Common Enzymes May Be 1st Remedy for Digestive Disorder
An enzyme from a common fungus can break down gluten in breads and pastas -- and can survive in the acidic conditions of the human stomach -- opening the possibility for the first treatment of the digestive disorder celiac disease, according to a study published today.
Dutch researchers said an enzyme called AN-PEP broke down gluten in test-tube experiments relatively quickly, fast enough that patients could take the enzyme with their meals to avoid the intestinal inflammation they experience from gluten.
The findings, published in the American Journal of Physiology, follow a study by Stanford University researchers published Monday describing another enzyme, EP-B2, found in barley seeds, that gave similar results.
Packaging the enzymes into pills could free celiac patients from the constant battle to keep their diets free of gluten, a protein component of grains such as wheat, barely and rye that shows up in many common foods.
The enzymes could “take the worry out of eating” for celiac patients, said biochemist Chaitan Khosla, leader of the Stanford group.
There is currently no treatment for the disease, which afflicts about 2 million people in the United States.
In celiac patients, gluten proteins interact with immune cells in the small intestine and cause inflammation. Depending on the patient, the immediate effects can range from mild bloating and fatigue to severe cramping and diarrhea.
Some patients can suffer long-term effects, including malnutrition, anemia and osteoporosis, which result from damage to the intestinal lining that prevents nutrients from being absorbed.
Because symptoms vary widely, doctors often do not recognize the disease -- only about one sufferer in seven gets a proper diagnosis, estimates say.
The resistance of both AN-PEP and EP-B2 to the harsh conditions of the stomach is a key breakthrough.
Previously investigated enzymes could not survive in such conditions, so they had to be targeted instead to the intestine -- meaning the gluten was late to break down in the digestive tract and could still trigger inflammation.
The Dutch research group, led by immunologist Frits Koning at Leiden University Medical Center, acquired AN-PEP from Dutch chemical conglomerate DSM Corp., which holds a patent on the enzyme.
DSM officials had originally developed the enzyme for an industrial food application, but they contacted Koning when they saw that gluten was similar to the proteins they were working on.
Koning said that animal safety testing of AN-PEP had been conducted and that his group was in the early stages of planning clinical trials.
Khosla’s group has shown that EP-B2 is effective at breaking down gluten in animals’ guts. They are currently conducting animal safety tests of EP-B2 and hope to begin clinical trials early next year, Khosla said.
