Coeliac research improves lives

Coeliac research improves lives

Illuminate newsletter index page, December 2018
December 2018


For more than a decade, Dr Jason Tye-Din has been passionately
leading the way in understanding what triggers coeliac disease.

It has been a busy and productive year for our coeliac researchers, with the launch of trials for a world-first coeliac vaccine, the release of two influential gluten-free food studies, and research examining patient adherence to the gluten-free diet.

Coeliac disease occurs when dietary gluten – found in wheat, rye, barley and oat – triggers a damaging immune response that attacks the body. The disease affects one in 70 Australians and there is no cure.

Dr Jason Tye-Din is head of the Institute’s coeliac research program and a gastroenterologist at the Royal Melbourne Hospital. For more than a decade, he has been passionately leading the way in understanding what triggers coeliac disease and translating findings from research into the clinic for the benefit of patients.

World-first coeliac vaccine in trials

In October, the world’s first ever coeliac disease vaccine Nexvax2® entered phase 2 clinical trials in Melbourne, following US trials led by the biotechnology company ImmusanT Inc. Nexvax2® is designed to restore what is lost in coeliac disease – the ability of the immune system to tolerate gluten.

Dr Tye-Din, who is running the trials at the Royal Melbourne Hospital, said the therapy could one day allow patients to safely eat gluten.

“This vaccine could revolutionise coeliac disease management,” Dr Tye-Din said.

Research underpinning the vaccine was initiated at the Institute in 2003 by Dr Bob Anderson – now chief scientific officer at ImmusanT Inc. – and then PhD student, Dr Tye-Din. Their work identified the toxic parts of gluten and paved the way for the design of Nexvax2® and its subsequent phase 1 trials.

The results from the phase 1 trials showed that the therapy was safe and well tolerated.

“Phase 2 trials would not have been possible without this early data and it is great that the Institute is still playing a pivotal role in this work,” Dr Tye-Din said.

  • [See June 2019 update below]

Improving regulation and awareness

Two influential studies published this year in the Medical Journal of Australia have raised awareness of the need for improved education and regulation around gluten-free food processes.

An undercover investigation of 127 Melbourne restaurants and cafes revealed one in 11 samples of ‘gluten-free’ foods sold were contaminated with gluten. The presence of gluten in the foods was associated with a lack of knowledge and staff training on gluten-free food preparation.

“The research identifies this as a common issue and examines why gluten contamination might occur,” Dr Tye-Din said. “With the right awareness, training and practices, restaurants can offer options that are in line with the Food Standards Australia New Zealand (FSANZ) Code.”

Coeliac Australia has developed a helpful suite of resources to assist food businesses prepare gluten-free options that comply with national food regulations.

Engaging with non-compliant companies

Subsequent research published in November revealed that some companies selling packaged ‘gluten-free’ foods might need to examine their practices, after samples were found to contain gluten.

The findings revealed that one in 40 foods labelled as ‘gluten-free’ did not comply with the national standard of ‘no detectable gluten’, after testing 256 of the most commonly purchased foods labelled as ‘gluten-free’.

While the amount of gluten was small and posed a low risk to consumers, precautions were taken, and the details reported to the state food safety authorities.

“We want to engage in a constructive dialogue with food businesses, the manufacturing industry and regulatory authorities to influence the long-term improvement of processes,” Dr Tye-Din said.

“A punitive response is ineffective as it carries the risk of companies using unhelpful ‘may contain traces of gluten’ disclaimers on products or stopping their gluten-free food production altogether.”

Helping patients manage diet

In two other studies that examined the gluten-free diet, Dr Tye-Din surveyed over 7000 people with coeliac disease in Australia and New Zealand to understand the demographic, medical and psychological patient factors associated with strict adherence to this diet.

The research showed that the key factors shaping a patient’s ability to maintain dietary adherence were knowledge of a gluten-free diet and psychological wellbeing.

“Based on the results we were able to develop strategies to identify patients at risk of struggling with the gluten-free diet and provide the right management to get them on track.”

Patients at the heart of efforts

Dr Tye-Din said the results from the studies conducted throughout the year were really important for coeliac patients whose health depended on a gluten-free diet.

“Improving the quality of gluten-free food options and ensuring patients can maintain dietary adherence will lead to better outcomes for people who depend on a strict gluten-free diet for their wellbeing.

“Helping patients with coeliac disease is a professional mission of mine and a very personal one as well," he said.

More information

June 2019 update: US based biotechnology company ImmusanT Inc has announced it will discontinue its Phase 2 clinical trials of Nexvax2®. An interim analysis showed the drug did not provide statistically significant symptom protection from gluten when compared with placebo results. Nexvax2® was found to be safe with no concerning safety issues identified during the study.

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