A small protein fragment, administered orally, acting only inside the gut to close the seals between intestinal lining cells. It blunts digestive symptoms when gluten is deliberately eaten; the largest trial in people already avoiding gluten was abandoned early for lack of effect. No evidence it protects the intestinal lining. Safety appears benign. Higher doses work less well. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Tissue transglutaminase IgA (tTG-IgA) | Negative, below 4 U/mL | Tracks the ongoing immune response to gluten |
| Deamidated gliadin peptide IgA and IgG (DGP) | Negative | Catches disease activity when tTG-IgA is uninformative |
| Total IgA | 90–400 mg/dL | Confirms the antibody tests above are valid |
| Fecal gluten immunogenic peptides (GIP) | Undetectable | Shows whether gluten is still reaching the gut |
| Ferritin | 50–150 ng/mL men, 40–120 ng/mL women | Earliest marker of impaired absorption |
| 25-hydroxyvitamin D | 40–60 ng/mL | Fat-soluble nutrient absorption and bone status |
| Vitamin B12 | 500–900 pg/mL | Absorption in the far end of the small intestine |
| Alanine aminotransferase (ALT) | 10–26 U/L | Safety threshold and celiac-related liver involvement |
| Estimated glomerular filtration rate (eGFR) | Above 90 mL/min/1.73 m² | Safety threshold used in the trials |
| High-sensitivity C-reactive protein (hs-CRP) | Below 1.0 mg/L | Background inflammatory burden |
| Serum zonulin | No established target; track change from the individual's own baseline | Proposed proxy for barrier leakiness |
Cadence: Baseline, then symptom scoring weekly for the first four weeks; full repeat of antibody testing, nutrient markers and metabolic panel at 12 weeks, and every 6 months thereafter if dosing continues