Stem Cell Therapy for Celiac Disease
Anyone with celiac disease who saw the press release from Regenerative Medicine Solutions (RMS) on January 21, 2014 might have reacted with great excitement. This company is offering something called “Regenerative ColoTherapy (RCT)” to treat both inflammatory bowel disease and celiac disease.
RCT is a “proprietary” stem cell therapy. This is said to be a different way to deal with celiac disease, possibly instead of a gluten-free diet, or in addition to the diet. There is nothing from the company that directly discusses the diet one way or the other.
Links to the website provide slightly more information, including all the steps of the procedure and testimonials from patients. There are no testimonials from anyone with celiac disease at the current time. In fact, stem cell therapy is not being used to treat celiac disease except in extremely severe, life-threatening refractory type 2 disease, and results of very limited trials have been called “disappointing.”
Celiac disease occurs because cells in the intestine react to parts of the gluten molecule. This starts a cascade of reactions that damage the intestine and cause inflammation. Celiac disease is considered an autoimmune disorder and there are immune cells involved. But it is different from other autoimmune disorders in many ways. It has a specific dietary trigger. There are a number of cell types involved in its development and the way it causes symptoms, from the cells lining the intestine to different types of white blood cells. Many different chemicals are released that lead to damage. Probably because of the unique interaction between inherited tendencies, dietary exposures and other things not yet completely understood, CD does not respond to many of the treatments used for other autoimmune disorders.
The gluten-free diet does improve the symptoms of celiac disease in most patients. While it may be unpalatable and expensive, it is safe and effective. Most people who do not improve are still getting gluten in their diet, either accidentally or because they are not following it strictly.
People with refractory celiac disease need to be treated by gastroenterologists who are experienced in dealing with this. Besides re-evaluating diet, in severe cases doctors may try some of the anti-inflammatory or biological drugs that help people with inflammatory bowel disease or rheumatoid arthritis, in an attempt to quiet some of the cells responsible for the disease. Sometimes this helps, especially in patients with type I refractory celiac disease.
In type II refractory celiac disease (RCD type II), there are large numbers of abnormal white blood cells called T cells that are doing damage. RCD type II can also progress into cancer, usually lymphoma, in the small intestine. This is called enteropathy-associated T-cell lymphoma (EATL). Researchers are trying to find treatments to improve the symptoms of type 2 refractory celiac disease as well as reduce the risk of cancer, because most patients die of EATL.
In this setting, stem cell transplants have been used. While these transplants are similar to the kinds that are being offered by RMS, they are always preceded by chemotherapy to kill off the abnormal T cells. The results from the few studies of this treatment for refractory celiac disease have shown very limited success when used along with vigorous chemotherapy. In one pilot study of 13 patients, there was some short term success. Other trials have been less promising.
There are no published studies about using stem cell treatment for people with celiac disease responsive to the gluten-free diet. While RMS uses a person’s own stem cells (and apparently there is no chemotherapy) so the procedure is probably safe, it has not been shown to be effective. It is also undoubtedly very costly.
Anyone can visit the RMS website and read about the procedure. A chat is offered immediately, or you can fill out forms for more information. There is no reason not to look at this. But unless someone can point to studies showing that stem cell transplants are both safe and effective in treating celiac disease, and that they eliminate the need for a gluten-free diet, spending time and money on such a procedure does not seem like a good choice.