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The safety, tolerance, pharmacokinetic and pharmacodynamic effects of single doses of AT‐1001 in coeliac disease subjects: a proof of concept study
Author(s) -
PATERSON B. M.,
LAMMERS K. M.,
ARRIETA M. C.,
FASANO A.,
MEDDINGS J. B.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03413.x
Subject(s) - medicine , tolerability , placebo , gastroenterology , intestinal permeability , adverse effect , coeliac disease , gluten , inflammatory bowel disease , pharmacology , immunology , disease , pathology , alternative medicine
Summary Background Lifelong adherence to a strict gluten‐free diet is the cornerstone of coeliac disease treatment. Elucidation of disease pathogenesis has created opportunities for novel therapeutic approaches to coeliac disease. AT‐1001 is an inhibitor of paracellular permeability whose structure is derived from a protein secreted by Vibrio cholerae . Aim To determine the safety and tolerability of 12 mg doses of AT‐1001 in coeliac disease subjects challenged with gluten. Methods An in‐patient, double‐blind, randomized placebo‐controlled safety study utilizing intestinal permeability, measured via fractional excretions of lactulose and mannitol, as an exploratory measure of drug efficacy. Results Compared to placebo, no increase in adverse events occurred in patients exposed to AT‐1001. Following acute gluten exposure, a 70% increase in intestinal permeability was detected in the placebo group, while none was seen in the AT‐1001 group. Interferon‐γ levels increased in four of seven patients (57%) of the placebo group, but only in four of 14 patients (29%) of the AT‐1001 group. Gastrointestinal symptoms were more frequently detected in the placebo group when compared to the AT‐1001 group ( P = 0.018). Conclusions AT‐1001 is well tolerated and appears to reduce intestinal barrier dysfunction, proinflammatory cytokine production, and gastrointestinal symptoms in coeliacs after gluten exposure.