Celiac disease: Prevalence, diagnosis, pathogenesis and treatment

Table 8 Future therapeutic approach for celiac disease treatment

Mechanism		Therapeutic agent	Stage of study
Hydrolysis of toxic gliadin	ALV003	Glutenenases and endoprotease	Phase II
	AN-PEP	Prolyl endopeptidase	Phase II
		Lactobacilli	Discovery
	VSL#3	Lyophilised bacteria, including Bifidobacteria, Lactobacilli and Streptococcus salivarius	Discovery
Prevention of gliadin absorption	Larazotide	Hexapeptide derived from zonula occludens toxin of Vibrio cholera	Phase II
		Synthetic polymer poly (hydroxyethylmethacrylate-co-styrene sulfonate)	Discovery
		Anti-gliadin IgY	Discovery
tTG2 inhibitor		Dihydroisoxazoles	Discovery
		Cinnamoyltriazole	Discovery
		Aryl β-aminoethyl ketones	Discovery
Peptide vaccination	Nexvax2	Three deamidated peptides derived from wheat α-gliadin, ω-gliadin and β-hordein	PhaseI
		Human hookworm (Necator americanus) inoculation	Phase II
Modulate immune response		HLA-DQ2 blocker	Discovery
		Interleukin blocker	Discovery
		NKG2D antagonist	Discovery
Restore intestinal architecture		R-spondin-1	Discovery

tTG2: Tissue transglutaminase 2; PEP: Prolyl endopeptidases; NKG2D: Homodimeric natural killer-activating receptor; HLA: Human leukocyte antigen; IgY: Immunoglobulin Y.