The Vancouver Chapter of the Canadian Celiac Association is a non-profit charity that supports people who are adversely affected by gluten, dermatitis herpetiformis, and other gluten-related conditions.



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The gluten problem: Found. Treated. Cured.

Celiac Disease (CD) is a genetic, multi-system, autoimmune disorder where the body reacts to gluten and other prolamines in wheat (e.g. durum, kamut, spelt), rye and barley.  Gluten consumption causes damage to the absorptive surface of the small intestine and can result in malnutrition, anemia, nutritional deficiencies and an increased risk of other autoimmune diseases and some cancers of the gut. Every person is different and there may be no symptoms, but damage is still being done.  More information can be found at the Canadian Celiac Association website.
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Last Updated
Jul 9th 2017
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The following are precise of scientific articles and news articles regarding Celiac Disease related issues. Links and bibliography information is provided if you wish to read the full article.

High Incidence of Celiac Disease in Adolescents
A study published in Gastroenterology in May 2017 of children at St. Joseph's Hospital in Denver, Colorado, looked at 1,339 children with genetic risk factors for celiac disease over up to a 20 year period.  Celiac Disease Autoimmunity was defined as those who developed tissue transglutaminase autoantibodies for at least 3 months. They found that more than 5% developed celiac disease autoimmunity, CDA over the ten year period and at ages 5, 10 and 15 years respectively those who actually developed celiac disease were 1/6%, 2.8% and 3.1% respectively.  Although more than 5% of children may experience a period of CDA, not all children develop celiac disease or required gluten-free diets.  This study also reconfirmed that 40% of the population carry the genes for Celiac Disease.
https://www.ncbi.nlm.nih.gov/pubmed/28188747

Seemingly Innocuous Virus can Trigger Celiac Disease
The University of Chicago and the University of Pittsburgh School of Medicine, found that a common, thought to be harmless virus, the reovirus, can trigger an immune response to gluten. Dr. Bana Jabri, the senior author of the study, indicated that the virus sets the stage "for an autoimmune disorder, and for celiac disease in particular."  He also stated the specific virus and its genes and the interaction between the microbe and the host, as well as the health status of the host are all important.  Dr. Jabri reported that IL-15, a cytokine upregulated in the intestinal lining of celiac disease patients, can break oral tolerance to gluten.   They found that genetic differences between reovirus strains could either protect against or cause celiac disease.  They found that celiac disease patients had much higher levels of antibodies against reoviruses than those without the disease.  This could lead to a vaccination in the future that targets viruses infecting the intestine in order to protect children at risk for celiac and other autoimmune disorders. 
https://news.uchicago.edu/article/2017/04/06/seemingly-innocuous-virus-can-trigger-celiac-disease

Anorexia Nervosa Diagnosis More Common in Women with Celiac Disease
Anorexia nervosa is an emotional disorder that involves an obsessive desire to lose weight by refusing to eat.  Data from 1987 to 2009 on 18,000 Swedish women diagnosed with celiac disease and about 89,000 women around the same age who did not have the autoimmune disorder.  Those with celiac disease were found to be 46% more likely to be diagnosed with anorexia nervosa.  The study was not a controlled experiment designed to prove that celiac disease causes anorexia or the reverse.  There may have been bias as those diagnosed with one condition were probably more closely monitored which could lead to a higher level of diagnosis of other disorders.  This is something that should be monitored by healthcare providers. 
http://www.reuters.com/article/us-health-celiac-anorexia-idUSKBN1752EG

Factors Associated with Villus Atrophy in Symptomatic Celiac Disease Patients on a Gluten-Free Diet
Despite sticking to a gluten-free diet, some celiac patients endure persistent duodenal damage, a condition associated with adverse outcomes.  The researchers from Columbia University and the Mayo Clinic found that of 1,345 symptomatic diagnosed celiac patients in the study, 38% were found to have villous atrophy.  People with villus atrophy were more likely to use proton-pump inhibitors, non-steroidal anti-inflammatory drugs (NSAID), and selective serotonin re-uptake inhibitors (SSRI). Adjusting for covariates showed that the symptoms alone were not tied to villus atrophy.  Further research into the impacts of proton-pump inhibitors, NSAIDs and SSRI's is indicated.
Alimentary Pharmacology and Histology Volume 45, Issue 8 April 2017 Pages 1084-1093, http://onlinelibrary.wiley.com/doi/10.1111/apt.13988/abstract;jsessionid=ED15F5C51D5E343FE71B5F0F6E850347.f04t04
 
Nexvax2 Moves to Next Stage of Research
Nexvax2 is a dose to protect against gluten exposure being developed by ImmusanT.  The first stage of study investigating safety and tolerability is completed.  The vaccine is initially designed to be used along with the gluten-free diet, with long range plans that would eliminate the need for the diet.  Previous studies have shown that the first dose of the vaccine prompted the immune reaction to gluten, with patients who received Nexvax2 showing activation of T-cells as well as typical celiac disease symptoms. But when the treatment ended after twice weekly doses of Nexvax2 for eight weeks, the T-cells were no longer active. Additionally, when patients who had received Nexvax2 ate gluten for three days, the immune reaction was not triggered.
https://www.beyondceliac.org/research-news/

Gluten:  ZERO Global
This is the name of a new book written by Dr. Rodney Ford, a respected pediatrician and expert in Celiac Disease from the UK.  Dr. Ford's contention is that 20 ppm is not OK.   There must be "zero" gluten ingested.  Dr. Ford states that you must get your tTG antibodies down as they are causing an immune effect in the gut, as well as doing neurological harm as shown by Dr. Hadjivassiliou (2002). 
Dewar and co-workers investigated 100 patients who had non-responsive celiac disease (refractory celiac disease). They found the following: 45 (45%) of these patients were not adequately adhering to a strict gluten-free diet, of whom 24 (53%) were inadvertently ingesting gluten, and the remaining 21 (47%) admitted non-compliance. <http://www.ncbi.nlm.nih.gov/pubmed/22493548>.
Dr. Ford's book is available at <http://www.glutenZEROglobal.com>

Clinical Trial Fails to Meet Its Objectives
ImmunogenX, the clinical stage biopharmaceutical company developing latiglutenase, an combination of two enzymes that are supposed to breakdown gluten, found that those receiving the drug did not do any better than those taking a placebo.   ImmunogenX is continuing to look at data from the trial related to specific groups of patients. They are optimistic about the future of the drug and its ability to help these patients improve their quality of life and better manage celiac disease, according to the company. And plans are in place for the next Phase 2 clinical trial. 
The recent CeliAction trial included nearly 500 celiac disease patients who had been on the gluten-free diet for a least one year and who had moderate to severe symptoms and intestinal damage. It was conducted from August 2013 to December 2014 throughout Europe and North America and had been widely publicized among celiac disease patients.
Among the 398 patients with a positive blood test, severity of abdominal pain improved for 57 percent and bloating for 44 percent. Tiredness and constipation were also shown to have decreased in these patients.  "While the published study showed no overall benefit, we have since discovered that people with symptoms and elevated celiac disease antibodies did have a significant benefit," said Peter Green, M.D., a study author and director of the Celiac Disease Center at Columbia University. "We are thrilled with that because it gives the medicine an ongoing opportunity to get out there to help patients."
https://www.beyondceliac.org/research-news/View-Research-News/1394/postid--75508/

Biopsy-Defined Adult Celiac Disease and Selective Immunoglobulin A Deficiency
Dr. Hugh James Freeman, University of British Columbia, Department of Gastroenterology published results of 234 biopsy-defined celiacs from 1982 - 2011.  7 were found to be IgA deficient (immune-deficient), or about 3%.  They also found that there is no apparent difference in the gluten-free dietary mucosal response from celiac disease with or without immunoglobulin deficiency.  Immunoglobulin A deficiency is well recognized to be a cause of false-negative or falsely low determinations of IgA antibodies (i.e., either anti-endomysial or anti-tissue transglutaminase antibodies or both) used in screening or case-finding for celiac disease. In this setting, use of an alternative antibody, such as IgG, or even endoscopic biopsy may be considered, if there is a high suspicion for adult celiac disease. The present evaluation, however, also documented that IgA antibodies to tissue transglutaminase were present in all patients that could be tested here with selective IgA immunoglobulin deficiency.  More study is required in this area.
 Available online at http://pubs.sciepub.com/ijcd/5/1/1

Mucosal Recovery May Take Longer Than Previously Thought
Recently Dr. Hugh James Freeman of the Department of Medicine, Gastroenterology <javascript:void(0)>, University of British Columbia, Vancouver, BC, Canada, conducted a study to assess healing time in celiac patients. In this study, 182 patients (60 males, 122 females) referred for evaluation of symptoms, including diarrhea and weight loss, were selected only if initial biopsies <javascript:void(0)> showed characteristic inflammatory changes with severe architectural disturbance.
All patients were treated with a strict gluten-free diet, and diet compliance was regularly monitored. Up to 90% or more of patients showed a complete mucosal response or healing, many within 6 months. However, most patients required up to 2 years for full healing and recovery to take place in the gut.
http://pubs.sciepub.com/articleinpress/ijcd/ijcd-5-1-1.pdf 


University of Washington Spinout PvP Biologics has won $35 M to Develop Celiac Disease Therapy
Takeda Pharmaceuticals is providing $35M in research and development funding for a Phase I trial for an enzyme, KumaMax that targets parts of gluten that cause the autoimmune reaction that leads to Celiac Disease.  The hope is the enzyme will break down gliadin, the protein in gluten.  Research will be done in Seattle.
http://www.bizjournals.com/seattle/blog/health-care-inc/2017/01/uw-spinout-wins-35m-deal-to-develop-therapy-for.html

Seeking a New Normality: Masculinity, Interaction and a Gluten Free Diet
A study from researchers in Sweden and the UK looked at the social experience of young men with screening-detected celiac disease and to highlight daily life situations five years after diagnosis.
The analysis also showed that the young men's daily experiences of living with celiac disease largely depended on their use of characteristics known to be associated with masculinity: such as being self-assured, demanding, and behaving authoritatively.  In food situations, where the young men had the ability to make use of such characteristics in their informal group, they experienced fewer negative aspects of the disease.
If the young men did not hold a strong position in their informal group, their situation was insecure and vulnerable and this could lead to avoidance of contacts and social meal situations.
So, basically, being relaxed and socially confident about eating gluten-free helps to ensure success with the diet.
International Journal of Celiac Disease http://www.sciepub.com/journal/IJCD Vol. 4, No. 4 <http://www.sciepub.com/IJCD/content/4/4>, 2016, pp 138-145. doi: 10.12691/ijcd-4-4-7 | Original Article  <http://pubs.sciepub.com/ijcd/4/4/7/index.html>

Study Compared the Effects of Gluten Reduced Beers
A study conducted by the Gluten Intolerance Group in conjunction with the University of Chicago Celiac Disease Centre found that gluten removed beers caused a reaction in those who had been diagnosed with Celiac Disease. 
Both gluten-free and gluten-removed beers have entered the marketplace recently.  Gluten-free beer is made using grains that naturally do not contain gluten, such as sorghum or brown rice, in the fermentation process.  Gluten-removed beer is made with wheat, barley or rye, and it then undergoes a process for the gluten to be removed.
The study used blood samples from individuals with celiac disease to see whether the proteins in gluten-free beer and gluten-removed beer were recognized by antibodies that were already present in the blood.  It was found that no blood samples reacted to the gluten-free beer.  However, a percentage of blood samples DID react to the gluten-removed beer.  The study was done as a proof of concept of the methodology and further study will be required to understand better the possible risk of gluten-removed products.
https://www.gluten.org/branchnews/gigbeerstudy/



the possible risk of gluten-removed products.
https://www.gluten.org/branchnews/gigbeerstudy/



Gluten-Free Certification Program -  The CCA has spent several years developing a voluntary certification program based on a preventative approach for managing the production of gluten-free products.  This symbol is the copyright of the Allergen Control Group who now manages the certification of gluten-free products.  To see vendors who have been certified check out their website or look for this symbol on products in your stores.