Potential Cure for Celiac Disease
Celiac disease is an autoimmune digestive disease that damages the small intestine and interferes with absorption of nutrients whenever gluten is ingested. Gluten is a protein that's found in wheat, barley, rye, and triticale.
According to National Foundation for celiac Awareness, about one in 33 Americans, or one percent of the population, has celiac disease.
The only treatment for those who suffer from celiac disease is avoiding gluten in foods. However, a new study published in the Journal of Allergy and Clinical Immunology
might shine a little hope on new treatments.
Scientists recruited 12 people with celiac disease and gave each individual 20 hookworm larvae to ingest.
Over the course of 52 weeks, the scientists gave varying amounts of gluten to the participants. These amounts included:
- 10-50 mg for 12 weeks
- 25 mg daily plus one gram twice weekly for 12 weeks
- three grams daily (60-75 straws of spaghetti) for two weeks
Scientists took tissue and blood samples to see if this therapy worked (please note that only eight out of the 12 individuals completed the trial). Scientists found that gluten toxicity levels did show improvement, and by the end of the trial, participants were able to eat about a bowl of pasta without any symptoms.
Does this mean a new treatment will soon be available?
Listen in as Dr. Mike shares the findings of this noteworthy study and what this means for those who have celiac disease.
RadioMD Presents:Healthy Talk | Original Air Date: May 12, 2015
Host: Michael Smith, MD
Living longer and staying healthier. It's Healthy Talk with Dr. Michael Smith, M.D. Here's your host, Dr. Mike.
DR. MIKE: So, I want to discuss a potential cure for celiac disease. Some of you may find it kind of disgusting and it is a little bit, but it seems to work. So, I'm going to have to explain what it is. It's a treatment using the parasitic hookworm. Yes, a parasite, a worm may be the potential cure for celiac disease. Now it's important, let me make the distinction right now, I'm not talking about gluten sensitivities. I'm talking about the true autoimmune condition that affects over, oh, maybe about 2% of the world's population--definitely over 1%. This is where if you have celiac disease, your body produces antibodies that create quite a robust overstimulated immune response to gluten.
This causes a lot of damage and inflammation to the gut lining. Celiac disease has been associated with type II diabetes and multiple sclerosis. As a matter of fact, in 2013, the journal Nutrients wrote a great article on the potential link to colon cancer with celiac disease. So, that's what I'm talking about here. Really, the only therapy here, the only treatment for celiac, is to avoid gluten completely. I think most of you know that it is almost impossible to do that nowadays. I mean, gluten is in everything.
That's why it is important, if you have celiac disease, to eat fresh food. You have to know what you're cooking with. It's hard to even go out. You know, you really have to trust the restaurant. If they say, "This is gluten free," you really have to trust them. So really, the only way to treat celiac disease right now is to avoid gluten, which is tough and getting tougher. So, I want to share with you this report.
Now, if you want to read the full report , my friend, Maylin Paez, from Life Extension wrote about this. You can go check this out at blog.lifeexension.com. She pulled this from an Australian research center. They published the results in the Journal of Allergy and Clinical Immunology, a great peer-reviewed journal.
They looked at 12...Now, okay it's a small amount, right? It's hypothesis generating. We're not going to draw any definite conclusions. That's why I called it a potential cure. Scientists from Australia recruited 12 people with celiac disease and gave each individual 20 hookworm larvae to ingest. I know this is making some of you squeamish. So, 20 hookworm larvae over a period of 22 weeks. Varied amounts of gluten were given to participants and this is an interesting set up. They did a really good job of exposing the subjects to gluten at different doses over an extended period of time.
So-- and this is important--they used different sources for gluten. So that's also important. So, this is a small, but well-designed study. For 12 weeks, after ingesting the hookworms, some of them were given 10 to 50 mg of gluten for 12 weeks and then they switched over to 25 mg a day, plus one gram twice weekly for 12 weeks and then they went to three grams a day using different types of pasta for two weeks. So, they did a really good job of varying up the dose of gluten and the source of gluten. Blood and tissue samples were taken to examine their response to therapy.
Now, of the 12 only eight completed the trial. So, again, we don't have any conclusive evidence here. It's what we call a pilot study. So, only eight actually completed the trial. Tests measuring gluten toxicity showed improvement overall. The participants reacted well to gluten and the hookworm therapy. By the end of the trial participants were able to eat the equivalent of a bowl of spaghetti symptom-free. Now, you have to understand, for somebody with celiac disease, the thought of eating a bowl of spaghetti makes them want to fall over and faint. There's just no way.
So, the fact that after this study, after being given the hookworms, they were given a bowl of spaghetti, or the equivalent of the amount of gluten in a bowl of spaghetti, without any symptoms. That's major. That's a major accomplishment. They go on to say here, samples of intestinal tissue-- because that's important, too. In celiac disease, there's a definite change in the mucosal lining of the gut. So, you want to see if there's any improvement in some of those classic celiac changes in the gut. Samples of intestinal tissues showed beneficial changes. T cells, immune cells, changed from pro-inflammatory to anti-inflammatory. That's awesome!
They also started noticing a decrease overall in what is called denuding of the gut lining, meaning the gut lining started to kind of fill itself in in areas where there were problems. Larger trials definitely are needed to confirm the benefits of hookworm therapy. What do you think? Hookworms? How is this working? What do you think the mechanism of action is? That was the first thing. I thought, "What's going on here?" No one knows what's going on here, but here's the thought: In countries that are developing, or even just underdeveloped countries, especially in the tropics, parasitic infections with worms are not that uncommon, in particular with hookworms. They come from water, often fecal/oral routes. You drink some contaminated water, you wash your dishes with contaminated water. It's quite common.
And I don't have percentages, but I remember learning about these different parasites in medical school and hookworm is just incredibly common and most people just have a few larvae. They don't grow too much. They don't divide too much or they don't make too many hookworms, if you will, and there are a lot of people who have hookworm infections or parasitic infections and they don't even really know it and they can have it most of their lives.
The theory is this: the hookworm itself -- and we already know this because you can show this in petri dishes -- the hookworms produce proteins that breakdown inflammatory proteins in the gut. We already use that in the industry. We use enzymes. It's called enzymatic therapy, where I can give enzymes to customers, Life Extension members, and these enzymes will breakdown pro-inflammatory proteins in the blood and it will reduce chronic inflammation. So, we already know that. We already have this idea of enzymatic therapy to break down inflammatory proteins, and hookworms produce natural proteins that do that.
So, the thought is, in these countries where hookworm infections are ubiquitous, there's a certain amount of protection against high inflammation in the gut. There's a suppression of the immune system in the gut and you don't see things like celiac disease, even in the events where gluten ingestion is increasing. It's unfortunate that these diets that we follow, the Standard American Diet, (SAD) is making its way throughout the world. McDonald's, fast food joints, are popping up everywhere even in underdeveloped countries. So, these countries, where the traditional diet had probably very little gluten, it is increasing and you're still not seeing sensitivity to celiac disease like you see in the United States.
What's happened in Western countries and developed countries is, we've eradicated these parasitic infections, which sounds great. It is good overall, but we have no natural anti-inflammatories from these hookworms, in this instance, to protect us from this over response in gluten. So, we see higher instances of celiac disease. At least that's the theory.
So, the hookworm is, in a sense, an inflammatory and immunosuppressive for the gut lining and it protects against things like celiac disease. Very interesting. More research is needed. We'll have to follow this one. This is Healthy Talk on Radio M.D. I'm Dr. Mike. Stay well.