title: Celiac disease: a challenging disease for pharmaceutical scientists.
abstract: Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten-containing grains that affects ~1% of the white ethnic population. In the last decades, a rise in prevalence of CD has been observed that cannot be fully explained by improved diagnostics. Genetic predisposition greatly influences the susceptibility of individuals towards CD, though environmental factors also play a role. With no pharmacological treatments available, the only option to keep CD in remission is a strict and permanent exclusion of dietary gluten. Such a gluten-free diet is difficult to maintain because of gluten's omnipresence in food (e.g., additive in processed food). The development of adjuvant therapies which would permit the intake of small amounts of gluten would be desirable to improve the quality of life of patients on a gluten-free diet. Such therapies include gluten-degrading enzymes, polymeric binders, desensitizing vaccines, anti-inflammatory drugs, transglutaminase 2 inhibitors, and HLA-DQ2 blockers. However, many of these approaches pose pharmaceutical challenges with respect to drug formulation and stability, or application route and dosing interval. This perspective article discusses how pharmaceutical scientists may deal with these challenges and contribute to the implementation of novel therapeutic options for patients with CD.
authors.affiliation: Department of Chemistry and Applied Biosciences, ETH Zurich Institute of Pharmaceutical Sciences, Wolfgang-Pauli-Str. 10, HCI, 8093, Zurich, Switzerland.
authors.forename: Simon
authors.initials: S
authors.lastname: Matoori
authors.forename: Gregor
authors.initials: G
authors.lastname: Fuhrmann
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Leroux
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002446:Celiac Disease / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D055050:Diet, Gluten-Free; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D057487:Enzyme Therapy; D019204:GTP-Binding Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism; D005983:Glutens / Q000378:metabolism; D006683:HLA-DQ Antigens / Q000276:immunology; D006801:Humans; D010539:Permeability / Q000187:drug effects; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D000893:Anti-Inflammatory Agents; D004791:Enzyme Inhibitors; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; D005983:Glutens; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins