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  • Jefferson Adams
    Jefferson Adams

    IMU-856 Shows Promise as a Potential Treatment for Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Positive phase 1b trial results offer clinical proof-of-concept for innovative gastrointestinal therapy drug IMU-856.

    IMU-856 Shows Promise as a Potential Treatment for Celiac Disease - Image: CC BY-SA 2.0--ForestWander.com
    Caption: Image: CC BY-SA 2.0--ForestWander.com

    Celiac.com 05/15/2023 - Biotechnology company Immunic, Inc., focuses on developing oral, small molecule therapies for chronic inflammatory and autoimmune diseases, including celiac disease.

    Celiac disease is an autoimmune disorder that affects approximately 1% of people globally. People with celiac disease have an abnormal immune response to gluten, a protein found in wheat, barley, and rye. This abnormal immune response damages the lining of the small intestine, leading to malabsorption and other serious complications.

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    The company recently announced positive results from the Part C portion of its Phase 1 clinical trial of IMU-856 in treating patients with celiac disease.

    The trial consisted of 36 patients with celiac disease who were randomized to receive placebo or one of two doses of IMU-856 (80 mg or 160 mg) for four weeks, followed by two weeks of gluten challenge. 

    The trial assessed the protection of gut architecture, reduction of gluten-induced intestinal damage, improvement of patients' symptoms related to gluten exposure, dose-dependent changes in biomarker responses, and enhancement of nutrient absorption.

    The trial results showed that patients treated with IMU-856 had a dose-dependent reduction in gluten-induced damage to their intestinal villi, the small, finger-like projections in the small intestine that play a key role in nutrient absorption. The results also showed that IMU-856 restored the absorption of essential nutrients, such as vitamin B12, for red blood cell formation and the functioning of the brain and nervous system. 

    Immunic believes the clinical evidence supports IMU-856's ability to re-establish proper gut cell renewal, which could prove useful in treating other gastrointestinal diseases. Patients treated with IMU-856 also saw improvement in disease-related symptoms such as bloating and tiredness, and the treatment was observed to be safe and well-tolerated.

    IMU-856's ability to re-establish proper gut cell renewal, observed in preclinical studies, translates into clinical benefits for patients with celiac disease.  Most importantly, the observed protection of intestinal villi from gluten-induced damage, independent of celiac-specific targeting immune mechanisms, seems to be unique among proposed therapeutic approaches, and may be applicable to other gastrointestinal diseases.

    Immunic is now preparing for clinical phase 2b testing of IMU-856 in ongoing active celiac disease, while also considering other potential clinical applications for this first-in-class and orally available molecule.

    The positive results from the Phase 1 clinical trial of IMU-856 offer some hope for the development of a new therapeutic approach to treating celiac disease and other gastrointestinal disorders. The trial's success represents a significant milestone in the effort to develop safe and effective treatments for patients with celiac disease, and other chronic inflammatory and autoimmune conditions.

    The company believes that this data set provides initial clinical proof-of-concept for a new therapeutic approach to gastrointestinal disorders by promoting the regeneration of bowel architecture.

    Now, the story of a promising new celiac drug treatment is a story familiar to many of us. So far, the story has always ended the same way: the promising drug fails in the end. Here's hoping this one ends more happily.

    Stay tuned for more on this and related stories.


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    Russ H

    You obviously had very bad symptoms and I am glad you are on the mend. You might not have coeliac disease though. You may have an inflammatory bowel condition that is antagonised by gluten. Gluten is highly immunogenic. Many people with active coeliac disease develop extreme intolerances to foods in addition to gluten. Milk is a common example. Milk used to make me extremely ill - much worse than gluten, but now I can consume it without problem. I think this is because my gut has healed. I am sceptical that hookworms can treat coeliac disease because of its mechanism. It is plausible that hookworms can treat inflammatory bowel conditions. Perhaps a hookworm infection has allowed the gut to repair permitting you to tolerate gluten? This is why it would be informative to see any change in your serology. I can understand your not wanting to resume eating gluten for an endoscopy. I refused but managed to get diagnosed on my symptoms and serology.

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    dixonpete

    I spent a good 10 years dodging gluten. When I got caught it wasn't subtle. My last gluten exposure was a big one with the reaction lasting a day and half. I had to sit in the bathtub for hours to catch all the vomit and diarrhea being projected out of me. It was gluten. Also, as I said, my symptoms were identical to my formally diagnosed relatives. It's kind of a slam dunk.

    What makes my case interesting, besides the hookworms, is that obviously my ulcerative colitis (which was diagnosed with a camera) and my celiac disease were connected at some level otherwise the hookworms wouldn't have been able to fix both conditions. I've never seen that talked about anywhere. Animal and nut protein for the colitis and gluten for the celiac. Both turned off like a switch.

    In the Helminth Therapy Support Group there are other celiacs who have also been put into remission. There are also some who haven't. You won't know which camp you'll fall into till you try.

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    Russ H

    I don't doubt your symptoms or reaction to gluten. It would be nice to have blood work to narrow it down as there is a whole spectrum of gluten related disorders.

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    dixonpete
    3 minutes ago, Russ H said:

    I don't doubt your symptoms or reaction to gluten. It would be nice to have blood work to narrow it down as there is a whole spectrum of gluten related disorders.

    I also had one bout of Dermatitis herpetiformis. Not sure why it only occurred once. Weirdest skin condition ever.

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    Guest Kitty

    Posted

    On 5/25/2023 at 10:15 AM, dixonpete said:

    I've told this story before here, but I guess it bears repeating.

    For two years straight I was sick multiple times a day was catastrophic diarrhea. Towards the end I was hitting over 10x a day. I rarely left my apartment and was considering suicide. My GP wasn't any help. One day after getting sick after a sandwich I finally figured out the association. The diarrhea stopped the next day but the blood and mucus took a good six months+ to resolve. I also had colitis which complicated things but having the diarrhea stop was fantastic.

    I refused to take the biopsy because I wasn't willing to restart eating gluten. Whenever I was accidentally exposed I got terribly sick. Turned out my aunt and cousin were both celiacs with the same symptoms. That was good enough for me. This was in 2008.

    Probably 20x I was glutened btw 2008 and 2018 till when I started doing hookworms. Horrible, incapacitating reactions - accidental exposures with a good reason for being fooled each time. The colitis remained terrible. Lots of screaming. Turned out eating meat and nuts caused most of that.

    The rash for the hookworm entry is awesome. It looks horrible and blistery but heals without a scar. I've got a new shipment coming in in a couple of weeks and this time I'm going to try using some antihistamine cream. I'm never had a stool test but I did have a colony collapse once and saw a whole bunch of worm carcasses in my stool. I use 25 Necator americanus at a time.

    It's been a night and day difference since I've been on hookworms. No colitis unless I eat pistachios. I'm still lactose intolerant but other than that I have no food limitations. Bread with most meals.

    I've got a guy I email 2x a year and pay him by PayPal. An envelope with the larvae gets shipped out by courier.

    It bears repeating. Sometimes hookworms work for celiac disease, more often though gluten reactions are simply less. I lucked out. Crohn's and ulcerative colitis tend to do better with hookworms. Maybe it was because I had both celiac and colitis I did so well on them, who knows?

    Hi, so glad that hookworms helped you. I've given them a couple of tries but I have gut pain that I need to use medications for and I think those medications killed them (I can't not take the meds since the pain becomes too much and I can't wait the months that it can often take for the worms to start making a difference. I know different doses work for different people. What dose do you do?

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    dixonpete
    1 hour ago, Guest Kitty said:

    Hi, so glad that hookworms helped you. I've given them a couple of tries but I have gut pain that I need to use medications for and I think those medications killed them (I can't not take the meds since the pain becomes too much and I can't wait the months that it can often take for the worms to start making a difference. I know different doses work for different people. What dose do you do?

    I was doing 25 larvae every 6 months which was handy coordinating with the cold weather here in Canada. This last cycle I managed to wait too long and aged out my hookworms and had to go gluten-free again. I just did my first gluten test today and so far so good (famous last words). I think I've exceeded the time that I reacted last week when I had an accidental gluten exposure. That was day 23. This was day 30 post-inoculation.

    If things continue to go well (as in not getting sick) I'll try a pinch of bread tomorrow. Going forward I'll be going with a 25 larvae 5-month cycle.

    Did you talk to John Scott about your issues? Maybe try one of the other helminths?

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    dixonpete

    I've been keeping a blog on this platform about my adventures with hookworms.

     

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


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