Gluten is a protein mainly found in grains such as wheat, rye, and barley, as well as in certain medicines and supplements. For some people, gluten can cause severe gastrointestinal problems. Some of these people have celiac disease, while others are simply gluten sensitive.
Celiac disease is an inherited autoimmune disorder, in which the body’s immune system will start to attack the small intestine when it detects gluten.
Gluten sensitivity shares some of its symptoms with celiac disease, but unlike the latter, it does not harm the small intestine. Gluten intolerance can also cause additional symptoms, such as leg numbness or muscle cramps.
The National Foundation for Celiac Awareness estimate that approximately 18 million people in the United States are intolerant of gluten, without having celiac disease.
A new study suggests that an enzyme called aspergillus niger-derived prolyl endoprotease (AN-PEP) can stop gluten from entering the small intestine, reducing the symptoms in gluten-sensitive patients.
The findings were presented at Digestive Disease Week 2017, an international conference that gathers specialists in the fields of gastroenterology, endoscopy, hepatology, and gastrointestinal surgery.
Studying the effects of AN-PEP on gluten intolerance
The researchers – led by Julia König, Ph.D., postdoctoral research fellow at the School of Medical Sciences at the University of ‘-rebro, Sweden – tested the enzyme on 18 patients that were self-reportedly gluten-sensitive.
The participants consumed a portion of porridge with two wheat cookies that contained gluten, and they were then administered either AN-PEP or a placebo. The enzyme was administered in a high dose or a low dose.
König and team monitored the levels of gluten in the stomach and small intestine over 3 hours.
The study found that both the high-dose and low-dose AN-PEP groups had 85 percent less gluten in their stomachs than the placebo group.
In the duodenum – the first part of the small intestine – the level of gluten was lowered by 81 percent in the high-dose group, and 87 percent in the low-dose group, compared with the placebo group.
Significance of the study
Previous research had indicated that the enzyme can break down the gluten when infused in a liquid meal, but this is the first study to have confirmed these results using a normal, solid meal.
Dr. König explains the significance of the findings, saying, “This substance allows gluten-sensitive patients to feel safer, for example, when they are out with friends at a restaurant and cannot be sure whether something is 100 percent gluten-free.”
“Since even small amounts of gluten can affect gluten-sensitive patients, this supplement can play an important role in addressing the residual gluten that is often the cause of uncomfortable symptoms,” Dr. König adds.
The researchers note that the beneficial effects of AN-PEP may not apply to patients with celiac disease. In celiac disease, long-term damage can be triggered by even the smallest quantities of gluten – so König and colleagues could not test the enzyme in these patients, nor do they recommend it to celiac patients.
However, the results remain encouraging for patients with non-celiac gluten intolerance.
“Studies show that even when following a gluten-free diet, unintentional gluten intake can still occur, depending on how strict a gluten-free dieter is. Our results suggest that this enzyme can potentially reduce the side effects that occur when gluten-sensitive individuals accidentally eat a little gluten. We are not suggesting that AN-PEP will give these individuals the ability to eat pizza or pasta, sources of large amounts of gluten, but it might make them feel better if they mistakenly ingest gluten.”
Dr. Julia König