The new gluten pill: why so hard to swallow?

Canadian researchers at the University of Alberta have developed a supplement from hen's eggs which may help people with coeliac disease consume gluten.

The details are a little unclear to me, but according to Professor Hoon Sunwoo, who co-developed the supplement, it will bind with gluten in the stomach and "help to neutralise it, therefore providing defence to the small intestine, limiting the damage gliadin causes" (gliadin being the key gluten protein responsible for most of the coeliac reaction). (Readers less alarmed about the complex science behind it than me might learn more from the recently published paper on the background research.)

The coverage of this story has been mixed. Popular Science's headline seemed to assume all coeliacs relentlessly fantasised about eating gluten and that gluten-free pizzas and beers weren't available to them. Meanwhile, a piece in Munchies exaggeratedly trumpeted the 'miracle' arrival of the pill, which will prevent any coeliac turning into a 'whimpering fart factory' - because wind production is the key major concern, after all, and not villous atrophy, osteoporosis or other life-damaging complications.

Gluten egg-sterminators?
Reaction from the coeliac community has been mixed too. Although there is some understandable scepticism and uncertainty, this could one day turn out to be a feasible treatment - if not allowing the consumption of small quantities of gluten, then as a useful insurance protection against the risks of potential cross-contamination when eating out - but I can't understand those who have reacted angrily to the news. It's not difficult on social media to find insults flung at the scientists, including the accusation that they're motivated by greed. Since when has profiting from your expertise, research and work been a crime, anyway?

This is what I find the most difficult to accept: the apparent view of some coeliacs - mainly in the US, as exemplified by this GlutenDude blog, and comments, from last year - that such science is unwanted and almost should not take place at all; that we should focus on improved awareness, eating out and food options instead. I have no issue with those who don't wish to take pills or vaccines or other in-the-pipeline medical treatments for coeliac disease; but I do with those who assume no other coeliac would want to either and call for their own preferences to be exclusively met. Why can't we have all - better and safer food options and better awareness AND medical treatments as well? One does not need to come with the sacrifice of the other, after all ...

All this will take time. Efficacy trials are needed. Three years has been mentioned as an overall timeframe. But it could be longer. We have been talking about gluten pills for almost a decade. I wrote this article for Coeliacs Matter in 2008, and seven years on the therapies aren't yet available.

When I recently updated the 'Future Treatments' section in the revised edition of my book on coeliac disease, I was excited by the number of new ones I discovered and could add to the chapter. And here is yet another one. We should be hopeful, but cautious, about them all - and supportive of the brilliant brains behind them.

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