Enzyme Supplements: A Solution for Celiac Disease?

Myron Yau, HK BioTek Nutritionist

Epidemiological studies revealed that around 1% U.S. population suffers from Celiac Disease. As this problem affects mankind worldwide, many different solutions are suggested, one of which is the use of gluten-specific enzymes. To comment on its efficacy, we have to know it in more details.

Celiac Disease is an intestinal disease characterized by the inflammatory response to dietary gluten in genetically susceptible individuals. Its pathology includes the penetrations of undigested gluten into blood stream, the subsequent stimulations and responses of the immune system localized in the small intestine, leading to destructions of the villi on the small intestine surface.

Since this disease is due to the presence of incompletely-digested gluten, any intervention that can break the intact gluten into amino acids is theoretically able to relieve the problem to a certain extent.

With the advance of the science and technology, we now know that the most pathogenic part of gluten is the proline- and glutamine- (two common amino acids) rich sequences. Thus, the enzymes usually used as supplements and under researches are those extracted from plants or micro-organisms and specific to these sequences.

A study held by Stanford University published in 2007 illustrated that the combination of a proline-specific and a glutamine-specific enzyme showed an enhanced effectiveness on the digestion of the most pathogenic sequences of gluten in gastric condition. This may suggest the light to increase the safe threshold of dietary gluten in Celiac patients, which gives them more flexibility in their gluten-restricted diets.

Yet this does not necessarily mean that with this ‘therapy’ Celiac patients can eat gluten freely afterwards because all enzymatic reactions can never attain 100% yield and there are always some pathogenic peptides left which still possibly cause inflammatory responses.

To conclude, the use of enzymes to treat or cure Celiac Disease is still lack of clinical trials to support. But it is likely to be an extra barrier to accidental ingestion of gluten for gluten-sensitive patients, in addition to our natural digestive mechanisms.