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Celiac Hope

By Jennifer Abney Anchor

Published: Thu, August 21, 2008 - 5:10 am Last Updated: Thu, August 21, 2008 - 5:52 am

Short URL: http://wkrg.com/a/17076/

Jennifer Abney

Celiac disease is a condition marked by sensitivity to gluten, a protein found in wheat, barley and rye. When foods with gluten are eaten, the body’s immune system attacks the tiny, finger-like projections in the small intestine (called villi). Normally, the villi enable the nutrients in foods to be absorbed into the bloodstream. But when the villi are damaged, nutrients can’t be absorbed.

According to the National Foundation for Celiac Awareness, celiac disease affects nearly three million Americans. Patients may experience stomach pain, gas, bloating, fatigue or weakness, diarrhea, foul-smelling stools, weight loss and anemia. Children may fail to gain weight, have poor growth or a delay in the onset of puberty. Some other signs include: joint pain, bone loss, development of mouth sores, an itchy skin rash, tooth discoloration/enamel loss, numbness or tingling in the legs, behavioral changes and seizures.

Treating Celiac Disease
There is no cure for celiac disease. So far, the best treatment is a life-long avoidance of foods containing gluten. Researchers say if a celiac patient sticks with a gluten-free diet, symptoms usually improve within days to weeks. The most common sources of gluten are products made with wheat, rye and barley. Less common grains with gluten are kamut, einkorn, spelt and triticale. Alternative, or “safe,” products are those made from potato, rice, soy or bean flour.

Patients must also be careful to avoid hidden sources of gluten in foods like breading, broth, imitation bacon and seafood, marinades, processed meats and sauces. Gluten may be used as a binder in some pharmaceutical products. In some cases, foods may appear to be free of gluten, but may be contaminated if processed with the same equipment or tools used to prepare foods with gluten.

AT-1001 for Celiac Disease
Anthony DiMarino, M.D., a Gastroenterologist at Thomas Jefferson University Hospital, says the hallmark of celiac disease is a “leaky gut.” In the wall of the intestine, there is a tight junction, or “gate,” between the cells. A chemical, called zonulin, controls the gate, enabling it to open and close, allowing immune cells, molecules and healthy proteins to pass from the intestines into the bloodstream, and keeping “bad” proteins (like gluten) out. In patients with celiac disease, it’s believed there is an inappropriate release of zonulin, causing the gates to open. That allows the gluten protein to pass through the gate into the lining, where it causes an immune reaction.

Researchers at Alba Therapeutics are testing an oral compound, called AT-1001, which appears to block the release of zonulin. That may prevent the gates in the intestinal wall from opening inappropriately and protect the lining from gluten.

An early study compared the effects of gluten exposure in patients who took AT-1001 against those taking a placebo. The researchers found no increase in intestinal permeability (i.e., opening of the “gates”) in the AT-1001 group, while the placebo group experienced a 70 percent increase in intestinal permeability. In addition, those in the placebo group were more likely to experience gastrointestinal symptoms after eating a small amount of gluten.

AT-1001 is designed to be taken before a meal. According to the manufacturer, AT-1001 will not completely eliminate a patient’s sensitivity to gluten. Instead, it will enable patients to tolerate small amounts of the protein. Thus, patients will still need to stick to a gluten-free diet. However, Alessio Fasano, M.D., Mucosa Biologist with the University of Maryland Medical Center, says the drug may provide peace of mind for patients who like to eat out with friends and aren’t always sure if the foods they are eating are completely gluten-free. AT-1001 received a “Fast-Track” approval status from the FDA in October 2007. For more information on current studies with AT-1001, log onto: http://www.clinicaltrials.gov. Type in the trial identification numbers in the search box: NCT00492960 and NCT00620451.

For information on the clinical trials for AT1001, log onto: http://www.clinicaltrials.gov. Type in the trial identification numbers in the search box: NCT00492960 and NCT00620451.
For general information on the drug, AT1001, http://www.albatherapeutics.com

For information on celiac disease:
American College of Gastroenterology, http://www.acg.gi.org
Celiac Disease Awareness Campaign, http://www.celiac.nih.gov
Celiac Disease Foundation, http://www.celiac.org
Gluten Intolerance Group of North America, http://www.gluten.net
National Institute of Diabetes and Digestive and Kidney Diseases, http://www.niddk.nih.gov