alice-bastCeliac disease evolved from a lethal to a treatable disease only 60 years ago when scientists discovered its link to gluten. More recently, medical students were taught that this autoimmune disorder was rare and relegated to childhood.

Today, we know that one in 133 Americans, or an estimated 3 million people of all ages, are affected by celiac disease and that they are four times more likely than those without the disease to suffer other health problems or die as a result. Yet the scientific community has only scratched the surface of all there is to discover about this increasingly common affliction.

To learn more about the hot topics pertaining to celiac disease research, we talked to one advocate who has her finger on the pulse of the research arena—Alice Bast, founder and president of the Ambler, Pennsylvania-based National Foundation for Celiac Awareness (NFCA)—who notes that the most
significant issue related to celiac disease is the future.

“The question is, ‘What are the greatest unmet needs?’” says Bast. “That’s where research is aimed.”

WHY IS CELIAC DISEASE ON THE RISE?celiac-disease

The number of people with celiac disease—which can develop at any age—has increased four-fold in the United States over the past half century.
“Researchers are looking at everything from breast-feeding practices to a change in microbial function in the gut,” says Bast concerning the cause of the condition.
Beyond genetics, new research published in the November 2010 issue of Theoretical and Applied Genetics shows that environmental factors may be to blame. Scientists from the Netherlands have discovered that modern varieties of wheat have greater amounts of celiac disease epitopes, or sites on the surface of the gluten molecule that trigger celiac disease.
On the brighter side, these same researchers suggest it may be possible to modify certain varieties of wheat to reduce its toxicity and perhaps even make wheat-based foods safe to eat for those with celiac disease.

INFERTILITY AND CELIAC DISEASE

“Two to three times more women than men are diagnosed with celiac disease,” says Bast. “The concern is that infertility and other reproductive problems are often symptoms of celiac disease, yet the average age of diagnosis is 45 years.”
According to a review article published in the December 14, 2010, issue of World Journal of Gastroenterology, which looked at more than 30 years of research on the role celiac disease plays in infertility, several studies discovered that the disease is more common in women with multiple miscarriages and low birth weight babies. As a result, obstetrician-gynecologists may start to selectively screen patients for celiac disease. This would be easier, Bast observes, if there were a simpler method of screening, something researchers are exploring.
In a study published in the January issue of the Journal of Pediatric Gastroenterology and Nutrition, for example, researchers in Italy describe a method of breast-cancer-researchscreening for celiac disease via the detection of antitissue transglutaminase immunoglobulin A in saliva. In school children, this noninvasive method
proved to correlate well with traditional diagnostic methods such as blood tests and intestinal biopsies.

A CURE?

At this time, avoiding gluten-containing foods is the only way to “cure” celiac disease. However, other long-lasting remedies are under investigation on the pharmacological front, says Bast, “including an oral enzyme that breaks down gluten, a zonulin antagonist that makes the space between intestinal cells less permeable to gluten, and a vaccine.”
One of the biggest breakthroughs in celiac disease is the identification by scientists in the United Kingdom and Australia of three protein fragments or peptides that trigger the immune system and cause intestinal damage in people with celiac disease. According to the research, published in the July 21, 2010, issue of Science in Translational Medicine, discovery of these celiac-disease-causing culprits has opened the door for development of a therapeutic vaccine that could desensitize and create a tolerance to these problematic protein particles.
Clinical trials involving these fragments are under way. If they are successful, the mainstay gluten-free diet would no longer be necessary. It’s a far cry from the days when a celiac disease diagnosis meant certain death.