Drug heals celiac monkeys
Support has come from treatment of rhesus macaque monkeys with celiac-like disease. In a recent study, six gluten-sensitive monkeys showed improvement when treated with human anti-IL 15 while on a normal, gluten-containing diet.
Karol Sestak, PhD, core scientist at Tulane National Primate Research Center in Covington, Louisiana, has spent 12 years describing and comparing celiac in monkeys with that in humans. Medical research has more often used mice genetically engineered to be gluten-sensitive. However, macaques are more similar to humans both genetically and physiologically, offering advantages when studying therapy for humans.
Besides, they do not need to be genetically altered. The disease naturally occurs in a small percentage of macaques as it does in people. Sestak says his team discovered this while studying digestive problems in the primate colony in 2006. Various viral infections in the monkeys had already been isolated.
“Occasionally, there would also be some disease in these nonhuman primates where you cannot trace any kind of infectious agent when they have chronic diarrhea. Back then, we were wondering what that could be,” says Sestak. “We reformulated their diet. We removed all the gluten sources from the monkey chow. It was our first gluten-free diet. Their conditions dramatically improved.”
The researchers then found the celiac monkeys had the same disease antibodies detected in humans. Those antibodies decreased when the animals were treated with a gluten-free diet. Another similarity with human patients is that gluten-sensitive macaques display a wide spectrum of disease. Some are seriously affected, some moderately and some mildly. When identified in their routine check-ups, these individuals are placed on a gluten-free diet or can be assigned to try out another promising therapy.
Sestak’s team conducted trials using 04H04, another clone of human anti-IL15 not identical to AMG 714. 04H04 reversed inflammation and damage in all six animals regardless of the seriousness of their disease. Their recovery was checked using biopsy for a close look at the gut lining. The treatment also improved some but not all markers for immune disease outside the intestine, such as antibodies detected by blood tests.
Anti-IL 15 works by suppressing IL 15, which appears to be a major immune agent but not the only one active in celiac. Since the drug healed intestinal tissue but did not reduce all disease markers, this suggests it might work best alongside a gluten-free diet or other therapy.
Undiagnosed celiac disease impacts pregnancy
Women with diagnosed celiac do not see the condition impact pregnancy and childbirth, according to Danish national statistics. However, prior to diagnosis and treatment, women had an increased risk for spontaneous abortion or stillbirth.
The data came from the entire population of Danish women between 1977 and 2016. The analysis included 6,319 women diagnosed with celiac who had follow-up records in the health registry. After diagnosis, they were just as likely to become pregnant as women in the general population. They had no more problems during pregnancy and childbirth.
In contrast, women with celiac had fewer pregnancies than average during the two years prior to diagnosis. Overall, women with undiagnosed celiac had 11 more miscarriages and 1.62 more stillbirths per 1,000 live births. This supports a focus on early diagnosis in women, especially those who lose pregnancies.
Van Waffle is a freelance journalist in Waterloo, Canada, and research editor for Gluten-Free Living. He blogs at vanwaffle.com.