Gluten Degrading Enzymes for Treatment of Celiac Disease.

Nutrients
Guoxian WeiDetlef Schuppan

Abstract

Celiac disease (CeD) affects about 1% of most world populations. It presents a wide spectrum of clinical manifestations, ranging from minor symptoms to mild or severe malabsorption, and it may be associated with a wide variety of autoimmune diseases. CeD is triggered and maintained by the ingestion of gluten proteins from wheat and related grains. Gluten peptides that resist gastrointestinal digestion are antigenically presented to gluten specific T cells in the intestinal mucosa via HLA-DQ2 or HLA-DQ8, the necessary genetic predisposition for CeD. To date, there is no effective or approved treatment for CeD other than a strict adherence to a gluten-free diet, which is difficult to maintain in professional or social environments. Moreover, many patients with CeD have active disease despite diet adherence due to a high sensitivity to traces of gluten. Therefore, safe pharmacological treatments that complement the gluten-free diet are urgently needed. Oral enzyme therapy, employing gluten-degrading enzymes, is a promising therapeutic approach. A prerequisite is that such enzymes are active under gastro-duodenal conditions, quickly neutralize the T cell activating gluten peptides and are safe for human consumption. Several enzymes...Continue Reading

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Citations

Sep 29, 2020·Critical Reviews in Food Science and Nutrition·Ilkem Demirkesen, Berrin Ozkaya
Dec 10, 2020·Nutrients·Fabiana Zingone
Apr 13, 2021·Current Opinion in Allergy and Clinical Immunology·Stephanie LeedsAnna Nowak-Wegrzyn
Apr 24, 2021·Gastroenterology·Nadine Cerf-Bensussan, Detlef Schuppan
Sep 24, 2021·Ear, Nose, & Throat Journal·Noah ShaikhJason McChesney

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Methods Mentioned

BETA
deamidation
chemical modifications

Clinical Trials Mentioned

NCT03409796

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