A Critical Review on the Gluten-Induced Enteropathy/Celiac Disease: Gluten-Targeted Dietary and Non-Dietary Therapeutic Approaches

ABSTRACT

As one of the most prevalent autoimmune diseases, celiac disease (CD) affects 1% of people globally and is frequently linked to the HLA-DQ2/DQ8 polymorphism and gut microbiota dysbiosis. The possibility of different symptom severities between pediatric and adult populations, as well as the heterogeneity amongst them, might make diagnosis difficult. However, there are currently accessible diagnostic techniques, such as duodenal mucosal biopsies, serological screening for IgA and IgG as transglutaminase 2 specific antibodies, HLA haplotypes DQ8 and DQ2 and endoscopic assessment that is assessed on both healthy and vulnerable individuals. The only effective treatment for CD at the moment is rigorous, lifetime adherence to a gluten-free diet (GFD), which is sometimes a difficult challenge. The symptoms of accidental gluten intake cannot be controlled or mucosal damage prevented by a GFD alone. Additionally, many people may experience long-term consequences. There is hence an unmet demand for further therapies that can contain a reasonable combination of dietary- and non-dietary-based therapies for the management of CD. In this review, while exploring various aspects of etiology, pathophysiology, and nutritional issues related to CD, the latest findings of preclinical and clinical studies related to dietary- and non-dietary-based therapies are discussed.

KEYWORDS:

• Celiac disease
• gluten free diet
• nutrient deficiencies
• pathophysiology
• probiotics
• postbiotics

Acknowledgments

This study is related to project NO. 1400/62977 From Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran. We also appreciate the “Student Research Committee” and “Research & Technology Chancellor” in Shahid Beheshti University of Medical Sciences for their financial support of this study.

Disclosure statement

No potential conflict of interest was reported by the authors.