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Update On The Search For A Gluten Free Cure

Dr Magnifying Glass

As researchers are learning more about what parts of the wheat proteins cause problems for people with celiac disease, there is a corresponding interest in trying to change the glutens into something people with celiac disease can digest.

Historically speaking, there are a higher percentage of people with celiac disease than in the past. There are a number of reasons for this. One is that better tests allow the diagnosis in people who have less severe symptoms and another is that wheat has changed, and this may be a reason why more people have celiac disease.

The wheat consumed today is mainly a hybrid of older wheat varieties. Perhaps trying to get a high-yield grain did something to make the grain more likely to activate celiac disease in genetically susceptible individuals.

Most of the wheat protein is broken down as it goes through the digestive tract, before it gets into the small intestine. However, there are large blocks of protein pieces, called peptides, that arrive at the small intestine in one piece. They contain more of the amino acids glutamine and proline than do most other proteins. This makes them sticky, and is one of the reasons for the texture of wheat.

Right now, a gluten-free diet is the only choice for treating celiac disease. Researchers, however, are looking at ways to select or treat wheat to make it less irritating (immunogenic, or stimulating to the immune system) to people with celiac disease.

Here are some of the directions of research:

  • Select less immunogenic wheat.  Wheat has already been hybridized by wheat growers, who usually use a hexaploid wheat called Triticum aestivum, which is a hybrid of so-called “pasta wheat” and another wheat. “Pasta wheat” evolved from wild strains of wheat. Laboratory research has shown that partially digested “pasta wheat” gluten is less immunogenic than Triticum aestivum. 16 existing wheat varieties show different abilities to trigger celiac disease. There is active research looking at genetic modification of wheat glutens. It is possible to remove the immunogenic areas, but this leads to a loss of wheat’s baking properties. This research is still mainly in the laboratory phase.
  • Pretreat the flour. Bacteria can be used to pretreat wheat, which is called fermentation. Bacteria can digest the proline/glutamine-rich peptides which makes the gluten less immunogenic. In one study, sourdough bread was made from 30% fermented wheat flour along with a mixture of buckwheat, oats and millet. The bread was similar in texture to regular sourdough bread. In the small study, 17 patients with celiac disease were able to eat this bread for two days. Much more research needs to be done, but this is certainly an area where there might be success. In addition, wheat germination naturally degrades the immunogenic parts of gluten. Enough germination might make gluten tolerable but also removes the properties it has that are needed for baking. There is also a way to pretreat wheat with enzymes from bacteria that link up the immunogenic parts of gluten.
  • Give people with celiac disease something to take that will help break down the pieces of gluten that cause the problem. There are a number of molds that make enzymes which can break down gliadin peptides. There are current studies using some of these, including combinations. It seems likely that taking enzymes might prevent symptoms from accidental ingestion of small amounts of the gluten that finds its way into everything, but probably not enough to allow people with CD to eat a normal amount of wheat.

There have been successes in these areas of research and the good news is that it’s ongoing. It seems likely that one or more of these ways to deal with gluten will work well enough and be inexpensive enough that people with celiac disease will have a way to deal with accidentally eating gluten, or make bread that they can tolerate it. It certainly seems as though we are on the right road to finding a cure but for the time being the best therapy is sticking to eating a gluten-free diet.

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