New Treatment For Gluten Enteropathy?

Gluten is a mixture of the proteins gliadin and glutenin and is contained in all products originating from cereals - wheat, barley, rye and oats.

Gluten enteropathy (celiac disease) is an autoimmune disease with a frequency of 1% worldwide, which is characterized by immune reactions against gluten in various products. In the small intestine, due to the autoimmune reaction, villous intestinal atrophy develops , which is the cause of malabsorption syndrome , osteoporosis, sterility and others. Some authors also distinguish between gluten sensitivity (non-celiac gluten intolerance), in which the body reacts to gluten as a foreign body with an inflammatory reaction, but without villous atrophy of the small intestine.

Celiac disease is proven by fibrogastroscopy and intestinal biopsy, as well as by testing for antitransglutaminase antibodies. A positive laboratory requires a biopsy. Unlike celiac disease, non-celiac gluten intolerance does not increase immunoglobulins, and the diagnosis is made indirectly by placing the patient on a gluten-free diet. It is important that the patient eats normally and eats cereals before testing for antitransglutaminase antibodies (antigliadins), otherwise the test may be false negative.

Celiac disease manifests itself clinically with flatulence, flatulence, colic-like pain, diarrhea, which may alternate with constipation, fatigue, pale stools, depression. Subsequently, patients develop malabsorbent syndrome with weight loss and anemia due to atrophy of the small intestinal mucosa. There are also skin changes - typically herpetiform dermatitis. Celiac disease can often be the cause of infertility due to malabsorption of vitamin D, calcium and others. nutrients.

To date, the treatment for celiac disease is to place the patient on a lifelong gluten-free diet , and after six months a repeat fibrogastroscopic examination is performed to determine the condition of the intestinal mucosa.

The new experimental treatment aims to induce immune tolerance in patients with celiac disease. Dr. Stephen Miller, a professor of microbiology and immunology at Northwestern University School of Technology in Feinberg, has been working with his team for years to create a treatment for patients with gluten enteropathy so that they can consume gluten-containing products without leading to inflammatory-atrophic changes in the intestinal mucosa.

The technology is based on innovative  biodegradable nanoparticles that help the immune system tolerate gluten molecules by "hiding" and modifying them. The researchers hope to adapt the new treatment for other autoimmune diseases - allergies, multiple sclerosis, type 1 diabetes, asthma and others. Prof. Miller presented his results at the European Gastroenterology Week (UEGW ), which took place this year in Barcelona, ​​Spain.

Prof. Miller gave the patients nanoparticles CNP-101 and made them take gluten for the next 14 days. Patients who did not take the nanoparticles developed, of course, symptoms of intestinal damage and inflammatory changes. However, patients who received nanoparticles had a reduced inflammatory response by 90% compared with those who did not. Prof. Miller believes that instructing the patient to follow a diet is not always enough due to poor compliance.

In addition to treating gluten enteropathy, the team is testing the new method to treat multiple sclerosis by encapsulating myelin in nanoparticles, and to treat type 1 diabetes by encapsulating beta-cell pancreatic protein in nanoparticles.