Stem Cell Therapy and Celiac

We all know that a gluten free diet is first and foremost the BEST treatment for celiac disease.  It doesn’t involve pumping yourself with any medicine (yay!), and the gluten free diet has its moments of not being as nutritious as we would like, but mostly, it’s pretty healthy for you.

But what about other treatments?  Vaccines and prescription medicines are being investigated and in some cases already in clinical trials, but another therapy came across my desk a few weeks ago, and I needed to take time to investigate a little bit — and that is Stem Cell Therapy.

Stem Cell Research in Celiac

So why is stem cell therapy and celiac even being used in the same sentence?  That is what I was wondering. I haven’t heard much about it. Turns out, researchers are looking into the possibility that stem cell transplants could help celiac patients.

In 2007, two reports came out declaring the hopeful possibilities of stem cell therapy and celiac disease.  In the March 1, 2007 issue of Blood, also published on Pubmed.gov, researchers explored stem cell transplantation for refractory celiac disease.

Refractory celiac disease (RCD) is when the disease becomes unresponsive to the gluten free diet and other available therapies.  People with the worst kind, RCD Type II, have a 60-80% risk of enteropathy associated T-cell lymphoma (EATL).  This specific lymphoma has poor outcomes: 31-39% of people with EATL survive one year.  Only 11-20% of these patients survive 5 years, according to the study.

Because of the high mortality rate, doctors researched how a transplant of stem cells — taken from their own bodies — could help.  The patients received a high amount of chemotherapy before getting their stem cells transplanted back in.

Biopsy results showed significant improvement for some patients as soon as three months of the procedure.  For others it took as long as 24 months.

In another study published in Pediatrics in September of 2007, a child who had confirmed celiac disease for 9 years was treated for leukemia at the age of 12. She received stem cells from her brother to treat the cancer.  Three months after her treatment, she went back on gluten. Five months after her treatment serology tests were still normal — showing no evidence of celiac disease.  Again at an appointment 3 1/2 years after the transplant, still no celiac disease.

Fast forward to April of 2013 the Journal of Pediatric Gastroenterology and Nutrition reported on two cases of people having celiac and beta thalassemia major (a rare blood disorder).  The patients received HSCT for the B-thalassemia. The stem cells came from donors. They were able to eat gluten again without celiac symptoms coming back even 5 years after diagnosis.  In this case, researchers concluded, “These data suggest that allogeneic HSCT may lead to induction of gluten tolerance in patients with CD.”

Stem Cell Therapy and Celiac

Back to the report that came across my desk.  I interviewed Dr. Burton Feinerman after receiving this press release declaring that stem cell therapies were now being offered for celiac in the US.

Here’s how it works.  The stem cells are removed from patient’s blood or fat tissue.  Doctors then isolate the mesenchyal stem cells and re-insert them into the patient. “These stem cells migrate only to the area of most damage to the body,” Dr. Burton Feinerman of Regenerative Medicine Solutions in Tampa, Florida says. “They will help reduce the chronic inflammation in the small intestine.  They have the ability to differentiate and replace the damaged villi with normal villi.”  The procedure is outpatient and only takes about an hour.

Anyone with diagnosed celiac disease who continues to have symptoms that affect their daily lives would be ideal candidates for this treatment, Feinerman says.  You can be newly diagnosed or have trouble ridding yourself of symptoms even with a longtime gluten free diet.

Dr. Feinerman says a patient can start to slowly introduce gluten into their diet after 60 days.  “Technically, [the therapy] should give them 100% protection.” he says.  However, since it is so new, they don’t know how long one treatment will last, but they hope it could last indefinitely.  Ultimately, Dr. Feinerman believes to really knock celiac out, you need the stem cell therapy and gene therapy to rid the body of gene mutations that can occur.   

So why isn’t this treatment mainstream?   “Ignorance.”  Dr. Feinerman says.  “America is one of the few countries in the western world that is way behind in stem cell therapy.”  He also believes politics and lobbyists for drug companies play a large role in the ignorance and are slowing this kind of medicine down.

Should people be seeking this treatment?

That is only a decision you can make (perhaps with other medical advice).

I emailed the University of Chicago’s Celiac Disease Center to see what Dr. Stefano Guandalini, founder of the University’s Celiac Disesae Center, thought about Regenerative Medicine Solutions’ therapy.  He admitted stem cell therapy has been used for T-cell lymphomas arising as a complication of celiac and that there are some studies showing that stem cell transplant may lead to induction of gluten tolerance in patients with CD (as noted above). But he adds, “People would be out of their mind considering such a serious treatment for celiac.” 

At the time of the aforementioned Pediatrics publishing in 2007, researchers concluded, “Although we do not advocate at this time allogeneic HSCT [Hematopoietic Stem Cell Transplantation]  as the definitive treatment for CD, the decreased morbidity and mortality associated with use of reduced-intensity stem cell transplants may someday allow HSCT to be an acceptable alternative to a lifelong gluten-restricted diet, which at best, is extremely difficult to adhere to for life.”

Will stem cell therapy someday be an alternative to a gluten-free diet?  We’ll have to wait and see.

*Note:  I am not a medical practitioner.  If you have further questions about this topic, please consult your medical professional.

Tags: autoimmune, celiac, cell, diet, disease, gluten-free, stem, therapy, transplant, treatment