The conclusions of a new study conducted at Northwestern Medicine may pave the way for treated celiac patients to eventually tolerate gluten in their diet.
After treatment with the technology, the patients were able to eat gluten with a substantial reduction in inflammation. The results also show a trend toward protecting patients’ small intestine from gluten exposure.
The findings were presented as a late-breaking presentation at the European Gastroenterology Week conference in Barcelona, Spain, in October.
The technology is a biodegradable nanoparticle containing gluten that teaches the immune system the antigen (allergen) is safe. The nanoparticle acts like a “Trojan horse”, hiding the allergen in a friendly shell, to convince the immune system not to attack it.
Beyond celiac disease, the finding sets the stage for the technology — a nanoparticle containing the antigen triggering the allergy or autoimmune disease — to treat a host of other diseases and allergies including multiple sclerosis, type 1 diabetes, peanut allergy, asthma and more.
The technology was developed in the lab of Stephen Miller, professor of microbiology and immunology at Northwestern University Feinberg School of Medicine, who has spent decades refining the technology.
“This is the first demonstration the technology works in patients. We have also shown that we can encapsulate myelin into the nanoparticle to induce tolerance to that substance in multiple sclerosis models, or put a protein from pancreatic beta cells to induce tolerance to insulin in type 1 diabetes models,” said Miller, the Judy Gugenheim Research Professor of Microbiology and Immunology.
When the allergen-loaded nanoparticle is injected into the bloodstream, the immune system isn’t concerned with it, because it sees the particle as innocuous debris. Then the nanoparticle and its hidden cargo are consumed by a macrophage, essentially a vacuum-cleaner cell that clears cellular debris and pathogens from the body.
In the celiac disease trial, the nanoparticle was loaded with gliadin, the major component of dietary gluten. A week after treatment, the patients were fed gluten for 14 days. Without treatment, celiac patients eating gluten developed marked immune responses to gliadin and damage in their small intestine. Celiac patients treated with the COUR nanoparticle, CNP-101, showed 90% less immune inflammation response than untreated patients. By stopping the inflammatory response, CNP-101 showed the capacity to protect the intestines from gluten-related injury.
Currently, there is no treatment for celiac disease.
“Doctors can only prescribe gluten avoidance, which is not always effective and carries a heavy social and economic toll for celiac patients,” Miller said.