Closer to a Cure for Celiac Disease

Bana Jabri, MD, PhD, first became interested in celiac disease during her residency as a pediatrician in France. She was caring for children who suffered from severe intestinal inflammation that no one knew how to treat. Jabri realized that her clinical work was not enough.

Since that time, Jabri has become one of the world’s leading researchers of celiac disease. An Associate Professor in the Departments of Medicine, Pathology, and Pediatrics at the University of Chicago Medical Center, she directs the research team at the University’s Celiac Disease Center. Under her leadership, the center is at the nexus of extraordinary discovery in blocking the trigger of celiac disease. Characterized by an abnormal reaction to gluten, celiac damages the small intestine. If left untreated, this can lead to severe malabsorption of nutrients and increases the risk of developing autoimmune disorders and cancer. Jabri’s most recent breakthrough, published in the March 2011 issue of Nature, brings us one step closer to finding a cure.

Jabri and her team have discovered the critical role that interleukin 15 (IL-15) plays in the immune system when it comes to decision-making made on the cellular level. IL-15 acts as a distress flag when a cell is in danger. IL-15 is present in everyone, but it is not highly expressed unless an individual is fighting bacteria, virus, stress, or inflammation. The human body has developed a failsafe system—to attack its own cells, if need be, in order to eliminate an invader. If it goes too far, however, tissue is lost. IL-15 signals this is happening.

Jabri’s groundbreaking study shows that not only does IL-15 serve to deploy the army that invades distressed tissue, it also influences how immune cells differentiate, i.e., what kinds of soldiers they become in the battle against inflammation. If we are able to block IL-15 in humans (as Jabri and team were able to do in their mouse-model study), disease prevention for at-risk patients is on the horizon.

Beyond celiac disease, what makes Jabri’s study so important is the implication it has for other autoimmune disorders such as Type 1 diabetes or rheumatoid arthritis. According to Jabri, mouse studies are important, but done in isolation, they are not helpful. Human studies are necessary to determine how a disease develops in people. Genetic studies pinpoint the genetic origin of a disease, but not why or how the genes are important. Jabri explains, “Celiac disease is the disease that researchers can study in humans because we can obtain the tissue in the presence and absence of gluten, we know the genetic background of the individuals studied, and we can do mechanistic studies on immortalized and primary immune cells. Expanded as a framework, discoveries within celiac could be the key to other autoimmune disorders.”

As she learned during her residency, clinical treatment and research must integrate. Today Jabri has expanded that concept at the University’s Celiac Disease Center. It’s the first center of its kind in the United States where you will find in one place researchers studying celiac in mice and in humans, treating pediatric and adult patients, and training future doctors. These critical intersections—the ability to test new therapeutic strategies in mice while at the same time working with adult and child patients—are what make discoveries on the level of Jabri’s possible.

Source: The University of Chicago Medicine