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Future treatment strategies for celiac disease

机译：腹腔疾病的未来治疗策略

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Introduction: Ingestion of dietary gluten in wheat, rye and barley by celiac patients leads to small-bowel mucosal villous atrophy, crypt hyperplasia and massive inflammation, often coupled with clinical symptoms and signs. Currently, the only effective treatment is a strict life-long gluten-free diet excluding all gluten-containing food products. In view of the extremely restricted nature of the diet, new treatment options would clearly be desirable. Areas covered: The improved understanding of celiac disease pathogenesis has enabled researchers to suggest alternative strategies to treat the disorder. This review covers current approaches toward developing an appropriate drug and discusses the possible problems associated with these approaches. Expert opinion: Phase II clinical trials are already ongoing to test the efficacy of novel alternative treatments for celiac disease. Before any of the candidates can enter Phase III trials, however, researchers must develop novel reliable non-invasive surrogate markers for intestinal injury and disease activity which also accurately reflect patient-related outcomes. Any novel medication for celiac disease should be as effective and safe as the gluten-free diet, and this constitutes a challenge for drug development. It is thus likely that the first medication entering the market will be supplementary to rather than substitute the gluten-free diet.
机译：简介：腹腔疾病患者摄入小麦，黑麦和大麦中的膳食面筋会导致小肠粘膜绒毛萎缩，隐窝增生和大量炎症，并常伴有临床症状和体征。当前，唯一有效的治疗方法是严格的终身无麸质饮食，不包括所有含麸质食品。鉴于饮食的极端局限性，显然需要新的治疗选择。涵盖的领域：对乳糜泻发病机理的进一步了解使研究人员能够提出治疗该疾病的替代策略。这篇综述涵盖了开发合适药物的当前方法，并讨论了与这些方法相关的可能问题。专家意见：II期临床试验已经在进行，以测试新型替代疗法治疗乳糜泻的疗效。但是，在任何候选者都可以进入III期试验之前，研究人员必须开发出新颖可靠的无创替代标志物，以检测肠损伤和疾病活动，从而也能准确反映患者相关的结局。任何治疗乳糜泻的新药都应与无麸质饮食一样有效和安全，这对药物开发构成了挑战。因此，有可能第一个进入市场的药物将补充而不是替代无麸质饮食。

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