Beyond the gluten-free diet:Innovations in celiac disease therapeutics  

作　　者：Sara Massironi Marianna Franchina Alessandra Elvevi Donatella Barisani 

机构地区：[1]Division of Gastroenterology,Fondazione IRCCS San Gerardo dei Tintori,University of Milano-Bicocca,Monza 20900,Italy [2]Department of Gastroenterology,IRCCS San Gerardo dei Tintori,Monza 20900,Lombardy,Italy [3]School of Medicine and Surgery,University of Milano-Bicocca,Monza 20900,Italy

出　　处：《World Journal of Gastroenterology》2024年第38期4194-4210,共17页世界胃肠病学杂志（英文）

摘　　要：Celiac disease(CD)is an autoimmune disorder exacerbated by the ingestion of gluten in genetically susceptible individuals,leading to intestinal inflammation and damage.This chronic disease affects approximately 1%of the world’s po-pulation and is a growing health challenge due to its increasing prevalence.The development of CD is a complex interaction between genetic predispositions and environmental factors,especially gluten,culminating in a dysregulated immune response.The only effective treatment at present is a strict,lifelong gluten-free diet.However,adherence to this diet is challenging and often incomplete,so research into alternative therapies has intensified.Recent advances in under-standing the molecular and immunological aspects of CD have spearheaded the development of novel pharmacologic strategies that should provide more effec-tive and manageable treatment options.This review examines the latest inno-vations in CD therapies.The focus is on drugs in advanced clinical phases and targeting specific signaling pathways critical to the disease pathogenesis.We dis-cuss both quantitative strategies such as enzymatic degradation of gluten,and qualitative approaches including immunomodulation and induction of gluten tolerance.Innovative treatments currently under investigation include transglu-taminase inhibitors,which prevent the modification of gluten peptides,and nano-particle-based therapies to recalibrate the immune response.These new therapies not only promise to improve patient outcomes but are also expected to improve quality of life by reducing the burden of dietary restrictions.The integration of these new therapies could revolutionize the treatment of CD and shift the para-digm from strict dietary restrictions to a more flexible and patient-friendly thera-peutic approach.This review provides a comprehensive overview of the future prospects of CD treatment and emphasizes the importance of continued research and multidisciplinary collab-oration to integrate these advances into standard clinical pr

关 键 词：Celiac disease Gluten tolerance Enzymatic degradation Therapeutic advances Transglutaminase inhibitors Tight junction modulators 

分 类 号：R725.7[医药卫生—儿科]