Early Exposure to Gluten May Help Babies Avoid Celiac Risk: Study

By Kathleen Doheny

HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Modifying an infant's diet to include the protein gluten while the mother is still breast-feeding could lower the risk of celiac disease, a common intestinal disorder, according to a new Swedish study.

That finding may sound counterintuitive, because celiac disease is a condition in which the lining of the small intestine is damaged by gluten-containing foods.

However, the researchers who conducted the study speculate that there may be a window of opportunity in which an infant can develop tolerance to the protein to possibly escape getting the disease.

"We now have proven this way of introducing gluten reduces the risk of getting celiac disease," said Dr. Anneli Ivarsson, a pediatrician at Umea University in Umea, and lead author of the study published online Feb. 18 and in the March print issue of the journal Pediatrics.

Gluten refers to proteins found in specific grains, including all forms of wheat and related grains such as barley and rye, according to the Celiac Disease Foundation.

Celiac disease affects about 1 percent of the population, according to Ivarsson. Genetic susceptibility plays a role. For those affected, a life-long gluten-free diet is advised.

Ivarsson and her team compared two groups of Swedish children: one born in 1993, during a time when the diagnosis of celiac disease increased four-fold, and the other group born in 1997, when it declined about the same amount. The children born later had a 25 percent lower risk of having celiac disease than those born earlier, they found.

"That's quite a lot," Ivarsson said.

While 2.9 percent of those in the earlier born group had the disease, 2.2 percent of those in the later-born group did.

The beginning and the end of the period in which the celiac disease diagnoses rose were both marked by changes in recommended feeding of infants, including the best age to introduce gluten-containing foods, the researchers noted.

In 1982, experts recommended that gluten-containing foods not be given until an infant was 6 months old. In 1996, the experts recommended that gluten be introduced from 4 months on.

Experts know that a baby develops what they call oral tolerance to an antigen (a substance that produces protective antibodies) early in life. Celiac disease ''can be viewed as a failure to develop oral tolerance to gluten, or a later loss of this tolerance," Ivarsson wrote in her report.

In her study, babies born in the later group, who were introduced to gluten-containing foods at 4 months on, were less likely to develop celiac disease.

"We can't prove there is a window of opportunity" for developing tolerance, Ivarsson said, but that is one speculation.

The findings suggest -- but don't prove -- that gradually introducing gluten-containing foods in small amounts from 4 months of age, ideally while breast-feeding is ongoing, may protect against celiac disease.

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A Pill So People With Celiac Disease Can Eat Freely?

By Barbara Bronson Gray

HealthDay Reporter

FRIDAY, Feb. 8 (HealthDay News) -- For people with celiac disease, everyday foods such as bread, pizza crust and muffins are potential enemies. But scientists anticipate that some day a simple pill could help prevent the digestive upsets caused by ingesting the gluten in wheat, rye or barley products.

The only current treatment for celiac disease is a gluten-free diet. A new study, however, offers some potential for hope. Researchers have re-engineered a naturally occurring enzyme, kumamolisin-As, to break down gluten in the stomach into much smaller protein pieces, called peptides. They say these are less likely to trigger the autoimmune response that can create a wide range of painful and irritating symptoms.

The re-engineered enzyme, named KumaMax, appears to be highly effective, at least in a test tube. It dismantled more than 95 percent of a gluten peptide that is thought to cause celiac disease, according to the study, which was published recently in the Journal of the American Chemical Society.

Ideally, the team could develop the enzyme into a food additive such as the gas remedies Beano or Gas-X and offer it without a prescription, said lead study author Justin Siegel, assistant professor of chemistry and biochemistry at the University of California, Davis. But this could take a few years to develop. If the researchers opt to make a prescription drug, the process of clinical trials and obtaining U.S. Food and Drug Administration approval could take a decade or more, he said.

An enzyme is a protein that performs a chemical reaction. Proteins are the workhorses in every cell of every living thing, and their function is defined by their shape and structure.

In this case, the researchers re-engineered the natural enzyme to recognize the peptide that triggers celiac disease and modified the protein in the laboratory so it would survive the acidic stomach environment. "We did the engineering to change the genes and sent that into standard microorganisms to create the protein," Siegel said.

The next step is to show that the enzyme is not toxic and functions as designed in animals. "It shouldn't be toxic; it's just a protein you're eating," Siegel said.

How effective might the enzyme be? "For some people, even flour in the air makes them stop breathing. Some are very sensitive, and in some it just upsets their stomach a little," Siegel said. "For those who are hypersensitive, this probably is not going to solve the problem, but it would allow them to go to dinner, and in case any gluten ended up in their meal, they wouldn't have to worry about it."

"For those less sensitive, they could pop one before each meal and eat anything they want," he added.

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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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Scientists Working Toward Pill for Celiac Disease

ByBrenda Goodman, MA
WebMD Health News Reviewed byBrunilda Nazario, MD

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.

Gluten-Free Diet: Getting Started

Other Research Also Under Way

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.”

Tough to Avoid Wrong Foods

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.

View Article Sources

SOURCES:

Gordon, S. Journal of the American Chemical Society, Nov. 15, 2012.

Joseph A. Murray, MD, gastroenterologist, Mayo Clinic, Rochester, Minn.

Justin B. Siegel, PhD, assistant professor of biochemistry and molecular medicine, and chemistry, University of California at Davis, Davis, Calif.

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