Pill Makes It Safer for People with Celiac Disease to Eat in Restaurants

Researchers say a drug already on the market could help protect diners with celiac disease against accidentally getting "glutened." The scientists shared their findings at the Digestive Disease Week 2017 conference in Chicago.

Finding gluten-free menu items is hard enough, but folks with food allergies and celiac disease also have to be concerned about cross-contamination with other foods cooked in the same kitchen because the tiniest morsel of peanut butter, shellfish, or gluten could trigger a reaction.

A fungus-based enzyme called aspergillus niger-derived prolyl endoprotease (AN-PEP for short) had previously been shown to help break down gluten in the gut. But those studies had only looked at AN-PEP's use for people with feeding tubes. Whether or not it would work with gluten consumed the old-fashioned way was not clear.

Researchers recruited 18 brave people with celiac disease and served each one a bowl of porridge into which they’d crumbled two gluten-rich cookies. One-third of the study participants took a low dose of AN-PEP; another third took a high dose; and the remaining porridge-eaters got a placebo. Then the researchers tracked how each person’s gut dealt with the offensive cookies.

Both high and low doses of AN-PEP helped break down the wheat protein in participants' stomachs and part of their small intestines. People who’d taken the AN-PEP had 85 percent lower gluten levels in their stomachs than people who hadn’t. That success continued into the small intestine, where levels were 87 percent and 81 percent lower for people in the high- and low-dose groups, respectively, than they were for the poor suckers who got the placebo.

Lead author Julia König is a post-doctoral research fellow at the University of Örebro in Sweden. Speaking in a statement, she said the drug “allows gluten-sensitive patients to feel safer, for example, when they are out with friends in a restaurant and can’t be sure whether something is 100 percent gluten-free.”

She cautioned that the drug is not a free pass, nor license to go wild in the bakery. “We are not suggesting that AN-PEP will give these individuals the ability to eat pizza or pasta,” she said, “but it might make them feel better if they mistakenly ingest gluten.”

With only 18 participants, this study was small, and more research will be needed to confirm these findings.