Asri Nastaran, Rostami-Nejad Mohammad, Rezaei-Tavirani Mostafa, Razzaghi Mohammadreza, Asadzadeh-Aghdaei Hamid, Zali Mohammad Reza
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Middle East J Dig Dis. 2020 Oct;12(4):229-237. doi: 10.34172/mejdd.2020.187.
Celiac disease (CeD) is a widespread autoimmune enteropathy caused by dietary gluten peptides in genetically susceptible individuals, which includes a range of intestinal and extraintestinal manifestations. Currently, there is no effective treatment for CeD other than strict adherence to a gluten-free diet (GFD). However, persistent or frequent symptoms and also partial villus atrophy were observed in some patients with CeD due to intentional or inadvertent gluten exposure during the use of GFD. It means that GFD alone is not enough to control CeD symptoms and long-term complications. Accordingly, new therapeutic approaches for CeD treatment such as gluten proteolysis, removing gluten from the digestive tract, promoting tight junction assembly, inhibiting intestinal tissue transglutaminase 2, using probiotics, and developing immunotherapeutic methods have been proposed through different strategies. This review focused on discussing the novel therapeutic strategies for CeD management.
乳糜泻(CeD)是一种在遗传易感性个体中由膳食麸质肽引起的广泛存在的自身免疫性肠病,其包括一系列肠道和肠外表现。目前,除了严格遵循无麸质饮食(GFD)外,尚无治疗CeD的有效方法。然而,在一些CeD患者中,由于在使用GFD期间有意或无意接触麸质,观察到持续或频繁的症状以及部分绒毛萎缩。这意味着仅靠GFD不足以控制CeD症状和长期并发症。因此,已经通过不同策略提出了用于CeD治疗的新治疗方法,如麸质蛋白水解、从消化道去除麸质、促进紧密连接组装、抑制肠道组织转谷氨酰胺酶2、使用益生菌以及开发免疫治疗方法。本综述着重讨论CeD管理的新型治疗策略。