Scientists Working Toward Pill for Celiac Disease

Dec. 21, 2012 -- Scientists say they’re working on a pill that may one day help people with celiac disease tolerate foods that contain gluten, a protein that is found in wheat and other grains.

“It would be pretty much like the Lactaid pill,” says researcher Justin B. Siegel, PhD, an assistant professor of biochemistry and molecular medicine, and chemistry, at the University of California at Davis, referring to a product that helps people who get an upset stomach when they drink or eat dairy foods.

In a study published in the Journal of the American Chemical Society, researchers describe testing a new enzyme called KumaMax that breaks down gluten.

In a test tube, the enzyme -- which was discovered in bacteria that live in Japanese hot springs and modified slightly in the lab -- dismantled more than 95% of a protein component that’s thought to trigger celiac disease.

The enzyme hasn’t yet been tested in people. Researchers say that’s the next step.

They aren’t the only group working on this kind of a treatment for celiac disease, says Joseph A. Murray, MD, a gastroenterologist and celiac disease specialist at the Mayo Clinic in Rochester, Minn.

Murray recently reviewed experimental approaches for treating celiac disease, but he was not involved in the research.

A company called Alvine pharmaceuticals is also testing an enzyme-based pill. Early results show that people with celiac disease who got the experimental pill had less damage to their small intestine after eating food containing gluten compared to those who got a placebo. But larger studies are needed to confirm those results.

Even if the pills work, they “won’t be a passport to eating gluten with impunity,” says Murray.

“It probably will only reduce your sensitivity to gluten, it won’t block it. Instead of taking in no gluten, you might be able to take in the equivalent of half a slice of bread and get away with it. It’s very unlikely that you could eat a pizza and get away with it,” says Murray, who has been a paid consultant for Alvine.

“It may make life better, but it’s really an adjunct to the continued effort to be gluten-free.”

In celiac disease, gluten proteins trigger an immune system attack on the lining of the gut. Over time, damage prevents the absorption of important nutrients and may lead to vitamin and mineral deficiencies that cause hair loss, depression, and brittle bones.

Currently, the only treatment for celiac disease is to avoid foods that contain gluten.

Murray says many of his patients find that despite their best efforts to avoid wheat, they end up eating some at least once a month because it turns up in foods they didn’t prepare themselves or because they can’t say no to a favorite treat.

“It’s very difficult to avoid. We’re in a very gluten-rich environment,” Murray says.

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