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Ask the Dentist: Oral enzymes may hold key to tackling coeliac disease

Dentist Lucy Stock of Gentle Dental Care in Belfast says an enzyme found in the mouth is a potential treatment for coeliac disease

Sticking to a gluten-free diet difficult can be hard as it is present in most refined foods; gluten-free foods include wild rice, oats and bread

RESEARCHERS have isolated an enzyme from bacteria present in human saliva that has potential as a therapy for coeliac disease (CD).

Coeliac disease is a lifelong autoimmune disease. It is caused by the immune system reacting to gluten and affects one in 100 people. However only 24 per cent who have the condition have been diagnosed, which means there are currently nearly half a million people who have coeliac disease but don't yet know.

If a first-degree family member (such as mother, father, sister or brother) has the condition then the chances of having it increase to one in 10. Symptoms include bloating, diarrhoea, nausea, wind, constipation, tiredness, sudden or unexpected weight loss (but not in all cases), hair loss and anaemia. Currently, the main course of treatment for people with CD is adherence to a strict gluten-free diet.

Gluten is present in wheat, barley and rye so when people with coeliac disease eat foods containing these ingredients their immune response in the small intestine goes into overdrive.

Many patients find sticking to a gluten-free diet difficult – in part because gluten is present in most refined foods. The search for new CD treatments has focused on methods that target the peptides in gluten that cause the immune system to overreact. This includes the use of enzymes that break down gluten before the gluten reaches the small intestine.

The study was published in the American Journal of Physiology. The research team wrote: "The aim was to isolate and identify the enzymes and evaluate their potential as novel enzyme therapeutics for CD. We have found that exceptionally high gluten-degrading enzyme activities are naturally associated with bacteria that colonise the oral cavity."

The research team saw that certain bacteria, found in human saliva, can break down gluten compounds that are typically resistant to the digestive enzymes that mammals produce. More research into the potential of the oral bacteria enzymes are needed before any new medicine would be available to coeliac sufferers.

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