The end of endoscopy?

Yes, you read that right! No more endoscopic biopsy to determine the damage or healing of the small intestine.

Simvastatin is a statin drug currently on the market currently used to lower “bad” cholesterol and raise “good” cholesterol. They found a unique property with this statin that demonstrates the drug stays primarily in the small intestine. They can study the amount of the drug excreted in urine to determine how much was absorbed thus determining the health of the small intestine. Smart, right?

They have studied this theory in mice and in 50 people. They had 11 healthy volunteers, 18 newly diagnosed, and 25 celiac patients on a gluten free diet for more than 1 year. This new testing method correctly identified 16 of the 18 newly diagnosed celiac patient and accurately represented the healing status of the celiac patients on the gluten free diet. The test was also able to distinguish healthy subjects as well.

Now, in Rochester, NY, at the Mayo Clinic they are putting this new testing method to clinical trial. They are currently recruiting 40 patients to take the statin, collect blood and urine, and test the theory. The criteria to be in the study is to be on a gluten free diet for 1 year, had a biopsy within the past month, and there can be no villious blunting in the biopsy.

If you live in Rochester and have Celiac, there are lots and lots of clinical trials going on. I would encourage you to look for a trial and participate if you can.

I think this method will be great for monitoring intestinal recovery for those on a long term gluten free diet. An annual check of mucosal health will be fabulous. I don’t think the TtG IgA test is sensitive enough to detect small amounts of gluten ingestion that could still be damaging the villi. And we are all in the dark about mucosal recovery for about 2 years until the repeat endoscopy is performed. We could think we are doing a great job by our blood test but there is still damage. This test could solve that problem.

I also think this test will be less than ideal for initial diagnosis. I like the idea that there is a direct method of measuring the damage in the small intestine rather than an indirect method. But over time and as this method proves to be accurate, I’m sure I will change my mind.

I can’t wait to read the results of this study and hopefully we will have a new, less invasive way of knowing more about this disease!!