Vaccine to treat celiac disease clears first stages of clinical trials

immusant-logo

Contributed

immusant-logoFor a number of years, an American company called ImmusanT has been working on a potential vaccine to protect celiac sufferers from the effects of exposure to gluten and the gastrointestinal symptoms that can result such as diarrhea, abdominal pain and bloating.

The Massachusetts biotech firm says it has completed its first phase 1b trial of Nexvax2.

As many of us are aware, celiac disease is remarkable among chronic diseases in that it is very common but has no proven, approved treatment beyond dietary restriction. It affects around 1% of people – though an estimated 90% remain undiagnosed. In most celiac cases, the disease is thought to be caused by a mutation in the HLA-DQ2 gene, which is involved in immune regulation.

Developing effective treatments is important as, despite being on the gluten-free diet, around a third of people with celiac disease still suffer from symptoms as well as damage to the cells lining the intestines – often without even realizing it.

This is rather complex, but ImmusanT’s big idea is to use three “peptides” (an amino acid-containing compound within our bodies) as an immunotherapy that it hopes will encourage the T cells involved in the inflammatory reaction in celiac disease to become tolerant to gluten. After a first course of the vaccine, to induce tolerance, the company hopes that this tolerance can be maintained by periodic re-injection with the vaccine.

It’s a case of “so far, so good”, with the phase 1b trial in 38 patients revealing no concerns about safety or tolerability and showing that the immunotherapy seemed to have the desired effects on the immune system.

The study also allowed ImmusanT to select a dosing regimen for planned phase 2 trials that will see if Nexvax2 can be used alongside a gluten-free diet to protect patients when they are accidentally exposed to gluten, which ImmusanT sees as the quickest route to approval in the United States.

Depending on the results, a follow-up program is planned that will focus on an immunotherapy that could do away with the need for the gluten-free diet entirely. The company is also developing a companion diagnostic for the vaccine which could guide its use and help improve diagnosis rates.

 

Gluten-free diets don’t help people without celiac disease, study finds

CBC Marketplace Gluten-Free

CBC Marketplace is running an interesting segment on how gluten-free diets don’t help non-celiacs.

CBC Marketplace Gluten-Free

Here’s an excerpt from the article.

Gluten-free diets shouldn’t be promoted to prevent heart disease among people without celiac disease, gastroenterologists say after a large U.S. study.

The food industry has stimulated popularity in gluten-free diets. Recognising this public interest, researchers at Harvard Medical School said they wanted to see whether avoiding gluten actually has health benefits for those without the disease.

To that end, Dr. Andrew Chan, an associate professor of medicine at Harvard, and his team used diet and health outcome data collected from 110,000 health professionals over 26 years to link estimates of gluten in the diet to diagnoses of coronary heart disease.

Read the full article on CBC.ca

May is Celiac Awareness Month

National CCA Release

Join the Canadian Celiac Association as we host several public outreach and education initiatives and encourage your support during our donor drive. Our goal this campaign is to raise $45,000. These funds will help us offer member-only education, increase counselling support and develop programs for safer places to eat.

Twitter Party — May 1

  • May 1 we’ll be hosting our first Twitter Party! Join us at @CCAceliac
  • Follow #AskTheCeliac from 8–9 pm EDT
  • Join us to learn more about celiac disease, gluten intolerance, and the gluten-free diet
  • Test your knowledge to win one of 10 prizes including a $100 Catelli prize pack
  • Thank you to Catelli Foods for generously sponsoring this party

2017 twitter party header

 

International Celiac Awareness Day — Tuesday, May 16

  • All federal Members of Parliament will be sent a letter with a Celiac Awareness ribbon and will be asked to wear it on May 16 to show their support
  • Watch your mail for a little something to help us spread awareness in your community on this day!
  • Help us reach our goal of $45,000. Watch your social media, share #CeliacAware and ask your friends and colleagues to donate to CCA.

CCA Education webinar — Wednesday, May 17

  • CCA will be offering two one-hour webinars on labelling
  • 5–6 pm EDT and then 8–9 pm EDT to accommodate time zones

Facebook Day — May 31

  • We’ll be hosting an “AskTheCeliac” Day on our public Facebook page on May 31 to round out the month of activities. Post your questions! Share with friends

Should we screen everyone for celiac disease?

uspstfThe US Preventive Services Task Force recently reviewed all the relevant research on screening for celiac disease to determine if it makes economic or health sense to screen everyone for the disease. They looked at the accuracy of the screening tests for people of all ages and debated the potential benefit and harm from screening.

The conclusion: there isn’t enough information to make a well-supported decision. There are too many false positive tests to make universal screening appropriate, and we don’t know enough about the benefits and harms of a gluten-free diet on someone with positive blood tests but no symptoms.

They did conclude that it is important to test people with celiac-related symptoms and they defined celiac disease as “a multi-system autoimmune disorder which can have both gastrointestinal symptoms (diarrhea, abdominal pain, and weight loss) and systemic symptoms (anemia, osteoporosis, chronic fatigue, peripheral neuropathy, and ataxia), both of which are improved by following a gluten-free diet”.

That definition of CD alone may remind family doctors that celiac disease is a lot more than just diarrhea. We need to take victories where they come.

Frying wheat products does not make them gluten-free

Canadian Celiac Association New Release

April 3, 2017 (Mississauga, ON.) The myth that frying wheat products makes them gluten-free is endangering people with Celiac disease.

gluten-free fryerPeople often liken the frying process to cooking an egg. In the case of an egg, frying it changes the colour and structure of the egg. While heating gluten in a fryer does change the structure of the gluten protein, it does not make it safe for someone with Celiac disease.

Heating wheat to 65°C (140°F) unwraps the three-dimensional structure of the protein, like it does for eggs, but that is not enough to prevent an immune system reaction for someone with Celiac disease.

The trigger for the gluten reaction in someone with Celiac disease is a very short peptide chain within the larger protein. Peptides are chains of amino acids that make up a protein. The only thing that will break the peptide chain apart and make gluten safe for people with Celiac disease is a complete breakdown of the chain into its component amino acids.

“These peptides are extremely difficult to break apart – they are designed to resist the harsh environment of the gastrointestinal tract,” explains Sue Newell of the CCA.

There is some question about the exact temperature for this complete breakdown, with a suggestion that heating the food to 315°C (600°F) for 30 minutes may be sufficient. At that point, however, the food is inedible.

The Canadian Celiac Association recommends that people with Celiac disease and gluten sensitivities avoid any food cooked in oil has also been used for wheat-based products.

How to Read the Ingredient List for Gluten

gluten-free label

Wheat – Rye – Barley – Gluten – Oats

If you see any of the words above on the ingredient list or CONTAINS statement, the product is NOT OK.

Fast Factsgluten-free label

  • As of August 2012, food manufacturers must declare gluten sources in the ingredient statement
  • Gluten-containing ingredients must be listed in either the Ingredient list OR the CONTAINS statement
  • Avoid packaged foods with no ingredient listing
  • Oats are safe to eat only when they are listed as “gluten-free oats”

Where to look:

Step 1: Find the ingredient label on the package

Step 2: Look for a CONTAINS or MAY CONTAIN statement (at the bottom of the ingredient list)

If you see a CONTAINS statement:

  • PRODUCT IS NOT OK: If you see wheat, rye, barley, oats or gluten listed
  • PRODUCT IS OK: If the CONTAINS statement does NOT include a gluten ingredient
  • If there is a CONTAINS statement, you can stop reading now. If not, look for a MAY CONTAIN statement.

If you see a MAY CONTAIN statement:

  • PRODUCT IS NOT OK: If you see wheat, rye, barley, oats or gluten listed
  • If MAY CONTAIN statement does not include a gluten ingredient, then go to Step 3

Step 3: If there is no CONTAINS statement, read the ingredient list:

  • PRODUCT IS NOT OK: If you see wheat, rye, barley, oats or gluten listed
  • Product IS OK: If you do not see any gluten containing ingredients

CCA 2017 National Survey

cca logo

cca logoThe Canadian Celiac Association is the national voice for all Canadians adversely affected by gluten. To make sure we are working on your behalf as best we can, we are planning to review of our priorities and the support, awareness and advocacy work we do.

You are a valuable member of our online community, and we would greatly appreciate it if you could take around ten minutes and complete a short survey to help us as we move forward. We’d request your input no later than March 18.

All Canadians with a “gluten problem” are invited to participate. All opinions are welcome.

Link to the survey: https://freeonlinesurveys.com/s/LJXqTryd

Thank you very much for adding your voice. We actively use feedback to improve our organisation and provide the gluten-free community with the best possible service. If you have any questions, please do not hesitate to contact me at [email protected]

Mark Johnson
Board of Directors
Canadian Celiac Associatio

No Need to Fear Modified Starches

corn starch mixed with water

corn starch mixed with waterIn the past, people eating gluten free were advised to avoid modified starch, not because of the “modified” but because of the “starch”. Starch is made from grains and although it doesn’t directly contain gluten, the starch and the proteins, including gluten, are mixed together on the inside of the kernel, the endosperm. When the type of starch was not identified on the ingredient list, it could be wheat starch. Unfortunately, many people focused on the wrong word, so when the rules changed and gluten-containing starches were required to be identified (wheat starch or modified wheat starch) people still worried about the word “modified”.

So that you can finally put that fear to rest, here is an exNo Needplanation of how and why starches are modified.

Natural starches can are made from many grains and vegetables, but the pastes and gels that are created are often too gummy to be used in commercial food processing, so their properties are modified for high or low temperatures, high and low pH (acids), and extensive mixing. Different techniques are used for the four biggest uses in food production: binding, thickening, forming a film, and tenderising.

For example, if you are making pudding, you need a different type of starch for a cooked pudding than you need for an instant pudding. Pregelatinized starch can be used to thickening products without heat. It is made by cooking the starch, drying it, and then grinding it to a powder or making flakes to mix with the rest of the ingredients. The properties of this type of modified starch can be changed based on the length of cooking time, the temperature used to dry the starch and the size of the ground fragments. Modified starches treated with phosphate absorb water so that when you are defrosting a frozen dinner, it doesn’t fall apart as it warms. When you are making candy, treating the starch with acid leads to the shell on the outside of the jelly bean. There are ways to process starch to meet almost any use in food production.

The important thing to remember is that none of the processing methods include gluten grains. If it doesn’t say modified wheat starch, you can stop worrying.

New App Tracks Gluten-Free Purchases for Tax Credits

celitax screen shot

Burlington-based chartered accountant Justin Gravelle, has developed a new mobile app called CeliTax that lets sufferers of celiac disease keep track of receipts for gluten-free products for a tax credit.  Gravelle witnessed the problems his Celiac girlfriend was having.

celitax screen shot

Gluten-free items are typically three to four times more expensive than regular items with gluten, Gravelle notes.“Individuals with celiac disease, they’re entitled to the incremental cost difference between gluten-free and non-gluten free products,” he says. But tracking things can be a hassle. Typically, people keep piles of receipts throughout the year, then go through them at the end of the year and enter all their gluten-free purchases into a spreadsheet, Gravelle notes.

The app is available as a free download in the Apple App Store. An Android version is in the works.  Visit the website CeliTax.ca to download.

Read more on theStar.com

What is Dermatitis Herpetiformis?

Prepared by: CCA Professional Advisory Council, June 2016

Definition: Dermatitis herpetiformis (DH) is “celiac disease of the skin”. It is a chronic skin condition with a characteristic rash with intense itching and burning sensations.

Causes: Genetic factors, the immune system, and a sensitivity to gluten play a role in this disorder. The precise mechanisms remain unknown.

Incidence: The prevalence of DH is about 10 cases per 100,000 population. It is more common in males. Onset is most frequently in the second to fourth decade of life. It is rare in children. About 10-15% of patients with celiac disease have DH. A new unscratched lesion is red, raised, and usually small, with a tiny blister in the centre. However, if scratched, crusting appears on the surface. The burning or stinging sensation can be very intense. The most common areas are the elbows, knees, back of the neck, scalp, upper back, and the buttocks. Facial and hair-line lesions are not uncommon. The inside of the mouth is rarely affected. The rash has a symmetric distribution.

Diagnosis: DH can be diagnosed with a biopsy taken from uninvolved skin adjacent to blisters or erosions. The vast majority of patients will also have features of celiac disease (villous atrophy) and do not require a small intestinal biopsy to confirm the diagnosis. The skin symptoms usually predominate over intestinal symptoms. Serological tests for celiac disease may be negative. Like celiac disease, patients may have nutritional deficiencies. Laboratory tests should be performed including complete blood count, iron studies, albumin, alkaline phosphatase, folate, phosphate, calcium and vitamin D, as appropriate for each patient.

Management: Treatment of DH consists of medications and a gluten-free diet. Oral dapsone (Avlosulfon) is often used to treat the skin rash. The response is often dramatic with rapid relief of burning and improvement in the rash. A strict gluten-free diet should be consumed with an elimination of all foods and beverages containing wheat, rye or barley. A referral to a dietitian with expertise in the gluten-free diet is recommended. Since DH is a chronic disorder, regular follow-up with the physician and dietitian is important.