Colella M, Cafiero C, Palmirotta R. Aspergillus niger prolyl endopeptidase in celiac disease. World J Gastroenterol 2024; 30(24): 3044-3047 [PMID: 38983964 DOI: 10.3748/wjg.v30.i24.3044]
Corresponding Author of This Article
Raffaele Palmirotta, MD, PhD, Associate Professor, Senior Researcher, Interdisciplinary Department of Medicine, Section of Microbiology and Virology, University of Bari “Aldo Moro”, P.zza G. Cesare, 11, Bari 70124, Italy. raffaelepalmirotta@gmail.com
Research Domain of This Article
Microbiology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Marica Colella, Raffaele Palmirotta, Interdisciplinary Department of Medicine, Section of Microbiology and Virology, University of Bari “Aldo Moro”, Bari 70124, Italy
Concetta Cafiero, Area of Molecular Pathology, Anatomic Pathology Unit, Fabrizio Spaziani Hospital, Frosinone 03100, Italy
Author contributions: Palmirotta R, Colella M and Cafiero C contributed to this paper; Palmirotta R designed the overall concept and outline of the manuscript; Palmirotta R and Colella M contributed to the discussion and design of the manuscript; Palmirotta R, Colella M and Cafiero C contributed to the writing, editing the manuscript and review of the literature; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raffaele Palmirotta, MD, PhD, Associate Professor, Senior Researcher, Interdisciplinary Department of Medicine, Section of Microbiology and Virology, University of Bari “Aldo Moro”, P.zza G. Cesare, 11, Bari 70124, Italy. raffaelepalmirotta@gmail.com
Received: March 19, 2024 Revised: May 10, 2024 Accepted: May 27, 2024 Published online: June 28, 2024 Processing time: 98 Days and 0.8 Hours
Abstract
We comment here on the article by Stefanolo et al entitled “Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet”, published in the World Journal of Gastroenterology. Celiac disease is a well-recognized systemic autoimmune disorder. In genetically susceptible people, the most evident damage is located in the small intestine, and is caused and worsened by the ingestion of gluten. For that reason, celiac patients adopt a gluten-free diet (GFD), but it has some limitations, and it does not prevent re-exposure to gluten. Research aims to develop adjuvant therapies, and one of the most studied alternatives is supplementation with Aspergillus niger prolyl endopeptidase protease (AN-PEP), which is able to degrade gluten in the stomach, reducing its concentration in the small intestine. The study found a high adherence to the GFD, but did not address AN-PEP as a gluten immunogenic peptide reducer, as it was only tested in patients following a GFD and not in gluten-exposing conditions. This study opens up new research perspectives in this area and shows that further study is needed to clarify the points that are still in doubt.
Core Tip: Involuntary or voluntary exposure to gluten can lead to severe and persistent symptoms in celiac patients on long-term gluten-free diets. Aspergillus niger prolyl endopeptidase metabolizes gluten before it reaches the small intestine, reducing the celiac disease-specific symptoms. That was demonstrated by the decrease in the concentration of gluten immunogenic peptide.
