The purpose of this study is to examine whether a cocktail of two common food-grade enzyme supplements leads to decrease of serum activity markers in celiac disease patients insufficiently treated by previous gluten exclusion.
Celiac disease is genetically determined abnormal immune response to gluten, a component of wheat, rye and barley proteins that cause damage to the villous structure in the small bowel. The active disease is characterized by the induction of gluten-dependent autoantibodies to transglutaminase type-2, which are sensitive and specific non-invasive markers of gluten-sensitivity. Gluten-free diet normally leads to clearance of antibodies from serum in 6-12 months. Persistent seropositivity is a problem in patients who only incompletely exclude gluten or frequently transgress the diet. In such cases, damage of the small bowel may persist and complications may occur at higher frequency. The central hypothesis to be tested is that enzyme treatment designed to degrade a certain amount of gluten before absorption in the gastrointestinal tract will lead to a clinically meaningful decrease in auto-antibody levels in these patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
38
3-4 capsules/day at meals
3-4 capsules/day at meals
3-4 capsules/day at meals plus 500 mg gluten b.i.d
Heim Pal Children's Hospital
Budapest, Hungary
University of Debrecen
Debrecen, Hungary
Negative seroconversion or a drop of more than 50% in anti-transglutaminase antibody blood levels by ELISA
Time frame: 12 weeks
Negative seroconversion or drop of at least two dilution steps in the EMA test
Time frame: 12 weeks
Negative conversion for celiac antibodies in the blood by the rapid test
Time frame: 12 weeks
Change in symptoms or rash (if any)
Time frame: 12 weeks
Favorable changes in morphometry in small bowel biopsy specimens
Time frame: 28 weeks
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