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A vaccine for gluten sensitivity?
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
A vaccine for gluten sensitivity?
Most people are about as happy as they make up their minds to be.
- Abraham Lincoln
- Abraham Lincoln
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MaggieRedwings
- King Penguin
- Posts: 3865
- Joined: Tue May 31, 2005 3:16 am
- Location: SE Pennsylvania
That's an interesting project, but one that I'm afraid is doomed to failure, (or at best, limited success). Call me a skeptic, but I see all sorts of problems with this project, (and obviously, so does big pharma, otherwise trying to find investors wouldn't be such a daunting task). The problem lies in the fact that if true effectiveness is to be achieved, the approach requires isolating every form of gliadin and glutenin peptides to which gluten-sensitive individuals react, and then synthesizing those peptides, and desensitizing the patient to each one of them. Needless to say, only a few of the more common forms of those peptides have so far been cataloged. I'm aware that a few of the problematic gliadins have be identified, but if any of the alergenic glutinins have been identified, I haven't seen any information on those discoveries, and there may be more troublesome glutenins, than there are gliadins. It's possible that researchers may never be able to isolate and identify each and every one of them. That implies that this program will only be able to attenuate reactions to gluten, it may never be able to completely eliminate them. Eating gluten after such a treatment will be like eating a little bit of poison, and hoping that it does not do any serious damage.
This flaw in the design of the treatment, will mean that repeated endoscopies, and collection of small intestinal biopsies, (which are quite expensive, invasive, and generally not much fun), will be required on a regular basis, to determine how much damage to the small intestine is accumulating, due to the "inadequacies" of the vaccine. Prior research has proven that biopsies are the only reliable way to ascertain the degree of damage present. In fact, it is quite common for roughly half the celiac patients on a GF diet, to still show a level of villous damage that is unchanged from when they were first diagnosed, two years after adopting the GF diet. It has also been demonstrated that only about one in five of those individuals will test positive to serum anti-tissue transglutaminase antibodies. IOW, the gold standard celiac blood tests are worthless for monitoring disease activity, during treatment. Does anyone know the whereabouts of a research article that verifies that claim about only one in five testing positive?
EDIT:
Okay, I found an abstract for the article I was searching for, but unfortunately, the observations mentioned above, are not included in the abstract, and since the publisher demands almost 50 bucks for a copy of the full article, I reckon we will just have to remain ignorant on the rest of the details in that article.
http://www.ingentaconnect.com/content/b ... 4/art00008
I know that the information is in that article, because it's described and referenced in this article:
http://www.coeliacsociety.com.au/downlo ... search.pdf
Note this conclusion, from the research article cited below:
The bottom line is, it's an interesting idea, but it's much like the flu vaccine - it will only work against the gliadin peptides for which it is formulated, and that will prove to be it's Waterloo, I'm afraid. How many of us would be willing to reduce our reactions to the level where we can sort of tolerate the symptoms, but our risk of non-Hodgkin's lymphoma and other cancers will remain elevated, due to the continued accumulation of intestinal damage?
Obviously, though, if enough people are willing to accept that risk, then by George, the project might be a success.
Tex
This flaw in the design of the treatment, will mean that repeated endoscopies, and collection of small intestinal biopsies, (which are quite expensive, invasive, and generally not much fun), will be required on a regular basis, to determine how much damage to the small intestine is accumulating, due to the "inadequacies" of the vaccine. Prior research has proven that biopsies are the only reliable way to ascertain the degree of damage present. In fact, it is quite common for roughly half the celiac patients on a GF diet, to still show a level of villous damage that is unchanged from when they were first diagnosed, two years after adopting the GF diet. It has also been demonstrated that only about one in five of those individuals will test positive to serum anti-tissue transglutaminase antibodies. IOW, the gold standard celiac blood tests are worthless for monitoring disease activity, during treatment. Does anyone know the whereabouts of a research article that verifies that claim about only one in five testing positive?
EDIT:
Okay, I found an abstract for the article I was searching for, but unfortunately, the observations mentioned above, are not included in the abstract, and since the publisher demands almost 50 bucks for a copy of the full article, I reckon we will just have to remain ignorant on the rest of the details in that article.
http://www.ingentaconnect.com/content/b ... 4/art00008
I know that the information is in that article, because it's described and referenced in this article:
http://www.coeliacsociety.com.au/downlo ... search.pdf
Note this conclusion, from the research article cited below:
http://www.ncbi.nlm.nih.gov/sites/entre ... d_RVDocSumSerologic tests, in clinical practice, lack the sensitivity reported in the literature.
The bottom line is, it's an interesting idea, but it's much like the flu vaccine - it will only work against the gliadin peptides for which it is formulated, and that will prove to be it's Waterloo, I'm afraid. How many of us would be willing to reduce our reactions to the level where we can sort of tolerate the symptoms, but our risk of non-Hodgkin's lymphoma and other cancers will remain elevated, due to the continued accumulation of intestinal damage?
Obviously, though, if enough people are willing to accept that risk, then by George, the project might be a success.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Hi Guys!
I am having trouble with the basic premise. Food intolerances are mediated differently by the immune system then allergic, anaphylactic reactions, right? At least we always say that the skin tests are not good indicators of food intolerances. Is Dr. Anderson's premise that multiple injections of gliadin might build up the capability to develop antibodies to it? But then don't these antibodies roam around in the bloodstream? If the gliadin stays in the gut where it belongs, how do the antibodies get to it? Wouldn't you need to have a continuous leaky gut for most of the antibodies to get to the gliadin? To cure MC and other food intolerances don't we need to get RID of that leaky gut? That's what Dr. Fasano's promising research is doing - using a peptide to close those "gates" in the leaky gut so that NO offending proteins get into the bloodstream.
Also, our underlying problem is that we already make antibodies to food proteins.....normal folks don't do this, so why would we want even MORE antibodies? And Dr. Fine says that it is not the gliadin itself that makes us sick, it is the antibody reaction to it that causes fatigue, fever, joint/muscle aches, etc. Why would we want more antigen-antibody wars going on in our bodies?
Am I making any sense at all? Maybe I'm missing something here.
Love,
Confused Polly
I am having trouble with the basic premise. Food intolerances are mediated differently by the immune system then allergic, anaphylactic reactions, right? At least we always say that the skin tests are not good indicators of food intolerances. Is Dr. Anderson's premise that multiple injections of gliadin might build up the capability to develop antibodies to it? But then don't these antibodies roam around in the bloodstream? If the gliadin stays in the gut where it belongs, how do the antibodies get to it? Wouldn't you need to have a continuous leaky gut for most of the antibodies to get to the gliadin? To cure MC and other food intolerances don't we need to get RID of that leaky gut? That's what Dr. Fasano's promising research is doing - using a peptide to close those "gates" in the leaky gut so that NO offending proteins get into the bloodstream.
Also, our underlying problem is that we already make antibodies to food proteins.....normal folks don't do this, so why would we want even MORE antibodies? And Dr. Fine says that it is not the gliadin itself that makes us sick, it is the antibody reaction to it that causes fatigue, fever, joint/muscle aches, etc. Why would we want more antigen-antibody wars going on in our bodies?
Am I making any sense at all? Maybe I'm missing something here.
Love,
Confused Polly
Blessed are they who can laugh at themselves, for they shall never cease to be amused.
Tex/Polly,
Thanks for deciphering this for the rest of us!
Once you think about it, what you are saying makes a ton of sense. I guess if it were all that simple over time just by ingesting the various protiens we would all achieve a level of tolerance, yet we know that is not the case, it's really more like we hit a wall with the level of toxicity and achieve hyper sensitivity????
I don't remember a darn thing from biology (well I remember grossing out my wife, who was my girlfriend at the time, during the frog/pig fetus disection!) Since there is a "cure" for most of us, or at least a means to get us into remission, by dietary changes alone, at least we can find some level ground to stand on a be reasonably healthy. Hopefully someday gains will be made to help future generations of people with gluten sensitity type disorders.
I noticed recently that even my local paper (The Contra Costa Times) has a weekly feature on Gluten Free Living. To me just the awareness of this is huge. The population at large has very little knowledge of gluten sensitivity, and how it can/could be affecting their health.
Even in my line of work (metal fabrication) sometimes it takes us multiple times to get a project right, record our findings and file information away for future projects that arise. I'm sure many studies and trials will be needed, and they are probably years/decades away from finding a solution, but the ball rolls on and that is important in and of itself.
Thanks for looking at this article. With that I am heading out to do a little rock fishing with my little brother, need to stock the freezer up, I have been having to buy fish the past several months (yuk!)
Dan
Thanks for deciphering this for the rest of us!
Once you think about it, what you are saying makes a ton of sense. I guess if it were all that simple over time just by ingesting the various protiens we would all achieve a level of tolerance, yet we know that is not the case, it's really more like we hit a wall with the level of toxicity and achieve hyper sensitivity????
I don't remember a darn thing from biology (well I remember grossing out my wife, who was my girlfriend at the time, during the frog/pig fetus disection!) Since there is a "cure" for most of us, or at least a means to get us into remission, by dietary changes alone, at least we can find some level ground to stand on a be reasonably healthy. Hopefully someday gains will be made to help future generations of people with gluten sensitity type disorders.
I noticed recently that even my local paper (The Contra Costa Times) has a weekly feature on Gluten Free Living. To me just the awareness of this is huge. The population at large has very little knowledge of gluten sensitivity, and how it can/could be affecting their health.
Even in my line of work (metal fabrication) sometimes it takes us multiple times to get a project right, record our findings and file information away for future projects that arise. I'm sure many studies and trials will be needed, and they are probably years/decades away from finding a solution, but the ball rolls on and that is important in and of itself.
Thanks for looking at this article. With that I am heading out to do a little rock fishing with my little brother, need to stock the freezer up, I have been having to buy fish the past several months (yuk!)
Dan
Most people are about as happy as they make up their minds to be.
- Abraham Lincoln
- Abraham Lincoln
Yep, I like that photo, too. As Polly said, you have a real talent - that's one striking, and dignified looking rooster. You have captured the essence of what he represents to most people, IMO.
Back to the vaccine project, though - if you will read what Dr. Anderson has to say in the article that I linked to above:
http://www.coeliacsociety.com.au/downlo ... search.pdf
You will see that some of what he says seems to be sort of pseudo-science, and he appears to be somewhat of a "tinkerer" who is proposing a "simple fix" to a complex problem, by a method that may or may not be scientifically sound; however, he also raises some interesting points that most of us have been overlooking, (if they are indeed true - which, at this point, I have no reason to doubt). For example, he points out:
Looking at this another way, maybe it takes much, much longer for the gut to heal, than the medical establishment claims. I have always felt that most GI docs don't have the slightest inkling how long it takes the gut to heal when MC is involved, and the same may hold true for villus damage to the small intestine, in the case of fully-developed celiac disease.
By the way, doesn't he have this relationship bass-ackwards, or am I not thinking clearly, at the moment?
Anyway, the bottom line is, his rationality for pursuing this line of treatment, seems to be predicated on the fact that the GF diet is a far-from-perfect treatment, in itself, so maybe a medical treatment doesn't have to be technically "perfect", in order to be effective, for all practical purposes, (as engineers love to say).
Does anyone have any insight on this? This is the first time that I can recall ever seeing such damning evidence about the histological "ineffectiveness" of the GF diet. As demonstrated by that research project, since most doctors will use the blood tests to verify that patients are in compliance with the diet, 80% of diagnosed celiacs may well be walking around with the same intestinal damage that they originally presented with, but no one is aware of it, due to the poor sensitivity of the "gold standard" blood tests. So why are their clinical symptoms in remission, (at least for most of them)? The fact that their histology is unchanged, even though their symptoms have been resolved, adds credence to my "slow-healing" theory, but raises a lot of serious questions about the procedures, and the criteria, commonly used to determine remission. So Polly, now we're all confused - at least I certainly am.
Love,
Tex
Back to the vaccine project, though - if you will read what Dr. Anderson has to say in the article that I linked to above:
http://www.coeliacsociety.com.au/downlo ... search.pdf
You will see that some of what he says seems to be sort of pseudo-science, and he appears to be somewhat of a "tinkerer" who is proposing a "simple fix" to a complex problem, by a method that may or may not be scientifically sound; however, he also raises some interesting points that most of us have been overlooking, (if they are indeed true - which, at this point, I have no reason to doubt). For example, he points out:
Hmmmmmm. That's rather profound, really. That reference, (number 9), is the one I cited in my previous post, that cannot be accessed for free, (not the full text, anyway). If this is all true, (and it is, according to the research article), then I can't help but wonder what our own mucosal histology looks like, after being on the diet for a couple of years or so.there is little comfort in knowing that there have been only three “randomised, controlled” studies of the gluten free diet – one in children and two in adults – the largest with 57 participants (6-8). Little wonder then that there continues to be debate over the safe limit to gluten contamination in food.
The effectiveness of the gluten free diet and any new treatment needs to be assessed by biopsy of the small intestine, as well as symptoms and control of long term complications like osteoporosis. However, repeated endoscopy and collection of biopsies is expensive and unpleasant for volunteers, so studies to establish the effectiveness of “cheap” treatments like the gluten free diet have been limited in size and complexity (in reality, the gluten free diet is not cheap – the cost is similar to ongoing medications for blood pressure combined with a drug for high cholesterol, around A$1000 annually).
Testing of drugs for coeliac disease must be much more rigorous than those for dietary treatment. But how effective does a drug need to be for the treatment of coeliac disease? In a recent study from Italy, it was found that two years after adopting a gluten free diet, about half those people diagnosed with coeliac disease continued to have villous atrophy as severe as when they were first diagnosed (9). Only about one in five of those with severe intestinal damage (villous atrophy) on a gluten free diet had raised (abnormal) blood levels of transglutaminase antibody, meaning that standard blood tests to monitor disease activity were relatively ineffective. Probably this study means that the amount of gluten needed to raise blood levels of transglutaminase antibody is much lower than that needed to allow healing of the small intestine, and that many Italian coeliacs are in fact following a gluten reduced rather than gluten free diet.
Looking at this another way, maybe it takes much, much longer for the gut to heal, than the medical establishment claims. I have always felt that most GI docs don't have the slightest inkling how long it takes the gut to heal when MC is involved, and the same may hold true for villus damage to the small intestine, in the case of fully-developed celiac disease.
By the way, doesn't he have this relationship bass-ackwards, or am I not thinking clearly, at the moment?
IOW, shouldn't he be saying that the amount of gluten needed to raise the blood levels of transglutaminase antibody is much higher than the maximum amount which will allow healing of the small intestine. Not only would that correlate with the research results, but it would make much more sense, in light of the typically low sensitivity of the serum tests used for this purpose, in the first place. The presence of that mistake does not boost confidence in his thought processes in general, but then, no one is perfect, obviously, and I'm not about to cast very many stones, since I'm certainly not immune to making dumb mistakes, also.Probably this study means that the amount of gluten needed to raise blood levels of transglutaminase antibody is much lower than that needed to allow healing of the small intestine
Anyway, the bottom line is, his rationality for pursuing this line of treatment, seems to be predicated on the fact that the GF diet is a far-from-perfect treatment, in itself, so maybe a medical treatment doesn't have to be technically "perfect", in order to be effective, for all practical purposes, (as engineers love to say).
Does anyone have any insight on this? This is the first time that I can recall ever seeing such damning evidence about the histological "ineffectiveness" of the GF diet. As demonstrated by that research project, since most doctors will use the blood tests to verify that patients are in compliance with the diet, 80% of diagnosed celiacs may well be walking around with the same intestinal damage that they originally presented with, but no one is aware of it, due to the poor sensitivity of the "gold standard" blood tests. So why are their clinical symptoms in remission, (at least for most of them)? The fact that their histology is unchanged, even though their symptoms have been resolved, adds credence to my "slow-healing" theory, but raises a lot of serious questions about the procedures, and the criteria, commonly used to determine remission. So Polly, now we're all confused - at least I certainly am.
Love,
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.