The gut is necessary for life, as it digests energy and nutrients which are then delivered to cells throughout the body. The immune system has a large presence in the digestive system. The immune system typically functions fine and helps keep potential invaders from causing harm in the body, however, many autoimmune diseases begin in the gut. When the immune system attacks healthy cells in the gut, a number of issues can occur and result in various autoimmune diseases.
One of the more well-known autoimmune gut diseases is celiac disease. Patients who suffer from celiac disease have an immune reaction to gluten, which can damage cells in the intestine that absorb nutrients. This can prevent patients from receiving the proper nutrients they need to live healthy lives.
The quality of life of patients with celiac disease can be greatly impacted. Patients with celiac disease may have difficulty getting pregnant and staying pregnant. Keeping weight on can be difficult, as the body is unable to properly absorb nutrients from food. Celiac disease can also affect various parts of the skin.
Celiac disease affects about 1% of the population, so about three million people in the United States suffer from celiac disease. Researchers estimate that two and a half million Americans are undiagnosed and at risk for serious long-term health implications. Patients need to be aware of the symptoms of this condition to ensure that they can take the proper steps to treat their condition.
The medical community has failed to develop effective treatments for patients who are suffering from celiac disease. There are currently no approved medicines and treatment protocols for celiac disease. Patients can only avoid gluten and hope that the gut can repair itself while the small intestines get to a point where they can absorb nutrients properly again.
Advances in regenerative medicine have given hope to patients where they previously had none. Stem cell therapy may be able to improve the outcome of patients who are suffering from celiac disease. Stem cells have unique properties that could help patients regenerate the damaged cells in the small intestine and prevent the immune system from attacking those cells. It may be helpful to have some more background on celiac disease to understand how stem cell therapy could improve patient outcomes.
What Is Celiac Disease?
Celiac disease is an autoimmune disorder that primarily affects the small intestine. Patients who suffer from celiac disease have an abnormal immune reaction in their gut when the gut is exposed to gluten. The immune system has a reaction, which damages some of the important cells in the small intestine. Gluten is identified as a potential invader in the body, which causes the immune system to damage certain parts of the small intestine.
The villi are incredibly important in the gut. They allow the body to absorb nutrients from food. When a patient has celiac disease, the villi in the gut are attacked by the immune system. Over
time, these attacks will destroy enough of the villi to a point where the gut can no longer absorb nutrients. The rate at which the villi are damaged is greater than the rate at which they are regenerated.
Researchers do not fully understand why patients develop celiac disease. If a patient has a family member with celiac disease, there is a greater chance that they will develop the condition themselves. Diagnosing celiac disease is not always straightforward. Patients may suffer from the symptoms of the disease for years before receiving a proper diagnosis.
Some patients may have gluten sensitivity and not full-on celiac disease. Patients with gluten sensitivity have trouble breaking down and digesting gluten. Patients should be aware of the difference between celiac disease and gluten sensitivity. Both conditions have similar symptoms. However, in patients with gluten sensitivity, the villi will not be destroyed. There is no immune reaction to gluten. The gut will still be able to absorb nutrients, as the villi will not suffer from any damage.
Typically celiac disease manifests itself in the gut, but it can also affect the skin. Dermatitis herpetiformis is an itchy skin rash with bumps and blisters that primarily form on the elbows, buttocks, and knees. This symptom affects somewhere between 15% to 25% of patients with celiac disease. Interestingly, patients who have this symptom typically do not have digestive symptoms. The immune system attacks various parts of the skin instead of the villi in the small intestine.
How Does Gluten Damage The Small Intestine?
Gluten itself does not damage the villi in the small intestine, but gluten is the start of the disease. When a patient digests food or product with gluten, a peptide called gliadin will end up in the small intestine. The gliadin will pass through cells in the small intestine known as the enterocytes. These are absorptive cells located on the lining of the small intestine and surface of the villi. The gliadin proteins will be absorbed by the enterocytes. When the enterocytes detect certain gliadin proteins, the cells will signal to the immune system that there is a potential issue with the proteins.
The immune cells will damage the enterocytes, as the body believes that the gliadin proteins are an invader. When the enterocytes are damaged, there is more space for gluten to pass through, which can further exacerbate the problem. Researchers also believe that the damaged enterocytes release an enzyme called tTG. The enzyme can attach to gluten and modify the molecules so that the immune system will respond to the gluten.
The gliadin proteins can then bind to antigen-presenting immune cells, which will signal Helper T-cells to fight against gluten. The helper T-cells secrete chemical signals in the small intestine, which causese three things to occur.
1) Helper T-cells release toxic chemicals that will damage enterocytes.
2) The T-cells express natural killer cell receptors. Natural killer cells have the ability to kill the enterocytes by mediating apoptosis. This will cause cell death in the enterocytes.
3) T-cells also signal to B-cells to create antibodies. These antibodies will attack the gluten cells and the enzyme that is secreted by the enterocytes. The antibodies do not directly attack the enterocytes, but there is a chance that the cells could receive damage during the process.
The overall culmination of these events is celiac disease. The immune system is damaging the enterocytes and villi, which prevents the body from properly absorbing nutrients. Patients who are suffering from celiac disease do not have many treatments to improve their quality of life and outcome.
Treatments For Celiac Disease
The medical community has not been able to develop any effective medical treatments for patients who are suffering from celiac disease. Patients will have to significantly alter their lifestyle and diet to prevent immune reactions.
The only effective treatment for patients with celiac disease is to remove gluten from a patient’s diet. Even a small amount of gluten can set off an immune reaction. If gluten is not introduced in the gut, then the immune system will not respond to the gluten and damage the villi. The body will still be able to absorb nutrients from other foods without gluten. Patients should be aware that some products, such as vitamins and medications, may contain gluten.
Avoiding gluten products and food helps the body repair the damage to the villi. The villi have the ability to regenerate in the small intestine after about 72 hours, as long as the gut is not exposed to more gluten. It may take more time to recover. If a patient has been continually eating gluten products, then the villi and small intestine will have undergone much more damage. The villi may not fully recover for weeks, months, or even years. Patients with celiac disease will have to maintain a gluten-free diet, while the villi recover.
Getting patients to avoid gluten for the rest of their lives is a difficult undertaking. Patients have to meticulously ensure that all foods and products that they ingest do not have any gluten. A patient who mistakenly ingests gluten could suffer from the immune reaction for several days or even weeks, depending on the reaction and amount of gluten consumed. Patients need to avoid gluten to prevent further intestine damage.
There have been some cases where avoiding gluten has not been enough to prevent malabsorption syndrome. The immune system is still attacking the villi. Researchers are not entirely sure why this can occur. In these cases, the patient is likely suffering from refractory celiac disease. A gluten-free diet does not prevent the immune system from causing further intestinal damage.
If a patient has extreme inflammation in the gut, medical professionals may recommend certain medications.
Patients who are experiencing high levels of inflammation from gluten may have to utilize medication. Steroids can be utilized to reduce inflammation, while the patient rids their diet of gluten. This can make the transition to a gluten-free diet easier. Medical professionals can also prescribe azathioprine or budesonide to help reduce intestine inflammation.
Abstaining from food and only drinking water is a potential treatment for patients with celiac disease. Some researchers believe that depriving the body of food can improve the outcome of patients who are suffering from celiac disease. If the gut is not busy digesting food, it may be able to repair the villi. Fasting may also have some effects on the immune system.
Yale researchers found that when patients fast a compound, known as hydroxybutyrate, is produced. This compound inhibits inflammatory responses, which may be able to reduce inflammation in celiac disease. Patients may be able to utilize fasting to lower the levels of inflammation in their gut.
MIT researchers found that intestinal stem cells from mice that had fasted for 24 hours had twice the regenerative capacity of mice who were not fasting. Researchers believe that fasting induces a metabolic switch in the intestines to improve regeneration. By burning fat instead of carbohydrates, fatty acid oxidation enhances the abilities of intestinal stem cells.
Researchers at the University of Southern California studied how the immune system reacts when the body fasts. Patients and mice underwent multiple fasting cycles between two and four days over a period of six months. The researchers found that the body gets rid of older and damaged white blood cells and completely repopulates the immune system with new white blood cells. This could prevent the immune system from responding to gluten.
Granted, most patients have difficulty skipping meals, let alone fasting for multiple days in a row. This is not an effective solution for patients suffering from celiac disease. Researchers may one day develop a drug that mimics the effects of fasting in the intestine, but that would not likely come to fruition for many years. A majority of the population would not be able to fast for multiple days in a row.
Unfortunately, patients with celiac disease will have to forever change their diet in order to prevent further destruction of the villi. This is a difficult change for many patients.
We have discussed how stem cells can help the body regenerate the gut and villi. Researchers are looking into how stem cell therapy can improve the outcome of patients who
Stem Cell Therapy For Celiac Disease
Researchers have been hopeful that stem cells may have the answer for patients who are suffering from a variety of autoimmune diseases. Stem cells have intrinsic properties that make them an attractive therapeutic candidate for celiac disease. Patients may be able to one day receive an IV of stem cells to improve their outcome.
Stem cells have immunoregulatory properties. Researchers believe that stem cells can interact with the immune system and shut off pathological responses, such as the immune system reacting to gluten. Stem cells release anti-inflammatory factors where they are introduced. These factors can lower inflammation in the small intestine.
Researchers do not fully understand how stem cells interact with the immune system to reduce levels of inflammation. Stem cells may be able to prevent the white blood cells from triggering an immune reaction when the gut digests gluten. There may be a chance that stem cells turn into new white blood cells that replace the damaged white blood cells. The new white blood cells will not elicit an immune response from the detection of gluten in the small intestine.
The body can also use stem cells to replace damaged cells and tissue. Stem cell therapy may be able to promote healing and regeneration in the small intestine. Stem cells can also potentially differentiate into enterocytes. Patients who have had celiac disease for a long period of time could use stem cells to potentially repair the villi.
Patients who are worried about any adverse reactions from stem cell therapy should feel calm about any potential side effects. Stem cell therapy is generally a very safe treatment for a variety of conditions. Multiple studies have shown that patients will not have an adverse reaction when treated with stem cells. The immune system does not identify stem cells as a potential threat or invader, so there generally is no immune reaction.
There have been some promising case studies that have demonstrated that stem cell therapy could be a potential treatment for patients who are suffering from celiac disease.
Promising Case Studies
A 51-year-old woman was suffering from celiac disease. The patient had been gluten-free for more than 14 years after being diagnosed with celiac disease. She was still suffering from severe diarrhea and fever that caused weight loss, dehydration, and electrolyte imbalance. The medical team found that she was suffering from Type II refractory celiac disease, where even a gluten-free diet could not improve her condition.
The medical team attempted other treatments, such as corticosteroids, but they did not improve her condition. Their last-ditch effort was to utilize stem cell therapy and hope that her condition would improve. The medical team was hopeful that the regenerative and immunomodulatory properties of stem cells could potentially help. Bone marrow was harvested from the patient and mesenchymal stem cells were isolated, expanded, and characterized from the bone marrow.
The patient received four separate infusions of 2,000,000 of the mesenchymal stem cells every four months. The patient did not have any adverse reactions to the treatment. The medical team monitored the patient’s malabsorption indexes, mucosal architecture, and percentage of aberrant intraepithelial lymphocytes at each injection.
During the 12 month treatment period the patient gradually improved. The patient had improved bowel movements, gained weight, positive lab test results, and improved architecture in the small intestine. A key inflammatory marker, IL-15, almost completely disappeared from the test results. The patient no longer needed to receive nutrients intravenously or needed to take steroids just two weeks after the first stem cell infusion.
The medical team believed that stem cells were able to both reduce the level of inflammation in the small intestine and promote healing. The stem cells likely interacted with the immune system to lower the level of inflammation to prevent the immune system from attacking the villi. The stem cells also may have contributed to the regeneration of the villi.
There have been other case studies that have shown the potential of stem cell therapy for patients with celiac disease. Two patients in Italy were suffering from a genetic blood disorder, known as thalassemia major. If this disease is left untreated, patients typically die before the age of 20. In order to treat the condition, the patients received a myeloablative allogeneic hematopoietic stem cell transplantation.
The patients recovered from the genetic blood disorder, but the researchers also found that celiac disease regressed in the patients as well. The patients were able to eat gluten without the reappearance of any celiac disease symptoms after receiving the transplant. The study followed patients for five years after they received stem cell therapy and during that time there was no evidence of celiac disease in any of the patients.
The researchers believe that stem cell therapy is a way to reset the immune system and gut. Stem cells have the potential to prevent further degradation of the small intestine while promoting healing. The researchers believe that stem cell therapy enabled the patients to become gluten tolerant.
BioXcellerator has worked with patients who are suffering from various autoimmune disorders. We are focused on achieving the best possible outcomes for our patients, no matter what condition they are suffering from. We only recommend treatments that have the best possible chance of working, whether that is stem cell therapy or a gluten-free diet. Our team will never recommend a treatment that has no chance of working.
Our research team recently looked into how we could improve the quality of every stem cell treatment that we administer to our patients. We realize that patients may be worried about the
quality of stem cells that they receive in treatment. Our team developed a quality control process that ensures every patient receives the highest quality stem cells.
We heavily researched the standards, regulations, and studies that identify the potency of stem cells. Our team identified the characteristics of stem cells that have high potency. These biomarkers help us identify stem cells that have the greatest therapeutic potential. We can then weed out the stem cells that do not possess these biomarkers.
Our team likes to call the group of stem cells that is left after this process ‘golden cells.’We believe that golden cells will improve the outcome of patients with various diseases and conditions. The higher therapeutic potential should decrease inflammation, improve regeneration, and prevent immune system overreactions in a more effective manner than conventional stem cells that do not go through the quality control process.
Reach out to your healthcare provider today to learn more about potential treatments for celiac disease. Stem cell therapy could help lower levels of inflammation and promote healing in the small intestine. Some patients may be able to even eat gluten products and foods again after utilizing stem cell therapy.