Is there a cure for celiac disease?

Source: Web exclusive, October 2010

According to the Canadian Celiac Association, an estimated one in 133 persons in Canada is affected by celiac disease, an autoimmune condition triggered by the consumption of gluten.

Gluten is a protein that tends to exist in carbohydrates such as wheat, barley, rye and kamut (and may also be found in products such as medications, vitamins, and lip balms), which causes inflammation and damage to the inner lining of the small intestine in those with celiac disease. This damage reduces the body’s ability to absorb key vitamins and nutrients such as iron, protein, calcium and vitamin D.

Symptoms of celiac disease are wide ranging and vary from person to person. However, common symptoms include anemia, fatigue, chronic diarrhea, weight loss, abdominal pain and bloating.

It is very important to receive proper diagnosis before switching to a gluten-free diet, says Kate Comeau, registered dietitian at atp nutrition in Montreal. She notes that your physician can order a blood test to screen for specific antibodies, but a biopsy is the only way to be really certain. In a small bowel biopsy, a gastroenterologist tests a piece of the small intestine for signs of inflammation and/or destruction of the villi (small projections on the walls of the intestine that aid in digestion and absorption of nutrients).

New research on celiac disease

Currently, the avoidance of gluten and gluten contamination is the only treatment for celiac disease, however recent research published in the journal Science Translational Medicine identified the three fragments in gluten’out of approximately 16,000 components’that cause intestinal damage. The key fragments in gluten are made up of sequences of amino acids that are broken down in the digestive systems of healthy individuals, but not broken down in those with celiac disease. This has led to the design of an injectable drug containing very small doses of each of these three components. The vaccine would expose the immune system to very small but regular doses of these three fragments, allowing the body to gradually get used to them. The hope is that the vaccine will target the immune response to these fragments, eventually allowing those with celiac disease to consume gluten.

What do experts think about this vaccine?

‘When I work with someone who has celiac disease, the most challenging part for them is the risk of contamination, as even trace amounts of gluten can cause damage to their intestines,’ says Comeau. ‘If my clients no longer had to worry about contamination, it would be a huge relief for them.’ However, advancements in science, such as this vaccine, must be rigorously tested in clinical trials before health care professionals can offer them.

Dr. Natasha Turner, naturopath and author of The Hormone Diet, says the vaccine may not be a miracle solution that leads to immunity, and advises that it may only ‘desensitize’ those with the disease. ‘There is no guarantee of how the patient will react, and the only way to regularly check to see if you have been ‘cured’ is through repeated endoscopy and small intestine biopsies, which are expensive and not enjoyable for patients,’ says Turner.

The rapid increase in those suffering from celiac and gluten intolerances has often been attributed to the increased gluten potency in foods, especially manufactured products. ‘Our bodies then pass a ‘tipping point’ where our genetic predisposition to celiac disease turns into an active disease. We have to consider the consequences that, if we take this vaccine, will we then continue to eat gluten even though it’s causing an allergic reaction in our body,’ says Turner.

Is it too soon to be hopeful?

The need for extensive testing of the vaccination in a three-phase trial in Melboure, Australia means that it will take several years before the vaccine reaches Canada, however Comeau says it is never too early to be hopeful. She encourages her clients to focus not only on advancements, but also on improvements in early diagnosis and the influx of gluten-free products on the market. ‘It is important that those with celiac disease continue to follow a gluten-free diet to avoid nutrient deficiencies, and to seek assistance from a dietitian or health care professional if they have recurring symptoms, are struggling to make choices, or if they are feeling frustrated.’

5 tips for living gluten-free

If you are living with celiac disease and are trying to adopt a gluten-free diet, Comeau offers these five tips:

‘ Focus on the "can-have" foods, not the "can’t have." Nuts, beans, lentils, fruits, vegetables, meat, fish and dairy are all gluten free!

‘ Incorporate gluten-free whole grains, such as amaranth and flaxseed, as well as legumes, such as lentils and black beans, to ensure you are getting enough fibre.

‘ Read ingredient labels every time you buy something. Product formulations can change without warning so even products you trust as being gluten free can change.

‘ Introduce friends and family to gluten-free meals and encourage them to help you find gluten-free recipes‘no need to be the only one eating rice noodles.

‘ Find foods you love! Go to local farmers markets, experiment with fresh herbs and spices and try at least one new gluten-free product per week until you’ve found your favourites.

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