Vaccine for Coeliac disease could mean the end of gluten free diets

Apr 15 2009

Australian scientists have developed an experimental vaccine to treat coeliac disease. The team at the Walter and Eliza Hall (WEHI) Institute in Melbourne are hoping a phase 1 clinical trial of the vaccine, due to begin this month, will eventually lead to an effective clinical treatment for the disease.

The symptoms of coeliac disease or gluten intolerance can range from severe to minor or and may even go undetected - some symptoms can be confused with irritable bowel syndrome or wheat or other food intolerance, while others may be put down to stress or getting older.

Coeliac disease is a chronic, autoimmune digestive disorder caused by the body's own immune system mistakenly attacking the lining of the small intestine. It is a serious medical condition that can result in a number of significant consequences if it is not diagnosed and treated properly.

The most common symptoms in adults can include: anaemia, bloating and flatulence, diarrhoea or constipation, fatigue, weakness and lethargy, nausea and vomiting, stomach cramps, weight loss - although weight gain is possible.

The most common symptoms in children include: abdominal pain, bloating and flatulence, bulky, foul-smelling bowel motions, chronic anaemia, diarrhoea or constipation, nausea and vomiting, poor weight gain or weight loss in older children, delayed growth or delayed puberty, tiredness and irritability.

The disease affects the small intestine which is the part of the digestive system responsible for absorbing nutrients - with coeliac disease, the lining of the small intestine is damaged by gluten - a protein found in wheat, rye, barley and oats.

Malnutrition, osteoporosis, depression, infertility and a small, increased risk of certain forms of cancer, such as lymphoma of the small bowel, are just some of the problems that can develop if coeliac disease is left untreated.

People are born with a genetic predisposition to develop coeliac disease and blood screening tests have shown that coeliac disease affects approximately one in 100 Australians.

The one year, phase 1 trial will involve forty volunteers who suffer from coeliac disease and will test for, in particular, drug safety, and an appropriate drug dose range and also look for any adverse effects.

If the phase 1 trial of the vaccine is deemed successful, a phase 2 trial can then be expected, which will determine the clinical effectiveness of the vaccine.

Should this phase 2 trial prove successful, a strict gluten free diet for coeliacs could become history and previously undiagnosed coeliacs could be detected and spared from premature deaths.

Globally, the disease is estimated to affect the lives of more than 6 million people in Europe, North America and Australia - but at least 5 million may be unaware that they are suffering from the disease.

Currently the only effective treatment for coeliac disease is a life-long avoidance of any food or drink that contains the slightest trace of gluten.

Dr. Bob Anderson from the Autoimmunity and Transplantation Division at WEHI , who led the research says the vaccine is meant to gradually desensitize the coeliac victim so that gluten is tolerated which should enable the villi in the small intestine to revive and absorb nutrients in the normal way - this could in theory mean the end of gluten-free diets for people with coeliac disease.

A gluten free diet is currently the only treatment as the avoidance of all gluten-containing foods allows the bowel lining to recover but this strict attention to diet must be lifelong.

Foods that contain gluten include bread, cakes and pasta but there is also a whole range of ingredients within prepared and commercial foods that can come from a gluten source and it is important that a person with coeliac disease becomes 'ingredient aware'.