More Celiac Research in 2020

Jumping for joy!

Hope everyone had a great time over the holidays!

I’ve seen lots of heartbreaking posts about holiday meal miscommunications – someone thought they would have a gluten free meal, but due to last minute changes no safe food was provided. I’ve seen lots of posts about accidental glutenings and wondering how this could happen. I’ve even seen some pain after waiting for a long time and then purposefully eating gluten and wondering why they feel so bad. I’ve seen posts about people mourning the loss of their favorite foods.

They have been tough to read. It breaks my heart to see so many people struggling with celiac. I know it isn’t easy. But there is some good news.

The President recently signed into law the new Fiscal Year 2020 budget. Specifically regarding celiac, the resolution states, “The agreement encourages NIH to devote sufficient, focused research to the study of celiac disease, including the autoimmune causation underpinning the affliction.”

So, this is interesting. They are looking at the autoimmune causation. I think we know about what causes the autoimmune reaction – gluten. We know how the autoimmune reaction starts and with information from the Nexvax Phase 1 trial, we have a clearer understanding of how the immune reaction happens in celiac. Here is the published results regarding the immune reaction. According to their study, the immune reaction starts in as little as 2 hours and peaks at about 6 hours after gluten ingestion.

I think what they are talking about is focusing on what causes the immune system to be sensitized to gluten and creating the autoimmune disease. This is an interesting question but there are some clues out there already. We know that increased rotavirus infections in young children has a significant impact on the development of celiac disease. Here’s the study that talks about rotavirus and increased incidence of celiac. Here’s another study that talks about enetrovirus and onset of celiac.

There is the controversial study earlier this year that said that higher gluten intake when children were younger the more likely genetically susceptible children were to develop celiac. This article says that parents should introduce gluten between 4 months and 7 months to avoid an increased risk for celiac. There is also the GEMMs study looking at infants and young children with celiac in their family to determine what may cause celiac to be triggered.

Then the question becomes why are people diagnosed early in life and others diagnosed later in life. It seems the symptoms and presentation of celiac are different based on the patient’s age. This is an article that describes the differences.

If I remove the request for a cure and simply look at understanding the disease, here is what I would like to know…..

  • Why do some people develop celiac later in life and some earlier?
  • What is the trigger for celiac development? Is it a virus and will a vaccine against that virus (as in the case of rotavirus) reduce the overall incidence of celiac?
  • Does celiac go into a “quiet” period where ingestion of gluten may not affect the small intestine?
  • Does celiac go into a “quiet” period where ingestion of gluten may not affect the small intestine?
  • Can there be development of a test to test for celiac while on a gluten free diet?
  • Can there be a non-invasive test for small intestine healing?
  • I would like to see a non-invasive tests for refractory celiac, to

That’s just my wish list. I’m sure I’ve got more things to think about and more questions than answers.

What would you like to know?

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