Coeliac disease vaccine

Scientists around the world are working to discover a pharmaceutical way to treat coeliac disease, seeking a vaccine that could block the autoimmune process that causes the condition. In the short term, a gluten free diet is set to be the only proven treatment for coeliac disease, but there are reasons for hope that the future will bring drugs that will make life a little or a whole lot easier for coeliac patients and people with gluten intolerance. 

But the path to scientific breakthroughs is rarely a straightforward one. One of the most promising candidates for a coeliac disease vaccine, called Nexvax2, was dropped after trials failed to yield positive results. But failures are the way in which the scientific community learns more about the objective researchers are trying to reach, and other candidate treatments are emerging to kindle the flame of hope. 

Nexvax2, a vaccine candidate developed by a Massachusetts biotech company called ImmusanT and which had generated considerable interest among the coeliac community, was based on a form of immunotherapy. Nexvax2 was based on peptides to attract the antibody T cells that the coeliac patient’s immune system directs at gluten, and disable them. The idea behind it was to build up the dosage of the vaccine over time and increase the ability to ingest gluten without suffering a reaction.  

Nexvax2 had reached phase II clinical trials in human patients, but these were discontinued in 2019 after results showed that the drug did not provide significant levels of protection from gluten when compared to a placebo. ImmusanT said that it would continue to actively investigate the data gathered from the trial to better understand the outcome and derive learnings from this. Even though the desired outcome was not achieved by Nexvax2, this data will help to inform the scientific community on ways to hone other future treatments for patients with coeliac disease. 

One of the most promising lines of research today is the development of nanoparticles containing fragments of gliadin, the protein in gluten that triggers the autoimmune response. Scientists at the University of Helsinki, working in collaboration with Cour Pharmaceutical Development Company, announced in 2020 that they had tested a nanoparticle treatment called TIMP-GLIA in mice with gliadin sensitivity, and found a significant reduction in gliadin-specific T cell activation, inflammation and tissue damage.  

Their findings support the idea that it may be possible to reprogram the immune system in coeliac patients, and to instruct the T lymphocyte antibodies to tolerate gluten again. If these promising signs were to translate into human coeliac patients not experiencing an autoimmune response to gluten in trials, the TIMP-GLIA treatment could be a major step towards a cure for celiac disease.  

A license for the development of TIMP-GLIA was acquired by Takeda Pharmaceuticals, and trials in the US are expected to take place in the next few years. But TIMP-GLIA is one of dozens of pharmaceutical products being investigated as potential vaccines or medicines that will help people with coeliac disease. As of today no one knows which one, if any, will provide the next breakthrough. But with each effort, the knowledge accumulated helps to shape the success of the future, whenever that may be.