Celiac enzymes may enable patients to eat wheat

Currently, a gluten free diet is the only way to manage celiac disease. But new drugs in clinical trials with humans, as well as more in the pre-clinical phase, may one day allow people with the disorder to enjoy gluten again.

These options are still years from commercial availability, but early results have been encouraging, according to a review of the drug pipeline in Gastroenterology Report.

“Based on data on ClinicalTrials.gov, there are two investigational products we are aware of which may enter large confirmatory trials in the not too distant future,” said lead author Dr. Klaus Gottlieb, senior medical director of the immunology and internal medicine department for Quintiles, a company that provides bio-pharmaceutical development services and consulting in Durham, North Carolina.

One of them is an enzyme that splits the molecule in wheat that causes celiac disease, gluten, into smaller harmless products and another one promises to make the gut less leaky and thus prevent potentially toxic substances (from) reaching deeper layers where they may cause inflammation,

For one potential oral therapy, patients take a mixture of two enzymes that split the gluten molecule into smaller harmless products. In a trial of adults with celiac disease, those taking this drug had no change in their intestinal biopsies after eating gluten, while those taking a placebo did have evidence of injury to the intestinal lining.

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