Celiac disease: the search for adjunctive or alternative therapies

Abstract

Celiac disease is a widespread disorder caused by intolerance to gluten, a common protein in food. Currently, a life-long gluten-free diet is the only available treatment for patients with celiac disease. However, adherence to gluten-free diet is difficult due to the widespread use of wheat-derived gluten in the food industry. Therefore, there is a pressing need for the development of novel non-dietary therapies. In this article, we will review several promising strategies focusing on reducing gluten immunogenicity or sequestering to gluten prevent its uptake by the intestinal epithelium. Other possible treatment strategies that will be reviewed include the suppression of the adaptive immune response, permeability modulation and the use of systemic T-cell or cytokine blockers.

Keywords::

• celiac
• gluten
• gluten protease
• gluten sequestrant
• immune modulation
• novel
• therapy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Celiac disease is a common disorder.

• The incidence of celiac is on the rise.

• Gluten-free diet remains the mainstay treatment for celiac disease.

• The search continues for non-dietary therapies.

• Several therapeutic options may be clinically validated in the near future.

• A therapeutic vaccine is under development.

• There is an urgent need for the development of surrogate markers that can measure disease activity.

Notes