We’re incredibly excited to get started and hopeful about what the next three years could mean for the future of coeliac disease care. Here’s to research that brings us one step closer to better monitoring, better care and better outcomes for people living with coeliac disease!
We know that around 30% of people with coeliac disease experience ongoing symptoms despite following a gluten free diet, yet we don’t know why this is the case. Previous research has suggested that inflammation may continue in the gut at a very low level, beyond that which we can detect with currently approved, conventional monitoring methods.
This project will build on previous evidence, further developing our understanding of low level gut inflammation and aiming to develop a new blood test to monitor this in people with coeliac disease. The research team has identified specific protein patterns that can reflect inflammation in the gut tissue, even at very low levels. They have used these patterns to develop a numbered protein score, which provides a measure of inflammation based on the proteins detected in a sample.
Being able to understand and monitor low level inflammation could transform the way we care for patients after diagnosis, inform dietary advice and help advance research related to new treatments.
The scientists will also be investigating if very low doses (micro doses) of gluten can trigger this low level inflammation in people coeliac disease to understand how the inflammation remains or when it might be triggered.
The project is led by Professor Sollid, an internationally renowned, world leading expert in coeliac disease research. He’s a Professor of Medicine at the University of Oslo, a Senior Consultant at the Oslo University Hospital, and the Director of the Norwegian Coeliac Disease Research Centre (NCoDiRC).
We asked Professor Sollid about his work.
What got you interested in coeliac disease research?
As a medical student, I wanted to do research in immunology. Two research groups I joined had worked on coeliac disease, and I found this research very inspiring. I therefore decided to devote my time to uncovering some of the secrets of coeliac disease.
What do you hope to achieve with this new project?
This new project is using a new method to look at how analysis of tissue composition can be used to monitor gut inflammation and tissue healing after treatment and whether a non-invasive blood test can be established to report similarly on gut inflammation. In a clinical trial we want to study whether low levels of gluten in the food can induce gut inflammation.
Why is this research so important?
Old fashioned histological examination of gut biopsies is still very central for the evaluation of coeliac disease. By contrast, modern technologies offer insight into underlying disease processes. We want to harness such technologies to address important questions, for instance whether low levels of gluten are safe for people with coeliac disease to consume.
What has previous research shown?
Previous work at the Norwegian Coeliac Disease Research Centre, using proteomics, has shown that a specific signalling protein signature (cytokine IFN-γ) was present in samples from patients with untreated (active) coeliac disease and also in patients with treated (strict gluten free diet) coeliac disease who underwent a gluten challenge. The signatures indicate immune activity at very low level, a level lower than can currently be identified in a biopsy sample. The researchers converted these signatures into ‘proteome scores’ as a quantitative measure of ongoing inflammation. The scores have performed well as outcome measures in gluten challenge trials. Research investigating the mechanism of coeliac disease suggests that the specific signalling protein (cytokine IFN-γ) has a role in altering the structure of the gut, increasing the crypts, dips between villi in the gut, another signal of inflammation.
What will they do in this project?
- Develop inflammation scores to monitor where inflammation is present in patients, even when there are no visible issues
- Correlate biopsy scores to blood markers to develop a non invasive blood test for monitoring inflammation
- Run a randomised, double blind, six weeks, low dose gluten challenge, clinical trial comparing biopsy and blood scores with patient reported symptoms at the beginning and at the end to determine the impact of gluten
- Test if gluten-specific immune cells (CD4+ T cells) drive protein signatures (cytokine IFN-γ) to understand how inflammation occurs
What is proteomics?
Proteomics is the large scale, systematic study of all proteins produced and edited in a particular cell, tissue or organism at any one time. In this study, the researchers will be looking at all the proteins in the gut and blood in the context of coeliac disease to understand their role in low level inflammation.
What could this research mean for people with coeliac disease?
- A better understanding of the cause of ongoing symptoms in people who follow a gluten free diet
- A new method for monitoring healing and health
- A clearer understanding of how much gluten can cause low level inflammation
- New insights into how immune cells and protein signatures drive inflammation and gut damage
Overall, this work is expected to improve the way that patients with coeliac disease are followed up and managed in standard care but also in clinical trials for new treatments.
How can I support this important work?
You can be part of making a real difference by donating to our research fund. Together, we can help drive research forward, improve how we monitor gut health, and work towards a future where people with coeliac disease receive better care and support. Every contribution truly matters, and we’re so grateful for your support. Please visit our website to donate.
https://donate.coeliac.org.uk/?campaign=Christmas-appeal-2026