AGY, a Novel Egg Yolk-Derived Anti-gliadin Antibody, Is Safe for Patients with Celiac Disease

Sample, Dory; Sunwoo, Hoon H.; Huynh, Hien Q.; Rylance, H; Robert, Cheri; Xu, Biwen; Kang, Sung Hyun; Gujral, Naiyana; Dieleman, Levinus A.

doi:10.1007/s10620-016-4426-5

Cited by 32 publications

(19 citation statements)

References 22 publications

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“…In a very preliminary pilot study published in this issue of Digestive Diseases and Sciences, Sample and colleagues report their experience with AGY, a specific chicken egg yolk-derived immunoglobulin (IgY) against wheat gliadin on a cohort of ten patients with biopsy-proven CD with the aim of assessing its safety in adult CD individuals already consuming a GFD for at least 6 months [9]. Previous preclinical studies performed by the same authors demonstrated that this polyclonal antibody is able to neutralize gliadin in the presence of simulated gastrointestinal fluids in mice.…”

Section: Discussionmentioning

confidence: 99%

Celiac Disease Treatment: Is It the Chicken or the Egg Yolk?

Discepolo

Guandalini

2017

Dig Dis Sci

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Section: Discussionmentioning

confidence: 99%

Celiac Disease Treatment: Is It the Chicken or the Egg Yolk?

Discepolo

Guandalini

2017

Dig Dis Sci

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“…Taking AGY capsules has been shown capable to reduce gliadin absorption from 42.8% to 0.7% in an animal study [47]. A clinical trial with AGY also obtained effectiveness [48].…”

Section: Prevention Of Gluten Degradationmentioning

confidence: 97%

Introductory Chapter: Celiac Disease - Now and Then

Chai¹

2021

Celiac Disease

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“…Ten patients completed the study, and no safety concerns were identified. Most patients had fewer celiac symptoms, improved quality of life, lowered antibodies, and lowered lactulose mannitol ratio when taking AGY as compared to the baseline run-in period (85).…”

Section: Novel Therapies For Celiac Diseasementioning

confidence: 99%

Evolving Therapy for Celiac Disease

Yoosuf

Makharia

2019

Front. Pediatr.

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Gluten is known to be the main triggering factor for celiac disease (CeD), an immune-mediated disorder. CeD is therefore managed using a strict and lifelong gluten-free diet (GFD), the only effective treatment available currently. However, the GFD is restrictive. Hence, efforts are being made to explore alternative therapies. Based on their mechanisms of action on various molecular targets involved in the pathogenesis of CeD, these therapies may be classified into one of the following five broad approaches. The first approach focuses on decreasing the immunogenic content of gluten, using strategies like genetically modified wheat, intra-intestinal gluten digestion using glutenases, microwave thermal treatment of hydrated wheat kernels, and gluten pretreatment with either bacterial/ fungal derived endopeptidases or microbial transglutaminase. The second approach involves sequestering gluten in the gut lumen before it is digested into immunogenic peptides and absorbed, using binder drugs like polymer p(HEMA-co-SS), single chain fragment variable (scFv), and anti- gluten antibody AGY. The third approach aims to prevent uptake of digested gluten through intestinal epithelial tight junctions, using a zonulin antagonist. The fourth approach involves tissue transglutaminase (tTG) inhibitors to prevent the enhancement of immunogenicity of digested gluten by the intestinal tTG enzyme. The fifth approach seeks to prevent downstream immune activation after uptake of gluten immunogenic peptides through the intestinal mucosal epithelial layer. Examples include HLA-DQ2 blockers that prevent presentation of gluten derived- antigens by dendritic cells to T cells, immune- tolerizing therapies like the vaccine Nexvax2 and TIMP-Glia, cathepsin inhibitors, immunosuppressants like corticosteroids, azathioprine etc., and anti-cytokine agents targeting TNF-α and interleukin-15. Apart from these approaches, research is being done to evaluate the effectiveness of probiotics/prebiotics, helminth therapy using Necator americanus , low FODMAP diet, and pancreatic enzyme supplementation in CeD symptom control; however, the mechanisms by which they play a beneficial role in CeD are yet to be clearly established. Overall, although many therapies being explored are still in the pre-clinical phase, some like the zonulin antagonist, immune tolerizing therapies and glutenases have reached phase II/III clinical trials. While these potential options appear exciting, currently they may at best be used to supplement rather than supplant the GFD.

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AGY, a Novel Egg Yolk-Derived Anti-gliadin Antibody, Is Safe for Patients with Celiac Disease

Abstract: In our cohort, AGY was safe and potentially associated with improved CD-related outcome measures in patients on a GFD. A larger study powered for further safety and efficacy evaluation is planned.

Cited by 32 publications

References 22 publications

Celiac Disease Treatment: Is It the Chicken or the Egg Yolk?

Celiac Disease Treatment: Is It the Chicken or the Egg Yolk?

Introductory Chapter: Celiac Disease - Now and Then

Evolving Therapy for Celiac Disease

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