(Gluten) (Coeliac Disease) "'Toxic trio' triggers gut disease"

Dolphin

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http://www.bbc.co.uk/news/health-10713775

I have gluten intolerance according to a urine test I did (initially designed for people with Autism) - but not Coeliac Disease. It seems sometimes gluten intolerance is said to mean Coeliac Disease but I think there is a distinction (I'm not an expert on the terminology). Anyway, the blood test showed up normal so I don't think gluten is damaging the intestine the way it does in Coeliac Disease. But I take gluten free bread etc and generally have a low (but not "no") gluten free diet. I wonder will this help people like me? Maybe others are interested also.

Health

'Toxic trio' triggers gut disease

By Helen Briggs
Health reporter, BBC News

The precise cause of the immune reaction that leads to coeliac disease has been discovered.

Three key substances in the gluten found in wheat, rye and barley trigger the digestive condition, UK and Australian researchers say.

This gives a potential new target for developing treatments and even a vaccine, they believe.

Coeliac disease is caused by an intolerance to gluten found in foods like bread, pasta and biscuits.

It is thought to affect around 1 in every 100 people in the UK, particularly women.

The link between gluten and coeliac disease was first established 60 years ago but scientists have struggled to pinpoint the precise component in gluten that triggers it.

The research, published in the journal, Science Translational Medicine [http://stm.sciencemag.org/], studied 200 patients with coeliac disease attending clinics in Oxford and Melbourne.

The volunteers were asked to eat bread, rye muffins or boiled barley. Six days later they had blood samples taken to measure their immune response to thousands of different gluten fragments, or peptides.

The tests identified 90 peptides that caused some level of immune reaction, but three were found to be particularly toxic.

Professor Bob Anderson, head of the Walter and Eliza Hall Institute of Medical Research [http://www.wehi.edu.au/about_us] in Melbourne, Australia, said: "These three components account for the majority of the immune response to gluten that is observed in people with coeliac disease."

Coeliac disease can be managed with a gluten-free diet but this is often a challenge for patients. Nearly half still have damage to their intestines five years after starting a gluten-free diet.

Professor Anderson said one potential new therapy is already being developed, using immunotherapy to expose people with coeliac disease to tiny amounts of the three toxic peptides.

Early results of the trial are expected in the next few months.

COELIAC DISEASE
Coeliac disease is an autoimmune disease
Gluten found in wheat, barley and rye triggers an immune reaction in people with coeliac disease
This damages the lining of the small intestine
Other parts of the body may be affected
Source: Coeliac UK


Sarah Sleet, Chief Executive of the charity Coeliac UK, said the new finding could potentially help lead to a vaccine against coeliac disease but far more research was needed.

She said: "It's an important piece of the jigsaw but a lot of further work remains so nobody should be expecting a practical solution in their surgery within the next 10 years."

The symptoms of coeliac disease vary from person to person and can range from very mild to severe.

Possible symptoms include diarrhoea, nausea and vomiting, recurrent stomach pain, tiredness, headaches, weight loss and mouth ulcers.

Some symptoms may be mistaken as irritable bowel syndrome or wheat intolerance.
 

Misfit Toy

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I have gluten sensitivity and think most CFS folks do. I never used to before becoming ill. I have tried to avoid wheat but it's impossible. I refuse to not go out and eat. I like getting out of the house and have even found that eating a cookie every now and then doesn't kill me or even affect me. There have been times in the past where I have had to run to the bathroom but it's not often. I buy gluten free breads and eat cereals like Quinoa and amaranth. It's just another piece of the puzzle with this illness.
 

dannybex

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Digestive enzymes for Gluten / plus VSL3 probiotics...

I also was diagnosed with (mild) gluten intolerance a few years ago. I agree w/Spitfire that it may be likely that a decent percentage of people w/CFS might be gluten intolerant.

There are a couple of digestive enzyme products that have actually been shown to be quite helpful for people w/gluten and casein intolerance. They're not recommended for people with outright celiac disease.

The first is called Peptizyde -- a google search will turn up a lot of info, and a lot of 'success stories' (especially with autistic-spectrum kids who were on gluten-free/casein free diets). I've tried it before and in hindsight think it really helped, esp with pain and brain fog (and mood swings).

And there's a newer, reportedly more effective product called Glutenease, made by Enzymedica -- which helps digest not only the protein parts, but the carb parts of the gluten grain.

Here's just one link to both products, and also other enzyme formulas (they're not sold on the site, just has a lot of info:

http://www.enzymestuff.com/basicsproductguidelines.htm

Also, the pricey probiotic VSL3 has been shown in clinical studies to digest gluten when it's added to the flour. Not sure if it would help digest gluten in the gut...but it is intriguing.

Having said all that, there is a doctor -- Dr. Kenneth Fine, who claims that those with gluten intolerance may eventually develop full-blown celiac if they keep eating gluten grains. I haven't emailed him yet, but I wonder if using the enzymes might help prevent that.

???
 

Rosemary

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Scientists Claim to Isolate Molecular Trigger for Celiac Disease

In a breakthrough that may pave the way for the development of the first drug treatments for celiac disease, researchers claim to have identified the molecular triggers for the chronic, painful gut disorder.

http://www.celiac.com/articles/2223...lecular-Trigger-for-Celiac-Disease/Page1.html

Since people with celiac disease must remain gluten-free for life, and since many foods are contaminated with gluten, many people with celiac disease are at risk of developing intestinal damage and other associated problems over time, says Robert Anderson, senior author of the study, and head of the celiac disease research laboratory at the Walter and Eliza Hall Institute of Medical Research in Parkville, Australia.

In Anderson's view, developing a drug that would control the immune response to gluten "would be a much more efficient way of dealing with celiac disease."

However, he adds, a lack of understanding about how gluten triggers the immune system response in celiacs has prevented researchers from pursuing such therapies.

Gluten is actually made-up of numerous different protein strands, and, until now, no one has teased out just which protein strands are inducing the immune response seen in celiac disease.

To design drugs that will effectively treat celiac disease, scientists must first understand exactly which of the gluten are triggering the immune response.

For their study, Anderson and his associates analyzed immune responses in blood samples from more than 200 celiac disease patients who had eaten meals containing gluten.

The team then performed thousands of gluten challenges on the samples using isolated fragments of gluten protein. Interestingly, of the thousands of gluten fragments they tested, only three of them triggered an immune reaction.

That only three of the thousands of protein fragments in gluten provokes an immune response suggests that "a very precise trigger is driving the immune response" in celiac disease, Anderson said. "The problem is not so much gluten, it's really these three peptides."

The authors also noted that most of the immune response to gluten appears tied to a single type of immune system cell, called the T cell. Their results appear in the July 21 issue of Science Translational Medicine.

According to Dr. Alessio Fasano of the University of Maryland School of Medicine in Baltimore, even with strong evidence against the three peptides in question, there may be more to the story. It's possible that the study missed other offending protein fragments, and that there are more players in the adverse immune response in people with celiac disease.

Interestingly, sequences from ω-gliadin (wheat) and C-hordein (barley), rather than α-gliadin, proved to be the immunodominant trigger, regardless of the grain consumed.

But before folks with celiac disease get too worked up about a possible cure, they need to remember that, because the study looked at patients with a particular genetic susceptibility to the disease, the findings do not apply to all people with celiac disease.

Although most people with celiac disease share this genetic background, others do not. That means the findings won't apply to everyone with the disease. Anderson and his colleagues are currently working to identify which gluten proteins induce the immune response in the other celiac patients.

The limited diversity of pathogenic T cells in celiac disease indicates that researchers should be able to develop peptide-based treatments for both celiac disease and likely for other HLA-restricted immune diseases.

Phase I clinical trials of a drug based on the three isolated fragments of gluten protein are currently underway in Australia.

Researchers hope the drug will successfully desensitize celiac patients by introducing small amounts of the offending proteins under controlled conditions. They expect results within the next couple of months.

The current study received funding from Nexpep, the Australian National Health and Medical Research Council, Coeliac UK, the Coeliac Research Fund, and others.

Source:

Sci Transl Med 21 July 2010: Vol. 2, Issue 41, p. 41ra51
 

Dolphin

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I also was diagnosed with (mild) gluten intolerance a few years ago. I agree w/Spitfire that it may be likely that a decent percentage of people w/CFS might be gluten intolerant.

There are a couple of digestive enzyme products that have actually been shown to be quite helpful for people w/gluten and casein intolerance. They're not recommended for people with outright celiac disease.

The first is called Peptizyde -- a google search will turn up a lot of info, and a lot of 'success stories' (especially with autistic-spectrum kids who were on gluten-free/casein free diets). I've tried it before and in hindsight think it really helped, esp with pain and brain fog (and mood swings).

And there's a newer, reportedly more effective product called Glutenease, made by Enzymedica -- which helps digest not only the protein parts, but the carb parts of the gluten grain.

Here's just one link to both products, and also other enzyme formulas (they're not sold on the site, just has a lot of info:

http://www.enzymestuff.com/basicsproductguidelines.htm

Also, the pricey probiotic VSL3 has been shown in clinical studies to digest gluten when it's added to the flour. Not sure if it would help digest gluten in the gut...but it is intriguing.

Having said all that, there is a doctor -- Dr. Kenneth Fine, who claims that those with gluten intolerance may eventually develop full-blown celiac if they keep eating gluten grains. I haven't emailed him yet, but I wonder if using the enzymes might help prevent that.

???
Thanks a lot for this, Dannybex. I don't follow treatment stuff that closely and hadn't heard of this stuff.

I showed up as sensitivity to gluten but not casein in the urine test - it just tested those two things.