A Breakthrough Coeliac Disease Vaccine
Australia offers hope to Coeliac Disease sufferers
Photo by Alpha Stock Images (Google)
by Morven Caie
If you’re part of the 1% that wanders around shops aimlessly searching for gluten-free items or ‘free from’ alternatives that don’t induce the gag reflex because you suffer from coeliac disease, then you’ll probably want to read on. A new vaccine has been developed.
Coeliac disease is an autoimmune disease that causes symptoms ranging from anaemia, diarrhoea, vomiting, chronic fatigue and stomach cramps. When gluten - a protein found in cereals such as wheat, rye and barley - is consumed, it sets off an immune response as the body mistakes it for a foreign and harmful substance. T-cells are stimulated, which secrete the pro-inflammatory cytokines and B-cells release antibodies. The inflammation that accompanies this causes damage to the lining of the small intestine, consequently reducing the absorption of nutrients into the body. Not only is this highly dangerous (especially for children, affecting their growth and development), but it also means patients are often misdiagnosed with other diseases such as irritable bowel syndrome, indigestion and lactose intolerance.
At the moment, the only treatment for coeliac sufferers is a strict gluten-free diet. In this day and age, a gluten-free diet is not vastly restrictive - there are many recipes available at the click of a button and you can even find aisles in supermarkets dedicated to specific dietary needs. With more people than ever before being diagnosed, it’s fair to say that a low-maintenance and simple treatment would be happily received by millions. Although not a cure, the Nexvax2 therapeutic vaccine developed by ImmusanT would allow patients to eat what they wanted without any of the debilitating symptoms. It is important to note, however, that the vaccine will only work with patients who carry the HLA-DQ 2.5 immune recognition gene, which is around 90% of coeliac sufferers.
So how does it work? It is an epitope-specific immunotherapy, which effectively reprograms the gluten specific T-cells to tolerate gluten and suppress an immune response, therefore causing no inflammation and allowing the intestine lining to go unscathed. Not only that, but damage previously caused by the T-cells can be reversed. Patients will receive an initial injection of the Nexvax2 vaccine, followed by periodic boosters to maintain immune tolerance.
Currently, the vaccine is gaining worldwide publicity, as the Phase 1 trials have reported it to show a good safety profile and be well tolerated even at high doses. From here, the vaccine can now move on to Phase 2 trials, recruiting a larger number of participants in order to identify any potential side effects, efficacy and dosage specifications. If successful, Nexvax2 would need to pass a third phase of clinical trials before it can be approved and brought to market.
The vaccine is also exciting other fields of drug discovery, as it differs from a traditional prophylactic vaccine - instead of preventing a disease, it remediates one. Furthermore, the vaccine is laying foundations for new immunotherapeutic regimes to treat other autoimmune diseases such as type 1 diabetes, rheumatoid arthritis and thyroiditis. Essentially, we will still be waiting a number of years before it’ll be licensed and available to coeliac patients, but it is definitely one to watch.