Celiac
disease is an autoimmune disorder that damages the small intestine when an
individual has eaten gluten. Gluten is a protein found in wheat, rye, and
barley. The disease is said to be hereditary and affects 1 in 100 people
worldwide; however, many cases go undiagnosed. There is a general belief that celiac
disease is incurable and that patients diagnosed must eliminate gluten from
their eating habits to have a tolerable diet. The ingestion of gluten in celiac patients triggers an immune response in their body that attacks the small intestine. The
continual damage to the small intestine’s lining creates malabsorption and can
also cause symptoms of diarrhea, fatigue, weight loss, bloating, and anemia,
which can lead to other serious complications if left untreated.
Soon to be tested in a clinical trial, the experimental vaccine created for celiac disease aims to protect patients from the effects of eating gluten. Nexvax2 is the name of the treatment created by ImmusanT Inc. and serves as a type of immunotherapy that "reprograms" the immune system to be tolerant of gluten. The vaccine will work similarly to an allergy shot- consisting of twice-weekly
injections administered over 16-weeks. The peptides made up in Nexvax2 will induce an immune response in patients with celiac. The early exposure to the
peptides will work to reprogram T-cells (immune cells that create responses) to
become tolerant to gluten by creating a non-triggering immune response. If
successful, the vaccine could allow patients that are already living with
celiac to begin eating a diet that contains gluten.
The
vaccine is intended for patients containing the gene HLA-DQ2.5 in their immune
system that is said to be found in 90% of individuals. It is a serotype group,
meaning there is a distinct variation of the cell in comparison to other immune
cells. Additionally, HLA-DQ2.5 is the gene most prevalent in autoimmune
diseases. The vaccine will be delivered intradermally, responding to gluten
antigens to stop responding defensively by triggering a pro-inflammatory
response. Patients will be able to resume an unrestricted diet due to the healing of the injured tissue in the small intestine that was triggered by T-cells causing inflammation. In the first trial, researchers showed that the vaccine was
safe and well-tolerated amongst the patients. In an upcoming trial that will
include 150 patients from Australia, New Zealand, and the United States, the
trial will aim to prove that the vaccine is safe, and in fact, effective in its
treatment.
Although celiac can occur from other
triggers, such as interactions between genes, environmental factors, surgery,
pregnancy, childbirth, or viral infection, the disease is commonly associated
with a gastrointestinal intolerance to gluten. Therefore, creating the Nexvax2
vaccination will serve as a desensitization therapy for celiac that will
restore long-term tolerance to the peptide, gluten, no matter the circumstance.
Peptide-based therapeutic vaccines have seen continuous success in preventing
and treating immune diseases.
References
Very good post on an important development. Catchy title and effective graphics. Good explanation of the immunochemistry involved in the treatment. Sources quite specialized.
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