Potential Treatment Alternatives and an Illustrative Case Study of Celiac Disease
AuthorWilliams, Colt Jonas
Biochemistry & Molecular Biology
Biochem and Molecular Biology
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Celiac disease (CD) has taken center stage in the public eye, now afflicting 1:250 to 1:100 people in the United States. While CD etiology is most certainly polyfactorial, stemming from genetic, environmental, and immunologic factors, a causative agent of CD has been identified as a malfunctioning tissue transglutaminase (tTG). A ubiquitous enzyme that has numerous roles body-wide, tTG most notably digests small peptides in the jejunum. When tTG in the brush border of the small intestine comes in contact with gliadin, the immunoreactive peptide segment within gluten, tTG forms an irreversible complex that signals for an immune and inflammatory response. Current treatment options are limited only to strict adherence to a gluten free diet—a lifestyle that is incompatible with the majority of the American population. I propose a radical treatment alternative, involving the silencing of the gene responsible for the faulty tTG. Using ß-cyclodextrin nanopolymers designed by Davis, et al. as a delivery vehicle, siRNA will be injected intravenously and specifically target small intestinal cells expressing tTG. An exemplary case study of a 23 year old female is included in order to illustrate possible celiac pathology and presentation.