title: Emerging drugs for coeliac disease.
abstract: BACKGROUND
  Coeliac disease is an autoimmune gluten sensitive enteropathy and is now known to affect 1% of the adult population. A gluten-free diet (GFD) should be curative; however, up to 30% of patients have persistent symptoms and many patients find the diet difficult to fully adhere to. Currently, there are no licensed therapeutic options for patients with coeliac disease outside of a GFD.
  
  
  METHODS
  This review will outline the case for alternative treatments and discuss the potential therapeutic targets. The products in the most advanced stage of development will be discussed in detail.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Royal Hallamshire Hospital, Regional GI and Liver Unit , Glossop Rd, Sheffield, S10 2JF , UK p_d_mooney@hotmail.com.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Mooney
authors.forename: Marios
authors.initials: M
authors.lastname: Hadjivassiliou
authors.forename: David S
authors.initials: DS
authors.lastname: Sanders
mesh_terms: D000328:Adult; D000818:Animals; D002446:Celiac Disease / Q000178:diet therapy / Q000188:drug therapy* / Q000503:physiopathology; D055050:Diet, Gluten-Free; D015195:Drug Design; D006301:Health Services Needs and Demand; D006801:Humans; D058990:Molecular Targeted Therapy
keywords: coeliac disease; gluten vaccine; glutenase; protease; zonulin inhibitor