Coeliac disease (CD) is an autoimmune disease which leads to damage in the small intestine as a result of dietary gluten. CD affects about 1% of the population and currently the only treatment is gluten avoidance. Now, a new nanoparticle technology has shown it may be possible to induce immune tolerance of gluten in CD patients. This is according to findings presented at this year’s European Gastroenterology Week conference in Barcelona, Spain, and reported in a press release dated 22nd October 2019.
This nanotechnology has been under refinement for decades by Professor Stephen Miller of the Northwestern University Feinberg School of Medicine, Chicago, USA. The nanoparticle is biodegradable and contains gliadin, the main component of gluten, which is a protein found in wheat. When it passes through the bloodstream the immune system is not activated as the gluten is encased in an innocuous shell. Once the nanoparticle is subsequently consumed by a macrophage, which gets rid of cell debris and pathogens in the body, the immune system is reset as it learns that the allergen is harmless.
The nanoparticles have been licensed by COUR Pharmaceuticals Co and hence is named CNP-101. After Fast Track from the U.S. Food and Drug Administration (FDA), the treatment was brought into Phase II clinical trials in collaboration with Takeda Pharmaceuticals. Patients in this study showed promising results after just a week of nanoparticle treatment, followed by a gluten diet for 14 days. There was 90% less immune inflammation response compared to untreated patients, who exhibited immune responses that led to damage to the small intestine.
Current treatments for autoimmune diseases are flawed in that they lead to toxic side-effects due to their immuno-suppressant activity, which is not the case with CNP-101. Professor Ciaran Kelly of Harvard Medical School, Boston, USA, believes that other autoimmune disorders can be treated with this method, such as peanut allergies, multiple sclerosis and Type 1 diabetes mellitus. However, she noted that CD was the perfect starting point for this treatment, as “Coeliac disease is unlike many other autoimmune disorders because the offending antigen (environmental trigger) is well known – gluten in the diet.”
Disclosure: Professor Miller is on the COUR scientific advisory board and is a stock guarantee and paid consultant for the company. Northwestern university also has a financial interest in COUR.