Celiac is an autoimmune disease, and because there is no cure for it, it is something that simply must be managed in order for the CD patient to lead as normal a life as possible. If we don't follow a strict diet, we suffer the consequences-- there is no way around it. What makes the diet so difficult to follow is inadvertently our own family and friends. They are not aware that just because a package does not say "gluten" in the list of ingredients, a food is safe. They are not aware of the hidden sources lurking in almost every prepackaged food product. They are not even aware of the dangers of cross-contamination in their own kitchens while trying to do their best to feed a gluten-sensitive friend.
Going gluten-free is expensive, and difficult. According to the LA Times, a doctor in Australia, Robert Anderson, is working on a vaccine which might actually work as a switch to shut off reactions to gluten, or even prevent a reaction to gluten. It is possible that in the future, a CD patient will be able to receive shots similar to allergy shots, or to take a pill before a meal, just as one might take a pill to prevent heartburn or indigestion. These are just two different categories of treatments that are currently being developed to help people with CD.
According to the article, enzyme therapy is one method in which enzymes are combined from bacteria and barley and will break down gluten into smaller fragments, causing less inflammation of the intestines. Alvine Pharmaceuticals (in California) is calling it "glutenase therapy" and has even gone as far as recruiting participants for a clinical trial. Of course, the particpants must be confirmed CD patients (through intestinal biopsy) and also must have the disease under control by following a g-free diet. The standard test will be with the drug or placebo, followed by a gluten challenge-- usually a couple slices of bread. I hope they are being paid well, because I wouldn't want to end up being the ones on the placebo or otherwise! Yet, so far, the study seems to be gaining some momentum.
Alba Therapeutics (in Maryland) has come up with their own bioengineered drug for this enzyme therapy, called larazotide. The drug doesn't remove the gluten peptides, but is supposed to prevent them from causing an immune reaction. Though I am all for life-saving medicines, I am not real fond of introducing any new drugs into my system if I can help it, especially one that is bioengineered. Regardless of my personal skepticism, patients in this clinical trial are apparently seeing some benefits and are less symptomatic after eating gluten.
Immunotherapy is another treatment that is being examined by scientists and doctors and actually sounds the most promising to me. The doctor in Australia, Dr. Anderson, is working on a vaccination that will depress or desensitize the immune reaction, just as with allergy shots. By placing these peptides under the skin (as opposed to in the gut), the body learns to tolerate them, and in theory will turn off the reaction that causes so much damage to the intestines.
If these ideas are too high-tech for you, there is always the good old-fashioned remedy: hookworms. That's right! According to the LA Times:
"Researchers at the Brisbane Princess Alexandra Hospital in Queensland, Australia, tested the effects of hookworm inoculation on 20 patients with celiac disease to see if it would blunt the immune response to gluten. In addition to hoping to provide relief for celiac patients, the researchers want to learn if this could be an effective therapy for inflammatory bowel disease and Crohn's disease" (The Los Angeles Times, Dec. 21, 2009).
Though the results of the hookworm test have not yet been published, it should be duly noted that the "patients were offered a medication that would kill the parasites, they all opted to keep their hookworms."
Need we say more?
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