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Going Beyond Gluten-Free: a Review of Potential Future Therapies for Celiac Disease

  • Pediatric Gastroenterology (SA Saeed and K Sandberg, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of Review

Celiac disease is a common chronic autoimmune condition for which the only therapy currently available is strict adherence to a gluten-free diet for life. Although the diet is effective in reversing the intestinal mucosal changes, it is cumbersome to follow, is associated with some dietary deficiencies, is less palatable, and has significant quality of life implications. For all these reasons, alternatives to the gluten-free diet would greatly benefit people with celiac disease.

Recent Findings

A better understanding of the pathophysiology of celiac disease has led to possible new treatments that target various steps in the development of the disease. These include intraluminal digestive enzymes and peptide-binding agents that render gluten non-toxic, drugs that modulate tight junctions between enterocytes or interfere with the inflammatory cascade that causes mucosal destruction, and agents designed to induce immune tolerance to gluten.

Summary

Although several of these new therapeutic agents currently under investigation are showing some promise, they still need to demonstrate they are as effective and safe as the gluten-free diet before they can be recommended as an acceptable alternative for treatment of people with celiac disease. The gluten-free diet remains the only proven safe and effective treatment for celiac disease.

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Abbreviations

CD:

Celiac disease

GFD:

Gluten-free diet

tTG:

Tissue transglutaminase

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Pediatric Gastroenterology, Hepatology, and Nutrition, Riley Hospital for Children at IU Health, 705 Riley Hospital Drive, Indianapolis, IN, USA

    Brandon Sparks MD

  2. Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children’s Hospital, Columbus, OH, USA

    Ivor Hill MD & Tracy Ediger MD, PhD

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Ivor Hill, MD, receives royalties from UpToDate as a chapter author. Brandon Sparks declares that he has no conflict of interest. Tracy Ediger declares that he has no conflict of interest.

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Sparks, B., Hill, I. & Ediger, T. Going Beyond Gluten-Free: a Review of Potential Future Therapies for Celiac Disease. Curr Treat Options Peds 7, 17–31 (2021). https://doi.org/10.1007/s40746-020-00217-0

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