Couldn't attend the Celiac Disease Foundation 2014 Celiac Disease Foundation Conference? Here's some key research points from Dr. Alessio Fasano about celiac and LabCorp about genetic testing. Please share. There are important facts in here about being gluten-free!
Below are some key learnings from the doctor. Now, I’m paraphrasing, but I’m going to get as technical as I can from my notes. Remember, I am not a doctor, nor do I play one on TV – but Dr. Fasano is. He talked about major milestones that science has discovered since they started studying celiac. These are noted in bold and labeled “milestone.”
- Milestone: There’s a recipe for celiac disease: 1) genes 2) something from the environment that will put you over the edge, attacking the body and 3) a leaky small intestine.
- Celiac is the only autoimmune disease in which we know the instigator – gluten
- Celiac is the only autoimmune disease in which food is a treatment (not a cure – there is no cure)
- Milestone: There’s an understanding why gluten is toxic. We as a species evolved to not eat gluten – for 99.9% of time since the dawn of time, we have been gluten-free. However, the birth of agriculture (and the grass family HORDEA – wheat rye and barley), we didn’t evolve to deal with these grains. As a whole, we cannot completely digest gluten. If undigested pieces of gluten find a way to come through intestine with leaky gut, it exposes the system for gluten. But should everyone go gluten-free because of this? No. Most of the time, people can win against this invader in your system (like most bacteria we fight off every day). However, those who don’t win against the gluten invader are celiacs.
- Myth busting: Have grains been changed to kill us all like some crazy books suggest? No. There is no genetically modified wheat and this is not the reason why there are more diagnosed celiacs.
- Myth busting: Fad diets. One third of Americans are consuming some gluten-free products. When asked why people are on a GF diet, 50% said to live a healthier lifestyle (not celiac disease). 24 million people in the general population are eating gluten-free to lose weight. While there is a fad component of the diet, Dr. Fasno is upset when journalists just want to address fad diet aspect. But it’s not a fad for for celiacs. It’s like INSULIN FOR DIABETICS. Those with diabetes will die quickly if not taking insulin, but for a celiac, if they are not on a GF diet, and will die slowly.
- Gluten sensitivity is still “in the working stages” of being figured out. He thinks that Wheat Belly and Grain Brain are extremes, “if you don’t eat gluten-free you’ll be extinct as a species or won’t be intellectual,” but he believes there has to be something in the middle. If you respond to gluten with autoimmune = celiac, if you have an allergic reaction= you have a food allergy, if you are part of the rest = you have gluten sensitivity.
- Milestone: They figured out the evolving spectrum of celiac disease diagnosis. There is an unparalleled test with IgA serological testing. In the future, they’re looking for a diagnosis without an endoscopy.There’s a test for kids with classical symptoms with genetic and high blood marketers that don’t have to do an endoscopy, but unfortunately it’s not out for adults yet.
- Milestone: We are not born celiac. They used to believe that if you have the genes and eat gluten it’s your destiny, but not so much. We in the midst of an epidemic of celiac – in the past 35 years the prevalence of celiac disease in US have doubled every 15 years. The key factors include the quality of gluten, the quantity of gluten consumed, breast feeding, gut functioning, timing of gluten introduction, and changes in the gut microbiome. There’s still so much more to come.
- Milestone: There are potentially alternative treatments integrated into the gluten-free diet like: genetically engineered grains, proline proplyl endopeptidases, zonulin inhibitor, CCR 9 inhibitor, and a peptide based vaccine.
- Milestone: They’ve figured out how much gluten is too much – the “less than 20ppm” threshold. See photo below:
Next we heard from LabCorp about the genetics behind celiac disease. Here are some fast facts:
- Fewer than20% of patients with celiac disease have been formally diagnosed.
- The average time between onset of symptoms and diagnosis is 11 years. Why so long? Celiac symptoms are shared with other disorders, and it’s not very high on physicians’ radars.
- not high on radar for physicians
- TOOL KIT includes IgA testing, small intestinal biopsy and genetic HLA testing.
- What are your options for testing for celiac when you’re already on a gluten-free diet? You can go on a gluten challenge for 2 months waiting for antibodies to return so you can do an IgA test and a biopsy, or you can have an HLA genetic test, which is accurate regardless of diet.
- The gene variants for DQ2 and DQ8 are positive in people with celiac, but not everyone with a positive genetic test will get celiac disease – only the potential to have celiac. This test is good for ruling out celiac disease. It has an accuracy of greater than 99% and you only need to genetic test once in your lifetime since it won’t change.
There was a lot of information in the conference, and I have many more slides to go through, but I thought those were the most pertinent to post online.