission were enrolled. They were inoculated with either hookworm or placebo, and all underwent a gluten challenge consisting of four pieces of white bread twice a day for 5 days after twenty weeks. They all had gastroscopies pre and post gluten challenge. The results have been positive and suggest the possibility of modulating the immune system with parasites is possible. Those who initially received the placebo have now been inoculated with hookworms and will undergo a repeat gluten challenge with biopsies.

Pictures above:  Dr James Daveson Inoculating the first participant in the hookworm in coeliac disease trial – Hugh Sheardown (President of the Queensland Coeliac Society) and (at left) the hookworm.

Click here for February 2010 ABC Catalyst Report

The effect of plant enzyme supplementation on duodenal histology in coeliac patients maintaining a gluten free diet.

Help may well be on the way for the many coeliacs who, at some time or another, encounter difficulties with the choice of food for their gluten-free diet. We would like to evaluate an improved treatment for coeliac disease based on natural enzyme supplements. This work follows an earlier successful trial which was conducted under supervision of Professor Finlay Macrae.

Professor Finlay McCrae and his research team at Melbourne Health are investigating plant enzyme therapy in the management of coeliac disease. During a six week trial treatment, some volunteers will take treatment whilst others will be given a placebo. The changes in the gut will be monitored and villous atrophy assessed before and after the research period as well as the level of tTG in the blood.

Glutenon has been registered by the Australian Therapeutic Goods Administration as an enzyme supplement aid for gluten digestion. The registration number is AUST L 154806.  Glutenon is now being evaluated for management of coeliac disease.  It is hoped that Glutenon will be able to serve as a safeguard for people on a gluten-free diet, help people who are travelling or are exposed to foods of uncertain origin when going out with friends.

The trial is sponsored by the Coeliac Research Fund and has ethics approval by the RMH Human Research Ethics Committee.  For further information on the study contact Virginia Bird virginia.bird@mh.org.au.

Stage 1 clinical trials into a vaccine for coeliac disease commenced on 21 April 2009.

An effective clinical treatement for coeliac disease is the ultimate objective of WEHI clinical scientist and Chairman of the CRF Board, Dr Bob Anderson.  This month will see the beginning of phase 1 clincial trials for an experimental vaccine in Melbourne.   If the vaccine development of Dr Anderson and his scientific team prove successful, a strict gluten free diet for coeliacs could become a thing of the past, whilst previously undiagnosed coeliacs could be detected and spared premature deaths.

Using forty volunteers who suffer from coeliac disease, the early trial will test for drug safety - in partiuclar, an appropriate drug dose range will be ascertained and any adverse effects will be noted.  If within the course of a year the Phase 1 trail is deemed successful, a Phase 2 trial will beckon to determine the clinical  effectiveness of the vaccine.

Dr Anderson said, “As both a coelic disease researcher and treating gastroenterologist, I am in an interesting postion.  I have overseen my basic scientific discovery about the troublesome elements in gluten being translated into an experimental vaccine that may eventually help patients. ”

It is hoped the vaccine will gradually desensitize the coeliac suffer so that gluten is tolerated and the villi in the small intestine should revive and absorb nutrients in the normal way.  Ideally that would mean the end of a gluten free diet for people with coeliac disease.