The Federation of Celiac Associations of Spain (FACE) estimates that 1% of the Spanish population suffers from Celiac Disease. However, 85% of those affected have not been diagnosed. Thus, in our country there may be between 450,000 and 900,000.
An underdiagnosed pathology, which can appear at any time in life, although it is more frequent in adulthood than in childhood. And more common in women than in men. But, there is still no cure.
The only treatment today is to carry one (protein found in cereals such as wheat, barley or rye) for life.
However, scientists from the Higher Council for Scientific Research (CSIC) have discovered a molecule that could play a role in treating celiac disease orally.
The research, published in , and led by F. Xavier Gomis-Rüth and next to Laura del Master-Master and Soraia Mendeshas identified a molecule that could counteract the toxic peptides that cause the disease.
The studies we have carried out have allowed us to verify that neprosin has enormous potential to be developed as a medicine
Specifically, it is neprosin, a molecule that is found naturally in the digestive fluid of carnivorous plants. Nepenthes ventrata. A tropical species, of Philippine origin but widely sold in Spain, which requires high environmental humidity and light.
Causes of celiac disease
Several proteins rich in prolamines, found in cereals, are the . When these proteins reach the stomach, they break into smaller ones, which is what is known as peptides, resulting in toxicity to those affected.
Of all the peptides, the most relevant is 33-mer, a wheat prolamine that is able to resist gastric acids from the stomach and cross the intestinal mucosa. Thus, the most characteristic symptoms of the disease occur: abdominal distension, constipation or gas.
IBMB-CSIC scientists have discovered that neprosin is a molecule that can degrade the 33-mer before it reaches the intestine and prevent the autoimmune inflammatory response.
It would be administered in a similar way to the lactase tablets taken by those who are lactose intolerant.
“The 33-mer is the most toxic peptide of those generated from gliadin and it remains to be seen whether its eradication would be enough to eliminate the manifestations and pathophysiological responses of celiac disease,” he explains. Francisco Jose Perez CanoUB researcher.
An oral treatment against celiac disease
“The studies we have carried out have allowed us to verify that neprosin has enormous potential to be developed as a medicine”, points out CSIC researcher F. Xavier Gomis-Rüth.
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“It is much more active under the extreme conditions of digestion in the stomach than other candidate proteolytic enzymes currently under study, collectively called glutenases, for therapeutic application, and it fulfills all the characteristics that are required a priori for an efficient glutenase.”
The treatment, which would be administered orally, should degrade most of the peptides that are toxic to celiac patients and harmless to the intestine.
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“One promising avenue is molecules that destroy toxic peptides, and that can be administered orally, similar to the lactase tablets taken by lactose intolerant people.”
The lactase It is medication, which is available in capsules or drops, it is indicated for people intolerant to lactose. Lactase is an enzyme that helps improve the digestion of lactose (commonly known as milk sugar). It should be taken just before consuming any product with lactose.
And although the first results are optimistic, “we are now going to move on to more specific trials to verify this potential before going on to clinical trials and working with mutant molecules that may be even more efficient,” he concludes.
How is celiac disease diagnosed?
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clinical suspicion. Either due to the presence of symptoms or family history.
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Serology. As FACE points out, “serological markers are very useful as indicators of the disease, since they help to select the individuals with the highest probability of presenting it. The negativity of these markers does not definitively exclude the diagnosis”.
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Biopsy. By means of a biopsy of the proximal duodenum (part of the intestine that connects the stomach with the jejunum, one of the parts of the small intestine), the diagnosis is confirmed. This test is done before establishing a gluten-free diet.
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Genetic tests. They are another option. Most celiac disease patients are positive for HLA-DQ2, two haplotypes (a set of genes that are inherited together).
The doctor specializing in gastroenterology or digestive is in charge of its diagnosis.
Refractory celiac disease: why is it so dangerous?
According to the study “Refractory celiac disease”, published in the , 5% of celiacs suffer from this type of celiac disease. And it is one of the most serious forms of the disease.
That’s how they define it santiago vivas and Jose Maria Ruiz de Moralesof the Digestive System and Immunology Service, respectively, of:
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“The main cause of non-response to a gluten-free diet is the continued and often inadvertent ingestion of gluten. The diagnosis of refractory celiac disease is established after the exclusion of other diseases, given the persistence of malabsorption and villous atrophy.