Coeliac Research Roundup – May 2018

There is some really interesting research into Coeliac Disease going on at the moment, which brings us ever closer to understanding how best to diagnose, prevent and treat the disease. Pop your geek hats on for a summary of some of the interesting things that have caught my eye in the news recently:

Risk Factors for Babies Developing Coeliac

The question of when, if and how to introduce gluten to babies in order to prevent developing coeliac disease continues to be the topic of investigation; as does whether other factors in infant birth and care could also play a role.

Caesarian sections are often mentioned as a possible factor in developing allergy, but a large observational study in Denmark has concluded that whether a child enters the world through vaginal birth or surgically doesn’t look to be associated with whether the child develops coeliac.

In fact, it’s probably a bit more complicated that, as the reason people theorise caesarean plays a role is due to lack of exposure to bacteria from the birth canal. A small study in North America has gone on to show that having a smaller range of gut bacteria (commonly called the ‘microbiome’) does seem to be associated with babies being diagnosed with coeliac. The growing public interest in gut health and the microbiome will no doubt lead to more detailed specific investigations, and prevention strategies.

Quick Coeliac Test being Developed

Diagnosis itself may also change in the future. Australian researchers are trialling an almost-instant pin prick test for coeliac disease which will be welcome news if it is reliable enough to be made widely available, especially for those with children.

A Coeliac Vaccine?

You may have seen recent news about a ‘breakthrough’ vaccine for coeliac disease also being developed in Australia. The truth, whilst interesting, is rather less sensational as this potential therapy is still quite some years from being available for use, prompting Coeliac UK to release a clarifying statement.

Currently the vaccine is in the early trial stages assessing the correct dosage regimen and effectiveness. As it stands the treatment would require regular injections so the company developing it will be looking to reduce this to something more manageable and affordable, at the same time as providing immunity benefits.

Other Potential Coeliac Treatments

Also from Australia (those guys have been busy!), comes an update to previous research into using hookworms (yup, parasites that live in your gut) to treat coeliac. According to this conference roundup the team are now looking to isolate the specific proteins from the worms that calms inflammation caused by the coeliac reaction. Good news for the squeamish, bad news for hungry worms.

A few other promising treatments are still in development, and a good summary of the main ones can be found on the Allergic Living site. Unfortunately one of the main candidates, Latiglutinase, which worked by breaking down the gluten molecules to prevent a reaction due to accidental gluten consumption, did not have good trial results. The team are hopeful that the treatment may still have a use in reducing ongoing symptoms for those already on a gluten free diet, however to me it seems like it will be hard for them to sell this into health care systems without proof of improvement in antibody levels and intestinal damage. Which brings me on to…

Tests to Identify Gluten Consumption

The company behind Latiglutinase are behind another recent study into the amount of gluten unintentionally consumed by coeliac patients using urine and stool tests. This looked at patients who continue to experience symptoms once going gluten free, excluding those who have other complications of coeliac disease. The findings were significant – that many individuals who report that they stick to a gluten free diet continue to consume enough gluten to trigger symptoms and be detected in stools or urine. We should of course, bear in mind that the company behind the study has a vested interest in proving that people need protecting against accidental gluten consumption.

The tests for gluten consumption used in this study are themselves the subject of new research, with a large study in America looking at whether regularly using them for children with coeliac can improve their ability to stick to the gluten free diet. I’m going to place a crisp £10 note on the outcome of this one being ‘yes’ – they’ll have to have some very clever research design to avoid participants’ behaviour changing anyway because they are the subject of a study. Nonetheless, an interesting tool in the doctor or dietitian’s toolbox for understanding why a patient’s immune reaction and symptoms may not be improving.

The tests themselves were developed in Spain, and are now licensed for sale directly to patients in USA too – not yet available in the UK, sorry poop-testing fans.

I hope you found this summary interesting and insightful! I’ll share more as it emerges – I tend to post articles that catch my eye over on my revamped Facebook page.



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