Emerging drugs for coeliac disease

Abstract

There is clearly an unmet need for alternatives to a GFD for the treatment of coeliac disease. Oral glutenase supplements to improve the degradation of gluten into non-toxic peptides appear to be the most likely to provide a breakthrough in the treatment of coeliac disease; however, other modalities such as a therapeutic vaccine or zonulin inhibitors to reduce intestinal permeability have shown promising results.

Serological Screening for Celiac Disease in Adult Chinese Patients With Diarrhea Predominant Irritable Bowel Syndrome

“… 2 After a strict gluten-free diet (GFD), the clinical symptoms and histological features in CD patients improve in the great majority of patients. 3 , 4 …”

Leaky gut – concept or clinical entity?

“…(4) As of now, there is no convincing evidence that an intervention that restores or improves barrier function in man can alter the natural history of a given disease or disorder. Though some encouraging data have emerged regarding the use of larazotide acetate, a regulator of tight junctional function [36], as adjunctive therapy in celiac disease [37 && ], tight junctional regulation remains an exciting goal rather than an already attained achievement in human disease [38,39]. Nonetheless, there are substantial pieces of circumstantial evidence that point to a more fundamental role for the barrier in certain disease states.…”

Enfermedad celíaca.Revisión

“…Lo anterior ha motivado nuevas estrategias terapéuticas, algunas ya en estudios de fases clínicas: ALV003 y AN-PEP, que son proteasas que lisan el gluten en el lumen gástrico evitando la generación de péptidos inmunogénicos; larazotide, que bloquea la apertura de tight junctions del epitelio intestinal disminuyendo su permeabilidad; y nexvax2, vacuna que desensibiliza a los pacientes portadores de HLA-DQ2 44 .…”