AT-1001 May Be Effective Treatment for Celiac Disease

At present, a lifetime devoted to following a strict gluten-free diet is the backbone of current treatment for celiac disease. However, as researchers have come to know more about celiac disease, they’re insights are leading to developments that offer more effective prognosis and treatment of the disease.

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One of those promising new approaches involves treating celiac patients with doses of AT-1001, a paracellular permeability inhibitor that is structurally derived from a protein secreted by Vibrio cholerae. Recently, a team of medical researchers set out to assess the safety and tolerability of 12 mg doses of AT-1001 in people with celiac disease who submitted to acute gluten exposure.

For the in-patient, double-blind, randomized placebo-controlled safety study, researchers looked at twenty men and women with celiac disease and measured intestinal permeability, through fractional excretions of lactulose and mannitol, as an exploratory measure of the efficacy of AT-1001 in treating celiac disease.

The test subjects were men and women with age ranging from 18 to 59 years old. Each was pre-screened and referred by a gastroenterologist. Each had positive biopsy and antibody screens that indicated celiac disease. Each had also been on a gluten-free diet at least six months, was not known to be IgA deficient, and presented with anti-tTG titres of <10 EU at enrollment.

Study shows safety and tolerability of 12 mg doses of AT-1001 in celiac disease

In the placebo group, acute gluten exposure brought an observable 70% increase in intestinal permeability, compared to no change at all in the AT-1001 group. Four of seven patients (57%) of the placebo group showed increased levels of Interferon-gamma levels, but in the AT-1001 group only four of 14 patients (29%) showed such increases. Also, the placebo group showed gastrointestinal symptoms more frequently than the AT-1001 group (P = 0.018).

From the results, the researchers concluded that AT-1001 is well tolerated and appears to reduce intestinal barrier dysfunction, pro-inflammatory cytokine production, and gastrointestinal symptoms in celiac patients subjected to gluten exposure.

Aliment Pharmacol Ther 26, 757-766