title: Recent advances in the development of new treatments for celiac disease.
abstract: BACKGROUND
  Celiac disease is a common autoimmune condition induced by dietary gluten in genetically susceptible individuals. So far, the only available treatment for the disorder is a lifelong strict gluten-free diet, because of which small intestinal histological changes recover and symptoms disappear. However, gluten-free dieting is restrictive, and nutritionally less than optimal, and gluten is difficult to avoid.
  
  
  METHODS
  With improving insight into the pathogenesis of celiac disease, several possible drug targets have been suggested. The new strategies include degradation of gluten intraluminally, reduction of mucosal permeability, inhibition of the transglutaminase 2 enzyme, blocking antigen presentation by HLA-DQ2 or HLA-DQ8, modulation of the immune responses of many cytokines, and vaccination.
  
  
  CONCLUSIONS
  Non-dietary treatment options are warranted either as adjunctive therapy together with dieting or to replace the gluten-free diet. The key question is whether the envisaged novel drug is able to prevent gluten-induced small intestinal mucosal injury as efficiently as a strict gluten-free diet, alleviating symptoms and signs of the disease. Furthermore, the gluten dose that can be detoxified, if at all, must be established. The new drug should also be as safe as dietary treatment. Several novel treatment options are under development.
authors.affiliation: University of Tampere, Tampere University Hospital, Pediatric Research Centre, Tampere, Finland. marja-leena.lahdeaho@uta.fi
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Lähdeaho
authors.forename: Katri
authors.initials: K
authors.lastname: Lindfors
authors.forename: Laura
authors.initials: L
authors.lastname: Airaksinen
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
mesh_terms: D002446:Celiac Disease / Q000188:drug therapy* / Q000276:immunology; D002986:Clinical Trials as Topic; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D016896:Treatment Outcome
chemical_list: D005983:Glutens