October 17, 2009

 

Celiac Disease – The Future

This post is fourth in a series.  You can read the first three posts here:

Celiac Disease – A Little History
Celiac Disease – Three Causes
Celiac Disease & Leaky Gut

There are approximately 110,000 people in the U.S. diagnosed with celiac disease.  According the the prevalence study done by the Center for Celiac Research, there are 3 million people who actually have the disease.  The incidence of celiac disease is also increasing over time and seems to double every 17 years (along with other autoimmune diseases).

Screening everyone for celiac is not cost effective, but screening symptomatic people is. As many of you know, going for years without diagnosis is costly both financially and in the price your body pays.  Early detection saves money and is better for everyone.

Point of Care Test – This pregnancy type test for celiac disease is available in Canada.  Dr. Fasano does not see it as being a good alternative for diagnosis for the average person.  He sees its uses as being limited to needing a diagnosis in the middle of nowhere, or for someone already diagnosed  to see if they might be getting cross contamination somewhere.

Diagnostic algorithms – These could be used in the future to avoid biopsy.

Prevention – A study on children (with a first degree relative with celiac) is in the early stages to determine if introducing gluten into a diet later (12 months rather than 6 months of age) allows the immune system to develop more fully and prevent the development of celiac disease. 

Drug treatments – There are a number of clinical trials going on in different parts of the world.  Each addresses the problem at a different stage in the process.  The gluten free diet  address stage zero.  If you don’t let gluten enter the body, the other steps cannot take place.  This is still the best treatment for celiac disease. Other treatments being tested include a vaccine, and enzymes found in bacteria which would break down gluten so it was not seen as a problem.  Gluten is a protein that is not completely digested by anyone.

The drug being tested by Alba Therapeutics here in the U.S. (I took part in the trial in 2006) is aimed at fixing the problem of leaky gut.  They are in phase III of the trials, so the drug has come a long way in the process of being approved, but at this stage, only 2 or 3 out of 20 drugs are actually approved.

If approved, it is a drug that would be taken before eating.  Dr. Fasano sees its uses as being limited to: a) people such as teenagers who will not comply with the diet, b) being used as a safety net when eating in somewhat risky situations c) being used for an occasional piece of birthday cake.  He would not recommend it to be used in place of the gluten free diet.

Dr. Fasano encouraged us more than once to not complain.  In the spectrum of autoimmune diseases, celiac disease is the one to have.  Because the environmental trigger is known, we have an effective, drug-free treatment in the form of the gluten-free diet.  Let’s all take heed and be thankful.

This is the last post in this series.  For more information as well as detailed pictures, read Dr. Fasano’s article in Scientific American entitled “Surprises from Celiac Disease.”

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Comments:
Honestly, the drug stuff weirds me out. I know people are always looking for quick fixes, and that some people have horrific reactions to gluten (mine aren't that severe), but one of the great things about celiac is that it is a drug-free disease. Yes, we have to avoid gluten, but thats not horrible in my mind.

Also, I know that even on a drug, I wouldn't eat any gluten on purpose. I was too sick for too long.

Anyways, great post & awesome series =D.
 
This series has been informative. Thank you. I do wonder about these drugs they create...I'm skeptical though about putting drugs in my body, especially new ones. I'd rather just do without the gluten, honestly! :)
 
I enjoyed reading your series of posts. I am glad that in the future there will be an alternative to the biopsy. Thanks, Linda for keeping us updated with the latest developments.
 
Thanks for the info! I'm glad that there may soon (?) be an alternative to the biopsy...especially for children.
 

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