At the occasion of the “New therapies in coeliac disease” conference hosted by Columbia University in New-York on March 20, 2014, Dr. Elena Verdú, our expert in Nutrition, is sharing with us the last trends in research in the field of Coeliac Disease (CeD), introducing the idea of a role of probiotics in the treatment of CeD.
Presence of intestinal dysbiosis has been demonstrated in two main categories of gastrointestinal disorders: functional, such as irritable bowel syndrome, and inflammatory bowel disease, including ulcerative colitis and Crohn’s disease, prompting fertile research into microbiota modulation in these disorders. In the past few years a new kid on the block, coeliac disease (CeD), has been added. CeD is a common chronic inflammatory condition of the small intestine caused by ingestion of gluten in genetically predisposed people.
At a recent meeting on the “Development of therapies for coeliac disease”, hosted in Columbia University, Dr. Julio Bai from the Hospital of Gastroenterology, Buenos Aires Argentina, indicated that, « patients with CeD have small intestinal microbial and fecal dysbiosis compared to healthy controls ». He also explained that after the gluten free diet, the only current available treatment for CeD, « only some of these changes are reversed ». Dr. Bai presented results from a clinical study in which supplementation with Bifidobacterium infantis reduced symptoms in patients with active CeD (See the following figure, Smecuol et al., J Clin Gastroenterol. 2013).
A follow up study in collaboration with with McMaster University demonstrated immunomodulatory effects of B. infantis in these patients, specifically in antimicrobial peptide expression in the small intestine (Smecuol et al., Gastroenterology (Suppl) 2013; 144:S894). Dr. Peter Green, director of the Coeliac Center at Columbia University highlighted that, « CeD is very common, affecting about 1% of the population. Current therapy is dietary, however, there is increasing interest in nutriceutical and pharmaceutical alternatives. Patients are very interested in these potential alternative (to the gluten-free diet) or adjunctive therapies, however further studies are necessary to determine if probiotics should be recommended for patients with CeD ».