Update on Celiac DiseaseThe SSCD CDURP member Celiac Center of Excellence Hartford Healthcare Connecticut GI PC has shared with volume one of their Update on Celiac Disease. Click here to read more.
Given the maturing state of the celiac disease clinical trial landscape there is an increased need for sites who are prepared to participate in celiac disease clinical trials. Join us for this exciting series here.
Four-Part Clinical Trial Webinar Series
We are excited to inform you of this new funding opportunity, a joint initiative by Beyond Celiac and the Society for the Study of Celiac Disease. This early career research award for SSCD members covers up to $90,000 per year for 2 years. The application deadline is 6:00 PM ET on June 5, 2023. Details regarding this funding opportunity are provided here.
Early Career Research Award
THE DOUBLE-EDGED SWORD OF GUT BACTERIA IN CELIAC DISEASE ANDIMPLICATIONS FOR THERAPEUTIC POTENTIALHeather J. Galipeau and Elena F. Verdu
Celiac disease (CeD) is an immune-mediated disease, triggered by gluten ingestion, in genetically susceptible individuals. Thegluten-free diet (GFD) is the only current treatment for CeD, but is difficult to follow, has high non-adherence rates, and does notalways lead to symptomatic or mucosal remission. Microbially-mediated mechanisms have been proposed to contribute to diseasepathogenesis, and clinical studies support an association, but mechanistic insight has been difficult to obtain. Recent advancesusing translational approaches have provided clues to the mechanisms through which bacteria could contribute to CeDpathogenesis. In this review we discuss these bacterially mediated mechanisms, which include the modulation of pathogenic orprotective pathways. Targeting these pathways through microbial therapeutics could provide adjuvant therapies to the GFD. Click here to read more.
Society for the Study of Celiac Disease Statement on Covid-19 Vaccines and ChildrenWith the news that the Food and Drug Administration (FDA) and Centers for Disease Control (CDC) have authorized the Pfizer-BioNTech COVID-19 vaccine for those ages 5-11, we have received inquiries about the advisability of proceeding with vaccination in this age group. We fully agree with the CDC recommendation that everyone ages 5 and older get a COVID-19 vaccine to help protect against COVID-19. This includes individuals with celiac disease.
Although the risk of severe COVID-19 is far lower in children as compared to adults, widespread transmission of this virus, particularly since the development of the Delta variant, has resulted in thousands of hospitalizations and hundreds of deaths among children in the United States. Vaccination in this age group has been shown to be highly safe and effective, and is the strongest tool we have to prevent transmission and severe illness. To date, there is no evidence to suggest that people with celiac disease are at higher risk of severe COVID-19 or of the vaccine having a different safety or effectiveness profile in people with celiac disease. Additionally, there is no gluten in any of the authorized COVID-19 vaccines. Patients with concerns about vaccination and their particular circumstance should speak with their health care provider. We urge the public to proceed with COVID-19 vaccination promptly.
Society for the Study of Celiac Disease
Benjamin Lebwohl, MD, MS
Ritu Verma, MD, MBChB
Daniel A. Leffler, MD, MS, AGAF
Vanessa Weisbrod, BA, CA, CHN
Ciarán P. Kelly, MD
Sheila Crowe, MD
Amy R. DeFelice, MD
Rachel Kay, MS, RDN, CSP, CD, CNSC
M. Ines Pinto-Sanchez, MD, MSc, CNSC
Society for the Study of Celiac Disease position statement on gaps and opportunities in coeliac diseaseProgress has been made in understanding coeliac disease, a relatively frequent and underappreciated immune- mediated condition that occurs in genetically predisposed individuals. However, several gaps remain in knowledge related to diagnosis and management. The gluten- free diet, currently the only available management, is not curative or universally effective (some adherent patients have ongoing duodenal injury). Unprecedented numbers of emerging therapies, including some with novel tolerogenic mechanisms, are currently being investigated in clinical trials. In March 2020, the Celiac Disease Foundation and the Society for the Study of Celiac Disease convened a consensus workshop to identify high- yield areas of research that should be prioritized. Workshop participants included leading experts in clinical practice, academia, government and pharmaceutical development, as well as representatives from patient support groups in North America. This Roadmap summarizes key advances in the field of coeliac disease and provides information on important discussions from the consensus approach to address gaps and opportunities related to the pathogenesis, diagnosis and management of coeliac disease. The morbidity of coeliac disease is often underestimated, which has led to an unmet need to improve the management of these patients. Expanded research funding is needed as coeliac disease is a potentially curable disease. Read the full article
SSCD STATEMENT ON COVID-19 VACCINATION
With the recent news that the Food and Drug Administration has granted Emergency Use Authorization for a vaccine against SARS-CoV-2, the virus that causes Covid-19, patients with celiac disease are asking for guidance about the advisability of this and other Covid-19 vaccines in the context of celiac disease, an immune-mediated condition. As scientists and clinicians who care for people with celiac disease, we urge people with celiac disease to receive a Covid-19 vaccine that has met government regulatory approval. This includes agents comprised of RNA (a vaccine technology that has been in development and has undergone safety testing for years) and peptide (protein) vaccines.
During the onset of the Covid-19 pandemic, there was initial concern that people with celiac disease might be at a slightly increased risk of severe outcomes from SARS-CoV-2 infection, given prior studies suggesting risks related to pneumonia and viral infections. Studies thus far, including the international registry www.covidceliac.org, have indicated no increased risk of severe outcomes. Even though the risk among people with celiac disease is comparable to that of the general population, we have seen that Covid-19 can nevertheless have devastating effects, and we share in the consensus belief by the public health community that mass vaccination is crucial. As the safety and efficacy data on Covid vaccination has emerged, there is no evidence to suggest that people with celiac disease would be more prone to an adverse effect of vaccination. Celiac disease is not considered an allergy, and by itself does not prompt additional precaution when proceeding with vaccination. Patients with concerns about vaccination and their particular circumstance should speak with their health care provider. We will undergo Covid-19 vaccination as soon as it is offered to us, and we urge our patients to do so.
Ciarán P. Kelly, MD, President
Benjamin Lebwohl, MD, MS, President-Elect
Alessio Fasano, MD, Secretary
Dawn W. Adams, MD, MS, Treasurer
Elena F. Verdú, MD, PHD, Past President
Sheila Crowe, MD, Councilor
Amy R. DeFelice, MD, Councilor
M. Ines Pinto-Sanchez, MD, MSc, CNSC, Councilor
Ritu Verma, MBChB, Councilor
Aryl hydrocarbon receptor ligand production by the gut microbiota is decreased in celiac disease leading to intestinal inflammation
Bruno Lamas1,*, Leticia Hernandez-Galan1,*, Heather J. Galipeau1, Marco Constante1, Alexandra Clarizio1, Jennifer Jury1, Natalia M. Breyner1, Alberto Caminero1, Gaston Rueda1, Christina L. Hayes1, Justin L. McCarville1, Miriam Bermudez Brito1, Julien Planchais2, Nathalie Rolhion3, Joseph A. Murray4, Philippe Langella2, Linda M. P. Loonen5, Jerry M. Wells5, Premysl Bercik1, Harry Sokol2,3,†,‡ and Elena F. Verdu1,†,‡
1 Farncombe Family Digestive Health Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
2 Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350, Jouy-en-Josas, France.
3 Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Hôpital Saint Antoine, Service de Gastroenterologie, F-75012 Paris, France.
4 Division of Gastroenterology and Hepatology, Department of Immunology, Mayo Clinic College of Medicine, Rochester, MN, USA.
5 Host-Microbe Interactomics, Animal Sciences Group, Wageningen University, Wageningen, Netherlands.
‡ Corresponding author. Email: email@example.com (E.F.V.); firstname.lastname@example.org (H.S.)
* These authors contributed to this work as co-first authors.
† These authors contributed to this work as co-senior authors.
Science Translational Medicine 21 Oct 2020:
Vol. 12, Issue 566, eaba0624
The advantage of a high-tryptophan diet
Although 40% of the worldwide population express celiac disease susceptibility genes, only 1% will develop the disorder, suggesting a role for environmental factors, including the gut microbiota. Lamas et al. show that celiac disease is associated with an impaired capacity of the gut microbiota to metabolize tryptophan into aryl hydrocarbon receptor (AhR) ligands in patients with celiac disease. Gluten-induced immunopathology in mice expressing a celiac disease susceptibility gene was ameliorated after AhR pathway activation by a high-tryptophan diet, or by treatment with a pharmacological AhR agonist or bacteria producing AhR ligands. AhR pathway modulation by the gut microbiota may have potential as a therapeutic strategy for treating celiac disease.
NANOPARTICLES SHOW PROMISE AS A TREATMENT FOR CELIAC DISEASE
New study suggests gluten could be prevented from triggering the damaging immune reaction
By Amy Ratner, Medical and Science Research News Analyst
A potential treatment for celiac disease in which nanoparticles act like a Trojan horse and carry a hidden component of gluten to reprogram the immune system not to react has shown positive early results in a new clinical trial.
Click here for more
Commentary: Safety of Adding Oats to a Gluten-free Diet for Patients with Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational StudiesMaria Inés Pinto-Sánchez, Natalia Causada-Calo, Premysl Bercik, Alexander C. Ford, Joseph A. Murray, David Armstrong, Carol Semrad, Sonia S. Kupfer, Armin Alaedini, Paul Moayyedi, Daniel A. Leffler, Elena F. Verdú, Peter Green
The study, published in Gastroenterology (April 18, 2017, article/S0016-5085(17)35474-4), found no evidence that addition of oats to a gluten-free diet affects symptoms or activates celiac disease. However, it is very important to stress that there were few studies in some of the analyses, the quality of the studies was low and most of them were conducted outside of North America. This means that although the [general] consensus is that pure (not contaminated with gluten) oats are safe for most patients with celiac disease, contamination with other cereal sources that may contain gluten, needs to be avoided. The purity of oats will depend on the country of origin and local regulations and, therefore, we were surprised to see that most recommendations in North America are still based on studies performed in Europe. The study raises the need for well-controlled studies in North America, using locally sourced oats.
It can be difficult to follow a strict gluten-free diet after being diagnosed with celiac disease. Oats, compared to other cereals like wheat, are a source of good quality proteins, vitamins and minerals and they improve palatability and the texture of gluten-free food. For a person diagnosed with celiac disease, adding oats to a gluten-free diet could not only increase food options, but also help them follow a better gluten-free diet and have a higher quality of life. However, issues have been raised regarding potential adverse reactions to oats by celiac patients and this has reduced the enthusiasm of adding oats to the gluten-free diet in many cases. For this reason, SSCD members decided to perform a meta-analysis to evaluate the evidence regarding the safety of adding oats to a gluten-free diet in celiac disease.