Episode 40: Recap of Digestive Disease Week 2023 Latest Celiac Disease Research and more

In this episode Erica recaps some of her favorite celiac disease research (and more) from Digestive Disease Week 2023. Learn about the advances in a cure for celiac disease with upcoming clinical trials for KAN-101, DONQ52 and more. Included is an interview with Dr. Jason Tye-Din about clinical trials for celiac disease research, new drugs, and the possibility to test for celiac disease without a gluten challenge (in the future). 

RESOURCES
Celiac Disease Foundation 2023 DDW Wrap-up
Beyond Celiac 2023 DDW Research
Celiac disease drugs show progress from Beyond Celiac

Study: OAT AVENIN TRIGGERS ACUTE SYMPTOMS AND IMMUNE ACTIVATION IN SOME PEOPLE WITH CELIAC DISEASE BUT ADVERSE IMMUNE AND CLINICAL EFFECTS ARE ABSENT WITH EXTENDED INGESTION

Study: KAN-101: PHARMACODYNAMIC DEMONSTRATION OF IMMUNOLOGICAL TOLERANCE INDUCED BY KAN-101, A NOVEL LIVER-TARGETED THERAPY FOR CELIAC DISEASE, PERSISTS FOLLOWING DRUG CLEARANCE

Study: DONQ52: A BISPECIFIC ANTIBODY TARGETING HLA-DQ2.5-GLUTEN PEPTIDES POTENTLY BLOCKS GLUTEN-SPECIFIC T CELLS INDUCED BY GLUTEN INGESTION IN PATIENTS WITH CELIAC DISEASE

Eating disorders and IBS study

Dating with Celiac Disease from Dr. Jessica Lebovitz on Celiac and the Beast's Instagram

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Transcript

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Erica [00:00:13]:

Hey, I'm Erica.

Jules [00:00:14]:

And I'm Jules. Most people have at least one thing that they can't or won't eat.

Erica [00:00:19]:

Yeah, we're definitely like that.

Jules [00:00:21]:

We started this podcast to talk about the gluten free food industry, like new.

Erica [00:00:26]:

Products and some of the stories behind.

Jules [00:00:27]:

Your favorite brands and living life with a specialty diet, and also some important healthcare topics.

Erica [00:00:34]:

Since we're basically both broken inside you.

Jules [00:00:37]:

Had me at Eat.

Erica [00:00:45]:

Hello, and welcome back to another episode of You Had Me and Eat. I'm Erica.

Jules [00:00:51]:

And I'm Jules.

Erica [00:00:52]:

And today we have a special episode for you today. Why is it special? Because we couldn't fit in anywhere else, and that's why it's special.

Jules [00:01:02]:

Just like we said we're told.

Erica [00:01:04]:

Special? Yeah, just like how you were told you were special growing up as a kid. That's what this episode is like.

Jules [00:01:10]:

That's right.

Erica [00:01:14]:

Okay, so here's the deal. DDW was a couple of months ago.

Jules [00:01:20]:

Yeah, but remind our listeners what that even means.

Erica [00:01:23]:

Erica, a few months ago, I went to Chicago and visited Digestive Disease Week, which is the largest international gathering of digestive disease experts, be it gastroenterologists, be it pharmacologists and pharmacy brands within the field of gastroenterology, nurses, dietitians, anything else related in the medical field to gastroenterology, including journalists. In journalists, there can be ranging from anywhere, like a little podcast like us, the little podcast that could or it could be up to helio journal or Journals of Gastroenterology, which are, like, major publications. And it's not lay person friendly, and that was not French lay L-A-Y person leperson friendly.

Jules [00:02:29]:

No.

Erica [00:02:34]:

It'S not for regular Joe Schmo off the street just wanting to learn more about gastroenterology. These are specific research related symposiums and research that's actually being done that is finally presented. There are poster presentations on anywhere ranging from the smallest molecule ever and learning about gut barrier dysfunction and what actually happens in the gut, to psychosocial issues that are around certain digestive disease, to pharmacy evaluating, like phase one, phase two, phase three clinical trials. I mean, literally anything that happens in.

Jules [00:03:19]:

Digestive disease, it cracks me up every time that these amazing medical professionals, these amazing hospitals, these practice groups, these pharmaceutical companies, like, high level thinkers, lots of money on the table, really, really complicated thoughts, and getting it all out there, sharing it, and they do it in posters. It just feels very high school science project, science fair like to me. And they do it all around the world. Whenever there's any one of these conferences, they're all like, I'm presenting a poster. And I'm like, oh, my gosh, it's so funny.

Erica [00:04:04]:

To me, it very much is just like a high school science project class where you go around the teacher looks, and each kid has their poster board up, and they're like, I wanted to share my findings and this, and I wanted to talk to this data point behind me. And that's how you make the volcano blow up with baking soda. And that's exactly hood as you walk around and they're standing there and the researcher is like standing there and like, hi, do you want to learn about my poster? And you're like, yes. And then you talk to them about their poster and they say the same thing over and over and over again for an hour and a half to 2 hours straight.

Jules [00:04:44]:

And then people try to share it on medical Twitter and everything. And I can't see that poster. It's like a picture of a poster. You can't blow it up and it's just like, what? Enemy not so low tech. It boggles the mind.

Erica [00:04:58]:

The fact that we were not able to share posters visually because that's not allowed. And everyone has their weird rules about posters. Some people are like, yeah, take my picture in front of me. I don't care. Others, I couldn't talk to someone presenting because I was a member of press. And I'm like, I know you. We're buds. And they're like, Technically, I can't talk to you. And I'm like, I'm not finding Donald Trump's tax records in his bathroom right now. I'm literally asking you what this poster means. I'm not an investigative journalist. I just want to know what were your research findings? And they can't talk to Press and I'm like, I'm a podcast. Like, if I was just a person, can you at least explain this to me? Because I still have no idea what this poster is about. It's weird. It is just a strange land where there's made up rules of everything and there is pharmaceutical companies spend like a bazillion dollars to have these massive boosts that are almost comically large and you have to go in them because that's the only place that you can find coffee. And then some only have alcohol and some have tea, and then some have morning breakfast croissants because you can't find food literally anywhere else in this entire place. Also for nominal Digestive conference, no gluten free food. And this happens every year. No gluten free food. Even in the gluten free specific lunches that you have to pay to be there, there is zero gluten free food. So I'm there with other dietitians who are gluten free. And of course I get one gluten taking to a restaurant that I was safe at before. That really sucks. Is that AMADALA?

Jules [00:06:33]:

It's Amidala.

Erica [00:06:35]:

Good God. What are you doing, girlfriend?

Jules [00:06:40]:

She was locked in my office.

Erica [00:06:42]:

Oh, poor baby.

Jules [00:06:43]:

It's almost time for food.

Erica [00:06:44]:

Ditto. So anyway, it's just wild. I can't eat anywhere and I'm hungry the entire time that I'm there. And it's so sad and so weird. And it's in Chicago, but the place that they're at doesn't have any gluten free food. No safe food around the area that you can walk to. You have to uber everywhere. San Diego. Same thing. It's downtown. Not a lot of safe options. And then Washington, you know what?

Jules [00:07:09]:

They should have it in Paris.

Erica [00:07:12]:

Oh, boy. Well, when they have ICDS in Paris sometimes. And that was a great year for you. There sure was. Anyway, so they have this meeting. It bounces back between San Diego, Chicago, and Washington, DC. Although it's going to be in DC. I guess next year, I don't really remember. So it bounces between the three places, and it is where all the research comes out for the entire year. So either people present their early research, meaning, hey, these are the early findings that we have, and then we'll present it in like a journal or a poster later in the year, or it's like, hey, these are the final journals that got published after we presented the research last year or something. There's been research and clinical trials and everything that I've followed since I started doing this six, seven years ago. So, I mean, it's not like research moves at the speed of light. Things happen pretty slowly. So some of this stuff I've seen wax and wane over the years as far as new research coming out. But I was there for sea life disease and for IBS, and there were quite a few things happening this year. IBS was the hot sexiest topic that no one could get away from everyone when to talk about IBS, which is great.

Jules [00:08:24]:

Yeah, it's really funny because that's really come around. It used to be that was the ugly stepchild of GI disorders. Like, yeah, we don't know what it is. Just call it IBS. It's probably all in your head anyway.

Erica [00:08:37]:

Yeah, it was called the garbage can diagnosis. Yeah, right. No, just put it in the trash. Put an IBS. So it used to be called something, and now it's called it was like a psychosomatic or not psychosomatic, but where it's like they're like, listen, it's mostly just the fact that you are a crazy woman, stress related, can't handle stress.

Jules [00:09:01]:

And so it's IBS. Yeah.

Erica [00:09:03]:

And now it's like disorders of gut brain interaction, meaning it is kind of all in your head. But there is another issue, and now we're getting to the point where we understand that, yes, the microbiome can be compromised. And while we do understand the interaction between the gut and the brain, we do know that there are other things that can be a part of it all. And a lot of microbiome research with SIBO and the bacterial count and how that changes even during the day and during seasons, they found out that there's like, seasonal changes in microbiome. And I'm like, oh, interesting. There's like a bunch of wackadoodle stuff that you're like, whoa, this is bonkers pick.

Jules [00:09:45]:

Like, I don't know, two or three top things that came out of DDW that you think our listeners would really, really like to hear about. That's, like, totally big newsworthy item.

Erica [00:09:57]:

So that's the thing is what's so weird is some things can be newsworthy, but we always have to say, the caveat of, like, this is just initial research. Sure. Because sometimes we find things like, oh, my God, this is going to be the next cure. And everyone's, like, totally freaked out. They're like, oh my God, in two years, I'm going to eat a croissant again. I'm going to pair it and have a regular croissant, which, as we just learned from our last episode, you don't need to. You can have a gluten free croissant. That's right. But the speed that research moves, it's not as easy as like, we found something in a mouse model and then that doesn't necessarily translate to regular grown ass people. So, yeah, it's really difficult. But one thing that's cool, again, going back to IBS, is the focus on how much the gut brain interaction was so critically important. And having GIS finally understand that you have to mitigate stress and look at some behaviors and look at how stress affects GI outside of just, like, the gut brain interaction. But how do eating disorders play into this? How does ARFID how do all these other things that are, like, also psychological disorders work hand in hand? I found this one slide that was talking about what SSRIs work best for abdominal pain. And I wasn't on the SSRI that's best for the abdominal pain. I'm just like, this is so cool. Now that we finally understand how they interplay together with the brain and gut directed Hypnotherapy, which even a few years ago, when I talked about doing Hypnotherapy for IBS, people were like, you might as well be doing summer solstice, yoga, moonstone worshipping, whatever. And now it's not essential oil. Woo woo. It legitimately has been proven to be cognitively statistically significant for improvement on IBS functions. So that's kind of the first finding. It's like finally understanding, yes, there's connection between the gut brain and getting GIS to finally understand it versus just like, she's clearly nuts. It's like, she may be nuts. Right?

Jules [00:12:05]:

But it also affects so much of the education around not just for gastroenterologists, but for all physicians. So much of the education is done by pharmaceutical companies. And so if you're talking about Hypnosis or something like that, what pharmaceutical company is going to be telling them about that? Again, it's not something that they're exposed to. And so where's my prescription pad? I need to be able to fix this with some sort of pill or medication.

Erica [00:12:38]:

And I am so for like, I'm pro Pharma, not like everyone needs to be on Pharma, but if you need it, that's fine. And they showed charts of pairing gut directed Hypnotherapy with a pharmaceutical, either for depression or anxiety, but also maybe it pairs up with your antidirel medication. How do we make these two work together and make it more synergistic versus just putting someone on a pill and thinking that that's going to change their IBS? When reality it may be stress from something else or like even PTSD. They talked about approach for sure, which is god, thank God, finally, it's only been like 100 years.

Jules [00:13:23]:

One of the things that I definitely wanted to make sure we touched upon in this episode was the finding about Oats. So would you lead us into that? Because I think a lot of our listeners want to hear about that.

Erica [00:13:36]:

Absolutely. So it's been known that some celiacs have reaction to Oats, even Purity Protocol Oats. It just layers in another murkiness in the whole Oat scenario with celiac disease. So if you have celiac disease, it's like, yeah, you can have Oats, but make sure that it's gluten free Oats so there's no cross contact. And is it certified gluten free Oats? Is it purity protocol Oats that don't have a necessarily label to them? What kind of oats can I have? And then you hear about people who are sick from Oats all the time. Was it cross contact or was it something else? And that's I think the something else part is what they're trying to clarify. And I think that GIS think that it's kind of a myth that all these people are reacting to Oats because they're like, it's just high fiber and it's like, "no, it's not." So that has now been myth busted. Like, yes, you can react to the high fiber of Oats, but if you eat other fibers and it's just oats that are the problem, chances are you are part of this. 8% 8% of celiacs that they studied that have a T cell response, meaning your inflammatory response to your body is happening because of this. It's specifically something called IL-2 and it increases with celiac disease for 8% of those who they research who have celiac disease who are eating pure uncontaminated Oats. So no cross contact at all, just pure avenue in itself. And they had an increase of pain, diarrhea and vomiting. And what was nice is while they did have an immune response to it, it was short lived. So it is not a long term immune response. You know how celiac disease is a long term immune response. It takes the villi from this to this. So villous blunting and atrophy, there was NO villous blunting, NO sustained immune response that could degrade villi. Which is actually great news because I think people get super freaked out if they eat Oats and like, oh my God, I'm going to have villous blunting and I'm never going to recover. Right? And I think that they made a great point that they're like Oats should be an allergen. We have to spell out Oats wherever they are in any sort of labeling because this is a large percentage of those with celiac disease who cannot eat Oats. Period, period. Point blank, not purity protocol, not no cross contact as Oats. Period.

Jules [00:15:59]:

Yeah, and just for a couple of points of clarification for people who don't know what we're talking about. The avenin is the protein, protein in the oats, just like the glutenin. And the gluten is the protein in wheat, barley and rye. Totally different animal altogether, which is why the avenin doesn't cause your body to attack itself in the same way that autoimmune response, which is why you don't have the Villis blunting and all that kind of response that you have for celiac. So it's not a celiac response necessarily that we're talking about like for the aven response, but it's 8% of people who have celiac disease also have this response. So it's not like because you have celiac, you are responding to oats. And that's a subtle difference. But it's important to understand because I think a lot of people think, just like when I was diagnosed with celiac disease, I was told, you can't have oats, it's wheat, barley, rye and oats. No, it's not like that. It's wheat, barley and rye. You also might be one of those people who has a separate reaction to the avenin in the oats. And it's good to know now that they've agreed it's 8%, which means 92% still can have oats. And it's a very valuable part of a healthy celiac diet if you can tolerate purity protocol oats, because the fiber is so healthy for you, and because oats are just really delicious. They're delicious and they're really good and you can bake with them and cooking and all kinds of different things is really useful. As a celiac, you want more things in your diet, not fewer things in your diet. So if it's something that you can tolerate, then you should be eating oats. But it's not something that everyone can tolerate. So this is very useful information and it's good to have dialed it in and to understand that you're not going to have the Villas Blunting and other autoimmune responses, even if you do have the inflammation and have a negative response to Avenues.

Erica [00:17:52]:

I think those that have never been able to tolerate oats have always really felt unheard in the celiac community. I have two friends in particular, Sarah and Aaron, that can't do oats, period. And they're just like, what am I? I don't understand. And they've all been told like, maybe it's 1%, maybe it's 2%. And now they're like, we did a study, it was 8%. It's probably more than we think. So I think that that's important. I also think it's really important for food manufacturers to understand if you're taking.

Jules [00:18:20]:

1%, we're putting oats on everything that's gluten free. Why would you do that?

Erica [00:18:25]:

1% of the world has to be gluten free. That's fine. It's still a ton of people. But then when you're taking out parts that don't want it because they don't know if it's purity protocol, they don't want it because there's 8%. You're chomping at this 1% of people and it's just like, come on, stop putting oats and everything because not everyone can have it or not.

Jules [00:18:45]:

Everyone wants it.

Erica [00:18:46]:

Come on.

Jules [00:18:46]:

Right? Oat, milk and all of that.

Erica [00:18:49]:

Everywhere. Everywhere. Prolific. Everywhere. And then the last thing that I want to talk about is every year everyone's like, when is the cure coming out? Like, great question. No idea. Because every year I'm like, oh, my God, in the next five years it's going to happen. And everyone's been saying that. And in the past three years, we've had some really disappointing fails of people that have pharmaceuticals that have gone through phase one, phase two, phase three clinical trial. And then, honestly, it has not gotten the response that it needs to get because you have to prove beyond just a statistical significance of the placebo effect, in some of these, the placebo did just as well as the other one. And it's like, oh, that's not what we want to happen from a drug. And some of these are like, intense. They're like IVs and some of them are shots and some of them are pills.

Jules [00:19:43]:

It's a big and you have to do it over and over again, forever and ever. Amen. It's not like I took that pill and I'm cured.

Erica [00:19:50]:

Yeah. So it's a big deal. So this is very important research that's happening. So we've seen things come and go and we've seen, fortunately, a lot of clinical trials fail. But I did get a chance to talk to one researcher. So first, the Kan-101 study, which is the ACED study. There are actually several studies that are going on right now Beyond Celiac and CDF are great places to find up to date clinical trial information. Kan-101 is actually it targets the liver to reeducate autoimmune cells to not have them attack gluten. And they just went through phase one and that went really good. There's a couple that are in early phase one. So phase 1A, where it's just like healthy people and that's great, but there are so many other phases of clinical trials that it's really hard to get excited about any of these because it's just you don't know if it's going to come to fruition or not. But I did talk to one researcher, Dr. Jason Tye-Din. He's a big, big celiac researcher from Australia and he is incredible and I love him. And he was so kind and he talked a lot about DonQ52, which is an antibody for treatment for gluten exposure, but not barley and rye, and only for those in HLA-DQ2. And it blocks gluten peptide very early on, very early on. Again, this is not going to like clinical trials quite yet, but there is some exciting research that's happening. He also did research, and why I love him is because he's just like all research all the time. He's like super, super involved in SSCD, which is the Society for the Study of Celiac Disease that I'm a part of. I'm a card carrying paying member. And he talked about is there a way that can we find increases in IL-2, which is an inflammatory marker specific for celiac disease, in whole blood, to where we cannot have to do a gluten challenge and just pull blood from patients? And that was, I think, one of the most exciting things that I heard, because gluten challenges are very difficult for a lot of people. Wouldn't it be nice people don't do.

Jules [00:22:03]:

It, they'll just say, Forget it, I'm not going to do it. And then they don't know. Their family doesn't know. And statistically, we don't know how many.

Erica [00:22:11]:

People actually have celiac disease. And then even if there was a cure, they couldn't get it because they don't know if they have celiac or not and what type of celiac disease because you have to have specific genes for some of these. So it's really interesting to see, can they pull blood from you, do something in a lab and actually pull the whole blood and say, yes, I can see based on that, if I put gluten in this blood pool, I mean, it's very fancy. But if you inject gluten into your blood in this lab, can we see that your blood is making an Il Two response based on your immune system that's outside your body? So you don't even have to take a pill, you just get your blood taken. Can that be the future? And I think that that's where his research is going, and that's really cool.

Jules [00:22:57]:

Yeah, well, and let's take a listen because I think that the listeners would really enjoy hearing a little bit more from him, specifically on where his research is going and the latest in celiac disease.

Dr. Jason Tye-Din [00:23:12]:

Yeah. So thanks, Erica. So, I'm an adult gastroenterologist, and for just over the last 20 years, I've been involved in celiac disease research and also the care of people with celiac disease. And my research has been really focused on understanding why does it happen and what are the immune mechanisms that lead to celiac disease. So I've come to DDW to present some of our data around several studies that we've been performing, including this particular study on a novel treatment.

Erica [00:23:42]:

Fantastic. So how long have you been in practice for celiac disease as a specialty?

Dr. Jason Tye-Din [00:23:48]:

So I think I started my first celiac clinic in 2003. So I have been working in the space since then, and I see a range of different people with gluten related issues and symptoms trying to get a diagnosis. I see patients who have struggles with their gluten-free diet and they're not healing up or they're getting ongoing symptoms or non responsive or refractory disease. So it really is a broad range of different things that I see, and that's combined with research into celiac disease as well. One of the biggest challenges, I think, for people with celiac disease is that even though many will follow a strict and very fastidious gluten free diet, some will continue to experience adverse symptoms. And some will be told by their doctor, oh, you're not healing up your bowel, which is super frustrating when you're trying to do all the right things. So this is a real problem because it tells us that whilst the gluten free diet is a treatment for celiac disease, it's not necessarily the most perfect treatment. And clearly it has impacts on lifestyle and quality of life and fear around accidental gluten exposure. So all of those things really mean that we do need to develop better treatments for people with celiac disease. Ideally things that allow them to have some gluten and not feel unwell and not get the damage inside that could lead to longer term health issues. So with that in mind, I've been doing a lot of work with groups to understand and develop new therapies. And this particular one that I'm talking about today is known as DONQ52. Now, DONQ52 is a custom design antibody that is designed to target the parts of gluten, we call them gluten peptides, that trigger the disease in people with celiac disease. Now, it's specific to those people who have a certain type of gene, which is called HLADQ 2.5 or 2.2. So about 80% to 90% of people with celiac disease will have this particular gene type. And for those people with celiac disease, when they ingest gluten, it can trigger an abnormal immune response. We call that a T-cell response. And that leads to all the manifestations of disease and the damage in the bowel and problems like that. So this approach is really designed to target that gluten specific T-cell response in people who have the HLADQ 2.5 or 2.2 gene. So if you could block that response, then you could potentially reduce the harmful effects of the gluten specific T cell. So on that basis, we recruited people with celiac disease in Australia and we actually asked them to undertake a gluten challenge. Now, this is not something we do lightly, but it's a really important tool to help us understand immune responses and to test drugs like this. So all these very willing and amazing participants undertook a three day gluten challenge where they consumed wheat for three days, wheat bread. And then we collected a blood sample six days after starting that. And we also asked a separate group of people to do that with rye, which they made into muffins, or barley, which they made into a kind of risotto. And what happens is, when people with celiac disease consume gluten, whether it be wheat, rye or barley, it triggers an immune response and we can measure that in the bloodstream. So on the 6th day, the blood is full of these T cells that cause the disease, and we can harvest that from the blood and then use those cells to test and study new drugs. So that's what we did. And what we were able to do is isolate those immune cells after wheat, rye or barley, and then put them in a test tube and mix them with relative different forms of gluten peptides that trigger the disease. Now, when you do that, it triggers a very strong response in those T cells and tells us, yes, those T cells aren't happy. Clearly the gluten is triggering them. But then we mixed some of those samples with this DONQ52 drug and lo and behold, it was very effective at blocking that immune response. So against a mixture of the most, what we call dominant gluten peptides in wheat, it blocked 80% to 100% of that response across the population of people we assessed. And for Ryan barley, it was around 40% to 80%. So about half of those responses were completely wiped out. So this was exciting findings. We showed that this particular drug didn't block responses to other proteins such as tetanus. So it means that people can still have an intact immune response against important infections. It's not broad immunosuppression, it's very targeted to the gluten that triggers the disease. So this blockade we thought was, this is very exciting because it was very potent. It really wiped down and reduced that response. Now, what does that mean? Well, I guess it's important now to undertake clinical trials in people where the drug is actually given to people and to assess both the safety and also confirm that it can actually effectively block the effect of gluten. So a phase one study, which is primarily designed to confirm safety, is currently underway here in the States, which is super exciting. And pending those results, I would imagine that the plan would be to move on to further phase two studies, to then show that this drug is effective.

Erica [00:29:40]:

Now, is this an injection? Is this enzymes that you take? Like, what is the ingestion method?

Dr. Jason Tye-Din [00:29:48]:

This will be most likely an injection of the medication and that will be tested in the phase one study and then subsequently in the phase two study.

Erica [00:30:03]:

So that was so cool. I love hearing from Jason, I think something else that I wanted to share with him as well. We kind of got off topic, but we talked a little bit about the importance of being a part of a clinical trial. And I want to stress, just like, if you can be a part of a clinical trial, sometimes it's weird, sometimes it's wonky, sometimes you may have to eat gluten. First thing of all clinical trials is do no harm. They will take you off if you are experiencing things that they don't want you to experience. Sometimes it can be scary, but it's the only way that we can move forward with the research and the future of celiac disease. I know plenty of people who are in clinical trials that love the experience and love the fact that they're being able to pay it forward to the next generation. But let's have a. Listen to Dr. Jason Tye-Din talk about the importance of clinical trials with celiac disease research.

Dr. Jason Tye-Din [00:30:55]:

Our research has also been involved in developing new diagnostic for celiac disease, and I presented some data just yesterday, preliminary data, but it's a blood test, and it assesses the immune response from these gluten specific T cells that I talked about before. Now, the beauty of this blood test is it seems to work even when people are not eating gluten. So we all know that it's a big challenge if you've gone gluten free to try to get a diagnosis of celiac disease because your doctor will ask you to get back onto gluten for six weeks or more, and that can be horrendous for many people who develop bad symptoms. So there's a real need to be able to test for celiac disease without asking people to get back onto gluten. So it's preliminary data at this stage, but it's certainly exciting that down the track. There may be ways to diagnose and monitor celiac disease just through a blood test without a gastroscopy and be accurate with that diagnosis and not ask people to eat gluten. We were doing the three day challenge years ago, then we're now down to a single dose challenge, and now we're down to just the gluten challenge in the test tube. So the hope is that this will really make life a lot easier for people to get some resolution about their diagnosis.

Erica [00:32:18]:

Yeah, I think that's the biggest thing. As a patient, I was forced to go back on a gluten challenge for Mayo Clinic. They were unsure of my diagnosis, and I had to go back on for six to twelve weeks. And I was so sick I couldn't complete the challenge.

Dr. Jason Tye-Din [00:32:30]:

I think it lasted probably six weeks.

Erica [00:32:32]:

And that's the biggest thing, is when I'm getting people trying to be screened for celiac or trying to be tested, they've already gone gluten free, and they said, no way.

Dr. Jason Tye-Din [00:32:41]:

Yeah, and I understand that. I have so many patients that do that, and it's completely understandable because I do a lot of work that does involve gluten challenge. I do see the reaction some people get, and it's certainly not pleasant and completely understand that. We're doing a lot of research on understanding why some people get such bad symptoms and then why some people don't. Some people can have accidental gluten quite a large amount and not get any symptoms. So there's a lot of variability there.

Erica [00:33:12]:

All right, Jules, so that's all I've got. Again, there was so much research hanging out at DDW, learning so much. I have stories on my Instagram stories, some posters from my girl Jessica Lebovitz from Columbia about dating with celiac disease. There's so many things that I put on Twitter, so I'm going to link all to that in the show notes. I will also put the link to CDF as a good recap. Yon celiac has a good recap of everything that happened at DDW for celiac disease specific stuff. I can even post a link to some stuff that happened on Gastro Girl for IBS. So lots of cool things at DDW, and we are here to make you known of all that's new in Gastroenterology. So thanks for listening, Jules.

Jules [00:33:54]:

Thanks for doing all the heavy lifting for us and for distilling it down to bite sized portions. I think it's been really helpful and interesting to hear from somebody who was there in person to see the posters with her very own eye, eating on.

Erica [00:34:10]:

The poster floor, sitting down with my juice box and my beef jerking and being like, I can't eat anywhere here, but I'm here for the research.

Jules [00:34:18]:

Thanks for having me.

Erica [00:34:20]:

Totally.

Jules [00:34:21]:

Well, thanks for listening, everyone. We appreciate your attention and share this link with anyone that you think would be interested in hearing more about celic disease research and also anything else that we hop on to talk about here at You Had Me at Eat. We'll be back next week with more, and in the meantime, stay well, be healthy and eat gluten free.

Erica [00:34:45]:

Yeah. Bye.

Jules [00:34:55]:

If you like this episode, make sure you rate it on your podcast provider.

Erica [00:34:59]:

And subscribe so you don't miss any of our episodes.

Jules [00:35:02]:

You had me at eat.