Effect of Aspergillus Niger Prolyl Endoprotease (AN-PEP) Enzyme on the Effects of Gluten Ingestion in Patients With Coeliac Disease
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ClinicalTrials.gov Identifier: NCT00810654 |
Recruitment Status
:
Completed
First Posted
: December 18, 2008
Last Update Posted
: January 19, 2011
|
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Celiac Disease | Dietary Supplement: Aspergillus niger prolyl endoprotease Dietary Supplement: Placebo | Phase 1 Phase 2 |
The objective of the study is to determine whether AN-PEP enzyme is effective in mitigating the effects of 8 g wheat protein ingestion in patients with celiac disease.
Fourteen patients with coeliac disease, 18-70 years old are recruited. During the first period, patients consume once daily a gluten-containing food product with the AN-PEP enzyme for 2 weeks. After a 2-week washout period (second period), patients enter the third period of this study, and are randomized to one of two groups and consume the same gluten-containing food product with AN-PEP or placebo.
Period 1: Patients are given a food product containing 8 g of wheat protein, to which AN-PEP is added, once daily for 14 d.
Period 2: Wash-out period of 14 d. During this period, patients will consume a gluten-free diet.
Period 3: Patients who are negative for coeliac disease symptoms during the 1st period will be randomized across two groups. Both groups receive a food product containing 8 g of wheat protein once daily for 14 d. One group receives additional AN-PEP with the gluten meal whereas the other group receives the placebo.
Patients will visit the outpatient clinic five times; one visit before the start of the study, a visit during and at the end of the first period, and a visit during and at the end of the third period. During three of the visits, spike-biopsies are taken from the duodenum by oesophago-gastro-duodenoscopy. Blood samples are taken during all of the five visits. Patients will also fill in a quality of life questionnaire at the start and the end of the first and third period.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 14 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Study on The Effectiveness of Oral Administration of Prolyl Endoprotease for Gluten Detoxification as a Means to Treat Coeliac Disease |
Study Start Date : | May 2008 |
Actual Primary Completion Date : | May 2009 |
Actual Study Completion Date : | December 2009 |

Arm | Intervention/treatment |
---|---|
Experimental: ANPEP
Aspergillus niger prolyl endoprotease (AN-PEP), a microbial-derived prolyl endoprotease which cleaves gluten
|
Dietary Supplement: Aspergillus niger prolyl endoprotease
160 PPU daily for 2 weeks
Other Name: AN-PEP
|
Placebo Comparator: Placebo |
Dietary Supplement: Placebo
Placebo
|
- Histopathological changes according to the Modified Marsh criteria [ Time Frame: One week before start, and 2 and 6 weeks after start ]
- The presence of coeliac disease specific antibodies (EMA, tTGA, gliadin) [ Time Frame: One week before start, and 2 and 6 weeks after start ]
- Presence and activity of gluten reactive Tcells isolated from biopsies and serum [ Time Frame: One week before start, and 2 and 6 weeks after start ]
- Immunophenotype of lymphocytes isolated from biopsies [ Time Frame: One week before start, and 2 and 6 weeks after start ]
- Clinical symptoms after gluten intake with and without AN-PEP [ Time Frame: One week before start, and 2 and 6 weeks after start ]

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Ages Eligible for Study: | 18 Years to 70 Years (Adult, Senior) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Confirmed diagnosis of coeliac disease (Marsh III B/C) ; that means crypt hyperplasia and subtotal or total villous atrophy, while using a normal diet followed by normalisation and clinical improvement on a gluten-free diet;
- Detectable coeliac disease specific antibodies (EMA, tTGA) at time of diagnosis.
- A strict gluten free diet for at least 1 year and normalised villous architecture (Marsh 0/I);
- Male and female, 18-70 years old;
- No detectable anti-endomysium and low anti-tissue transglutaminase (< 4 U/ml) prior to the start of the study;
- Patient is willing to undergo all protocol related assessments and visits (including up to 3 separate oesophago-gastro-duodenoscopies with multiple biopsies taken each time from the descending duodenum);
- Patient has read the information provided on the study and given written consent;
- Female participants at fertile age must use adequate contraception.
Exclusion Criteria:
- Use of any immunoregulatory drug within the last 6 months;
- Use of any anticoagulant drug;
- Clinically suspected bleeding tendency;
- Pregnancy or breast feeding;
- Presence of any concurrent active infection;
- IgA deficiency.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00810654
Netherlands | |
VU University Medical Center | |
Amsterdam, Netherlands, 1081 HV |
Principal Investigator: | Greetje J Tack, MD | VU University Medical Center |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | C.J.Mulder, VU University Medical Center |
ClinicalTrials.gov Identifier: | NCT00810654 History of Changes |
Other Study ID Numbers: |
RD.0601.54 NTR1281 |
First Posted: | December 18, 2008 Key Record Dates |
Last Update Posted: | January 19, 2011 |
Last Verified: | May 2009 |
Keywords provided by VU University Medical Center:
Celiac disease Coeliac disease treatment |
AN-PEP prolyl endoprotease gluten |
Additional relevant MeSH terms:
Celiac Disease Malabsorption Syndromes Intestinal Diseases |
Gastrointestinal Diseases Digestive System Diseases Metabolic Diseases |