Bruce Scott Dwyer asked:


If you are a celiac, your miracle cure is under way – being trialed in Melbourne Australia from April 2009! It could conceivably desensitize people with celiac disease to the point that the villi in their small intestine are not damaged by the gluten protein. However with the need for extensive testing in this three phase trial, the vaccine may not be ready for release for several years.

Before we go into the details of such a cure it should be noted that this vaccine might not be a ‘magic bullet’ that makes people permanently immune to the gluten protein, it might ‘only’ desensitize them. Also be aware that if you choose to undertake the ‘therapy’ there are no guarantees of how you will react, and the only way to regularly check to see if you have been ‘cured’ would be regular intestine biopsies. As it is known that some people take over two years to heal their intestines from gluten damage, how risky will this strategy be? It is expected that testing will be extensive so these questions may all sit under the ‘devil’s advocate’ category, and all may be well.

An even more philosophical question is what effect covering up the cause of your disease will have on your body. Books have been written that suggest that it is the increased gluten potency in wheat and other gluten grains as well as increased use in manufactured foods that has led to an overdose of gluten. Our bodies then pass a ‘tipping point’ where our genetic predisposition to CD turns into an active disease. If this is true, how wise would it be to continue ingesting unnaturally high levels of gluten, once ‘cured’ just because we can? Sure it would make life simpler not following a gluten free diet, however maybe we should wait for gluten to be decreased at the source, the growing fields, before we return to a gluten filled diet.

Different types of celiac disease identified

With all these issues under consideration, I am sure that every celiac would still be interested in a ‘cure’. A July 2007 article based on research conducted in Victoria, Australia, showed that “Celiac disease – is strongly associated with human leukocyte antigen (HLA) DQ2 and to a lesser extent with HLA DQ8.”

“HLA genes are part of the major histocompatibility complex (MHC), which plays a pivotal role in the immune system. HLA-DQ2 mediated celiac disease is common in people of European ancestry, with about 90 per cent of sufferers positive for DQ2. Another five per cent possess HLA DQ8. In China and East Asia, DQ2 genes are rare while DQ8 genes are as common as in Europe.”

So it appears that this preliminary research has been able to isolate two main versions of celiac disease. However the molecular workings of the immune response in the two antigens appear to be very different. The researchers discovered that T-cells in people with DQ8-associated celiac disease reacted quite differently to the small proteins in gluten than the T-cells in people with the DQ2 form of the disease.

“At the moment a gluten-free diet is the only treatment for celiac disease but nearly half the people on the diet still have damage to their small intestine. Consequently other therapies, including a vaccine and three different drugs, are in various stages of development. The research team believes celiac disease might be the first example of an immune disease where treatments are customized according to the genetic make-up of the patient.”

The celiac vaccine discovery

The discovery that lead to the creation of the vaccine was that the one critical part of wheat gluten protein that was toxic was the common genetic version (HLA DQ2) of celiac disease. “As much as the identity of the toxic component of gluten was important, it was the way in which it was found that has proven to be even more important. By eating gluten in wheat, rye, or barley for three days (even a single meal will suffice in some people), immune cells (T cells) that damage the small intestine are mobilized into blood for a few short days. The T cells in blood can be monitored and analyzed to define what part of gluten they recognize. The parts of gluten recognized by the vast majority of T cells involved in celiac disease can be condensed to a few “short” fragments of gluten that remain after its digestion in the gut. These gluten fragments can be synthesized using fairly standard chemistry and are the basis for the celiac vaccine.”

The Celiac Vaccine Trials

The original research began at Oxford England in 1997. The work continued in Australia in 2002 and by April 2009 Bob Anderson from the Walter and Eliza Hall Institute of Medical research (Melbourne, Australia) will commence the first world trials of a celiac vaccine that could reduce or eradicate the need for being gluten free. In fact Bob Anderson calls the vaccine a “next-generation desensitization therapy” that has been successful in mice and is soon to be tested on celiacs.

“The vaccine will be tested on 40 volunteers with celiac disease over 11 months to establish that it does not harm them. In a subsequent phase 2 trial, which is designed to find out if the treatment is effective, volunteers will receive the treatment and then be challenged with foods containing gluten. Their immune response and intestines will then be examined to see if a tolerance to gluten has developed. The therapy involves repeatedly injecting solutions of gluten at increasing concentrations. The aim is to desensitize the subjects slowly, in a similar way to hay fever and dust allergy desensitization treatments.”

Testing process

“For a new drug to be accepted for use in people in Australia, Europe, or North America it must have progressed successfully from Phase 1 (safety) studies usually involving up to about 30 volunteers, to Phase 2 (efficacy) studies to show that “it works” in people with the medical condition of interest (typically about 200 volunteers in several locations around the world), and to Phase 3 (similar to Phase 2 but involving several thousand volunteers in many sites around the world).”

The celiac vaccine future

Due to difficulties in funding, Bob Anderson (Walter and Eliza Hall Institute) co-founded a commercial company called Nexpep to develop the vaccine. Nucleus Network, Centre for Clinical Studies (CCS) in the Alfred Hospital in Melbourne, will be conducting the Phase 1 clinical trial.

The difficulty he has faced, besides the technical issues, is the low diagnosis level of celiac disease and the mass of associated symptoms has made a vaccine cure unattractive to traditional pharmaceutical companies. These companies always prefer well defined markets to accurately forecast payback periods for their R&D and marketing expenses.

The facts are that for this vaccine to prove financially viable, The US will need to approve the drug and doctors and celiacs will need to accept the treatment. One report estimates that only 600,000 people are diagnosed with celiac disease (out of the 5 million with celiac disease in North America and Europe).  

Compounded to the funding challenges is that previously, globally, there have only been three “randomized, controlled” studies of the gluten free diet – one in children and two in adults – the largest with 57 participants.”

The assessment of the vaccine treatment will require repeated endoscopy and collection of small intestine biopsies which are expensive and un-enjoyable for volunteers. However a recent trial in Italy has shown that biopsies are still the only ‘almost’ guaranteed method of assessing gluten damage. The study findings showed that “two years after adopting a gluten free diet, about half those people diagnosed with celiac disease continued to have villous atrophy as severe as when they were first diagnosed. Only about one in five of those with severe intestinal damage (villous atrophy) on a gluten free diet had raised (abnormal) blood levels of transglutaminase antibody, meaning that standard blood tests to monitor disease activity were relatively ineffective.”

So while the development of this vaccine is an important step in potentially eradicating celiac disease, philosophical questions still remain as issues for the long term efficacy of the vaccines. As an Australian first, this research is applauded by the gluten free community. We wish the researchers and medical staff all of the best in demystifying this illusive disease.

Article references are available on the gluten free pages website. 

Kirsty Cussens asked:


When your child is first diagnosed with celiacs disease, one of the biggest questions is ‘Should the whole family go gluten free?’

Certainly there are advantages to this option: equally there are disadvantages. It is a question that needs discussing and working through,preferably as a whole family, as everyone is affected, the earlier the better.

The first option is for only the affected family member to go gluten free, and the rest of the family to eat as they always have.

 

This may be the most popular option if brothers and sisters object to eating gluten free food – especially if they object to giving up certain gluten containing favourites such as cakes and biscuits! As my daughter used to say on occasion, ‘I’m not celiac- why am I not having my favourite food because he is?’ So this option would in some ways maintain family harmony, although it does continually point out the celiac child as being different. It also means that whoever is cooking for the family will often have to make multiple meals which is both time consuming and difficult.

Another argument is that if the rest of the family are eating gluten all the time it is incredibly difficult to avoid cross contamination for the celiac child. The whole family needs to be very aware of contamination

issues but mistakes happen – especially when children or teenagers are in a hurry!

On the other end of the scale, the whole family could go gluten free.

This has the great advantage of eradicating gluten from the kitchen completely, so cross contamination is not an issue at all. The family can eat together, the cook only has to prepare one meal, and the celiac child is not the ‘odd one out’. This can work well in a family where someone does most of the cooking and also bakes gluten free cakes and biscuits on a regular basis.

 The big disadvantage of this option, however, is the cost. If pre-prepared meals are a large part of the diet, or if you buy a lot of gluten free cakes and biscuits, this can be an incredibly expensive option! Gluten free products are generally quite pricey and for the whole family to eat it unnecessarily will cost! You may also get complaints from other family members who neither want nor need to eat a gluten free diet.

We, like many other families I have talked to, have settled for the middle option. We all eat… mainly gluten free!

Everything I bake is gluten free: the whole family has homemade gluten free cakes and biscuits in their lunchboxes and there have been no complaints about this at all. Family meals are also gluten free: this is very easy as I do not rely on pre-made sauces etc, and there are so many meals that are naturally gluten free that it really doesn’t take much planning.

However, because of the expense (and my complete failure with the bread maker) my son has his own gluten free bread while the rest of us have sliced (to avoid contamination) bread. We also have a separate tub of margarine with a big red cross on it for using on wheat bread, and two toasters. Also because of the expense, my son will have things like gluten free fish fingers while the others have normal, and the normal ones are cooked on a special baking tray.

In fact it is the gluten things that are singled out as being different in our kitchen, because most foods and kitchen areas are completely gluten free. It has worked for us. My son never feels any different, and the ‘gluten things’ are kept separately and carefully.

It is an issue that needs thinking through. But life gets so much easier when the whole family knows where they stand with it. And compromises can be reached to ensure that every member is happy.

Jack Sands asked:


When it comes to cooking, there are many dietary restrictions that will be encountered along the way. One restriction that is gaining some degree of notoriety in recent years is the need for a gluten free diet. Gluten is a substance that is commonly found in flour products that a decent sized portion of the population has a negative reaction to in some form or another. For these people, gluten free isn’t a choice it is absolutely necessary.

Gluten free cooking does impose many restrictions and often makes it quite difficult to enjoy something the vast majority of us take for granted-dining out. The good news from those who require gluten free cooking is that more and more restaurants are beginning to acknowledge this condition and offer some selections that are gluten free. It takes time, just as it did with low carb craze for the demand for these products to make it worth the industries while to make adjustments in their way of preparing foods.

While on the one hand it is frustrating to not have the option of dining out, there is some challenge to finding new and tasty foods and combinations for cooking each and every night without falling into a rut of the same old foods that you know you can eat without worry. Consider cooking gluten free a challenge rather than a chore and you may find that the process is much more enjoyable. You might even find that you appreciate the meals you’ve worked hard to prepare even better because of the great sense of accomplishment.

There are many resources available for those who need to eat gluten free foods. There are even more and more ‘convenience’ or prepackaged foods that are designated for gluten free cooking. This means that those who once had no option but creating meals from scratch do now have the occasional shortcut available to them. We are even finding cookie and cake mixes that are now gluten free in order to enjoy some of the finer things in life for those who would have been completely deprived only a few short years ago.

Changes are being made and resources are being shared through the Internet that help not only adults that require special gluten free cooking and diets but also support for the parents of children who must have gluten free diets. Cooking for children in the best of circumstances is often difficult. It is even more difficult when there are excessive dietary restrictions that often eliminate the possibility of our children enjoying childhood favorites. That is why it is so important to seek out the many resources and recipes that are available for gluten free cooking.

If you require a gluten free diet and have no idea where to start or what you should be cooking you should check out the many websites and blogs online that address the issues and needs that are faced by those requiring gluten restrictions. You will probably be amazed at the wealth of information that is available. Also, if you have a Trader Joes or Whole Foods store in your area, most of them either offer or will order gluten free products for your cooking needs.

Gluten free cooking does not have to be the chore many of us think it must be and all gluten free food doesn’t taste like cardboard. Take the time to get to know the wonderful gluten free recipes that abound and incorporate them one at a time into your cooking repertoire. You will be amazed at how wonderful you feel as well as how great the food tastes.

Andrew Van Vooren asked:

Autistic children often have lower levels of detoxification enzymes and antioxidants and may therefore be more susceptible to environmental toxins and food chemicals such as gluteus. Autistic children have significantly lower mean levels of detoxification/antioxidant enzymes making it much more difficult to break down glutens. There is no universal treatment for autism, but treatment programs and diets should address the three systems of the body that are compromised in autism which is the immune system, nervous system and digestive system.

The triggers of this disease are on the rise. More susceptible kids come in contact with triggers such as gluten. Kids exposed to toxins such as mercury, lead, pesticides, and second hand smoke have higher levels of autism. Some studies have reported many nutritional deficiencies in autism patients. Numerous studies have reported that supplemental nutrients such as omega-3 fatty acids, zinc, vitamins, and magnesium may provide moderate benefits to autism patients. Avoidance of glutens and other food chemicals may also provide some relief to autism patients.

Evaluate the Diet

Rebalance the nervous System

Improve Intestinal Health

Allergies and intolerances to food and food additives may also play a role in autism. Elimination of potentially allergenic foods such as gluten has been tried on autistic children with mixed results. A Norwegian study found that 10 children with autism on a gluten-free diet for 1 year improved on autistic traits, cognition, and motor skills to a much greater extent than 10 children given a standard diet. Other studies have reported that children with autism have a significantly higher rate of increased intestinal permeability (“leaky gut syndrome”) compared to controls.

I read that some researchers have suggested that oral probiotic bacteria supplements may be helpful in treating autism. The effect of refined sugar, food additives and gluten on autism patients is controversial, some studies showing that sugar and food additives can trigger worsened autism symptoms. A review of 16 studies with autism children found that sugar challenges were associated with worsened symptoms of inattention and hyperactivity in 4 studies, little change in 11 studies, and improvement in Autism symptoms in 1 study. Diets free of food coloring, food preservatives, and gluten have been widely used to treat children with autism since they were introduced in the 1970s. I also read that a meta-analysis of 15 double-blind, placebo-controlled studies in patients with autism reported that artificial colors such as tartrazine significantly increased autism symptoms. Of the 15 individual studies, 5 stated that food colors and gluten were associated with significantly increased autism symptoms, 8 showed that food colors and gluten were associated with no significant increases in autism symptoms, and 2 showed that food colors an gluten were associated with no significant decreases in autism symptoms.

Besides gluten and food colors, other dietary components that could possibly worsen autism symptoms include food preservatives such as benzoate, nitrates, and monosodium glutamate as well as food that naturally contains salicylates (such as almonds, oranges, raspberries, apples, cherries, grapes, peaches, strawberries, cucumbers, plums, and tomatoes).

Autism appears to involve a broad range of genetic, prenatal, social, developmental, nutritional, and environmental factors and it is unlikely that only 1 single cause will be found for either disorder. Multiple treatment modalities are probably needed to treat patients with autism and may include nutritional, environmental, pharmacologic, and psychosocial interventions.

All children born to this wonderful planet have obstacles to overcome. To children with autism, these obstacles may appear more difficult. These beautiful and wonderful children require tender coaxing back into the world so that they might experience the magnificence that life has to offer.

Jack Sands asked:


When it comes to cooking, there are many dietary restrictions that will be encountered along the way. One restriction that is gaining some degree of notoriety in recent years is the need for a gluten free diet. Gluten is a substance that is commonly found in flour products that a decent sized portion of the population has a negative reaction to in some form or another. For these people, gluten free isn’t a choice it is absolutely necessary.

Gluten free cooking does impose many restrictions and often makes it quite difficult to enjoy something the vast majority of us take for granted-dining out. The good news from those who require gluten free cooking is that more and more restaurants are beginning to acknowledge this condition and offer some selections that are gluten free. It takes time, just as it did with low carb craze for the demand for these products to make it worth the industries while to make adjustments in their way of preparing foods.

While on the one hand it is frustrating to not have the option of dining out, there is some challenge to finding new and tasty foods and combinations for cooking each and every night without falling into a rut of the same old foods that you know you can eat without worry. Consider cooking gluten free a challenge rather than a chore and you may find that the process is much more enjoyable. You might even find that you appreciate the meals you’ve worked hard to prepare even better because of the great sense of accomplishment.

There are many resources available for those who need to eat gluten free foods. There are even more and more ‘convenience’ or prepackaged foods that are designated for gluten free cooking. This means that those who once had no option but creating meals from scratch do now have the occasional shortcut available to them. We are even finding cookie and cake mixes that are now gluten free in order to enjoy some of the finer things in life for those who would have been completely deprived only a few short years ago.

Changes are being made and resources are being shared through the Internet that help not only adults that require special gluten free cooking and diets but also support for the parents of children who must have gluten free diets. Cooking for children in the best of circumstances is often difficult. It is even more difficult when there are excessive dietary restrictions that often eliminate the possibility of our children enjoying childhood favorites. That is why it is so important to seek out the many resources and recipes that are available for gluten free cooking.

If you require a gluten free diet and have no idea where to start or what you should be cooking you should check out the many websites and blogs online that address the issues and needs that are faced by those requiring gluten restrictions. You will probably be amazed at the wealth of information that is available. Also, if you have a Trader Joes or Whole Foods store in your area, most of them either offer or will order gluten free products for your cooking needs.

Gluten free cooking does not have to be the chore many of us think it must be and all gluten free food doesn’t taste like cardboard. Take the time to get to know the wonderful gluten free recipes that abound and incorporate them one at a time into your cooking repertoire. You will be amazed at how wonderful you feel as well as how great the food tastes.

Lars Garrett asked:


Have you recently discovered you’re experiencing gluten intolerance symptoms? Discovering this can create a lot of uncertainty and confusion about how to deal with it. After all we love our carbs, and some of the ones we love the most — like bread, pasta and baked goodies — suddenly become off limits when diagnosed with Celiac Disease (gluten intolerance).

When you’re forced to stop and think about it you realize how many foods we commonly eat that contain gluten… for breakfast, lunch and dinner. Where do you go from here?

Once you know that you need to adapt to a gluten-free diet it becomes a matter of changing your habits and patterns. Luckily more and more information is available about how to cook and live gluten-free. You’ll also find many new gluten-free products and more helpful labeling from manufacturers.

For starters anyone with gluten intolerance symptoms should become familiar with certain gluten-free pantry essentials and keep them on hand. These are ingredients that can be substituted for the common gluten containing flours to create gluten-free goodies.

Some of the common substitute flours include: brown and white rice flour, soy flour and tapioca flour. But there is a good list of flours that can be substituted. Find a growing & evolving list at our website (listed at the end of this article).

Gluten creates that nice texture in baked goods because it traps pockets of air. Gluten gives dough its elasticity and helps keep baked goods from crumbling and falling apart. It is also used to quickly thicken sauces.

Substituting gluten-free flours alone won’t make up for these lost attributes. When using a gluten-free flour mixture a gluten substitute should be added to the mix to mimic the qualities of gluten. Two popular gluten substitutes are xanthum gum and guar gum. These can generally be found online or at a health or natural food store.

It’s also helpful to keep a good gluten-free flour mixture and gluten substitute on hand. A gluten-free flour mixture consists of a blend of gluten-free flours. You may want to try a few to find the gluten-free flour mixture you like best. Then when you’re ready to bake just add a gluten substitute to the mix and you’re ready to go. (I have a couple recipes for gluten-free flour mixes on my website, listed at the end of this article)

If you don’t want to make your own gluten-free flour mix you can buy a good quality gluten-free baking flour to keep on hand. This way you can avoid the guesswork involved in substituting. These gluten-free baking flours are usually to be used as a cup-for-cup substitute for regular white or wheat flour, but you should always check the directions for each gluten-free flour mix to make sure this is the case.

So you can see how learning your way around these gluten-free flours and creating your own gluten-free pantry can bring a lot of old favorites back to life. Once you get started you may even find some new favorites. Happy Baking!