imgresFor many years, certain enzyme supplements have been touted to be able to help those with celiac disease digest gluten. As oral supplements, these enzymes are marketed to assist with breaking down the protein in gluten that those with celiac are usually unable to digest. However, a study conducted by Janssen et al, demonstrated that these commercialized enzyme supplements are actually ineffective at cutting gluten1.

People with celiac disease react to gluten because an amino acid chain in the substance binds to certain expressed genes that only those with celiac disease have. This prevents gluten from being broken down like it needs to be, allowing it to reach the small intestine. In turn, this triggers an over-reactive immune response, causing celiac disease symptoms. The common misconception about these supplements is that they are able to break down the amino acid chain that would otherwise not be digested. However, it was revealed that the commercialized enzymes cannot even survive the pH of the stomach (which is normally acidic, ranging from 1.5-3.5), let alone withstand the pepsin to which they are exposed in the digestive tract. Pepsin is an enzyme released by the stomach that aids in digestion, and it is most active in acidic environments. This means that the commercialized enzymes will not properly protect against gluten exposure to improve celiac disease symptoms.

In addition to looking into the efficacy of enzyme supplements, this study also demonstrated that AN-PEP, a pure digestive enzyme unavailable in stores, was able to successfully cut gluten in the high acidity of the stomach[1]. Indeed, DSM Food Specialties is in the process of developing a drug with AN-PEP as the main component[2]. However, the positive data collected for AN-PEP should be taken cautiously, since another study conducted by Tack et al demonstrated that AN-PEP’s effectiveness for alleviating celiac disease symptoms was inconclusive. The study observed no differences between the patients consuming gluten with a placebo versus those consuming gluten with AN-PEP. Moreover, there was no significant difference in the antibody titers between the two groups. If the antibodies had been greater in those with the placebo than those who took AN-PEP, it would have proven that AN-PEP was indeed effective for those with celiac disease. However, since there was no significant difference, it could not be verified that AN-PEP was either helpful or detrimental to those with celiac disease[3].

So far, research has established that commercialized enzyme supplements are unable to degrade the amino acid chain that causes celiac disease symptoms1. Although the competence of AN-PEP may seem more hopeful than that of the enzyme supplements currently on the market, the effectiveness must be taken with an air of caution since no research has been in agreement on whether it is actually effective. Overall, based on current research, caution is advised when considering enzyme supplements and drugs, since it very much depends on the type of enzyme used and how much research has been completed.

Celiac Disease Foundation is committed to making the lives of those with celiac disease easier and less burdensome, through education, advocacy, and the advancement of research. In order to achieve its mission, CDF collaborates closely with many organizations, such as the White House, NIH, and FDA. Through initiatives with these organizations, a national patient-powered research network (PPRN) for celiac disease, funded by the Patient Centered Outcomes Research Institute, will soon be released, making it possible for those with celiac disease to contribute to further advancement of research and clinical trials. Thanks to the Affordable Care Act, the celiac disease PPRN will give researchers incentive to study and deepen their understanding of celiac disease, which will eventually lead to alternative treatments to help relieve the suffering.

Works Cited

[1] Janssen, George, Chantal Christis, Yvonne Kooy-Winkelaar, Luppo Edens, Drew Smith, Peter Van Veelen, and Frits Koning. “Ineffective Degradation of Immunogenic Gluten Epitopes by Currently Available Digestive Ensyme Supplements.” Plos One 10.1371 (2015): CrossMark.

[2] “Effect of AN-PEP Enzyme on Gluten Digestion.” Effect of AN-PEP Enzyme on Gluten Digestion., 12 Aug. 2011.

[3] Tack, Greetje J., Jolanda MW Van De Water, Maaike J. Bruins, Engleina MC Kooy-Winkelaar, Jeroen Van Bergen, Petra Bonnet, Anita CE Vreugdenhil, Llma Korponay-Szabo, Luppo Edens, B Mary E. Von Blomberg, Marco WJ Schreurs, Chris J. Mulder, and Frits Koning. “Consumption of Gluten with Gluten-degrading Enzyme by Celiac Patients: A Pilot-study.” World Journal of Gastroenterology 19.35 (2013): 5837-847.