Advances in understanding and managing celiac disease: Pathophysiology and treatment strategies

Abstract

In this editorial, we comment on an article published in the recent issue of the World Journal of Gastroenterology. Celiac disease (CeD) is a disease occurring in genetically susceptible individuals, which is mainly characterized by gluten intolerance in the small intestine and clinical symptoms such as abdominal pain, diarrhea, and malnutrition. Therefore, patients often need a lifelong gluten-free diet, which greatly affects the quality of life and expenses of patients. The gold standard for diagnosis is intestinal mucosal biopsy, combined with serological and genetic tests. At present, the lack of safe, effective, and satisfactory drugs for CeD is mainly due to the complexity of its pathogenesis, and it is difficult to find a perfect target to solve the multi-level needs of patients. In this editorial, we mainly review the pathological mechanism of CeD and describe the current experimental and improved drugs for various pathological aspects.

Keywords: Celiac disease; Gluten-free diet; Pathology; Human leukocyte antigen; Immunotherapy; Treatment; Aspergillus niger prolyl endoprotease

Core Tip: This editorial provides a comprehensive review of the pathophysiological mechanisms underlying celiac disease and explores emerging therapeutic strategies, including the potential role of Aspergillus niger-derived prolyl endopeptidase. The discussion emphasizes the need for new treatments that address the multifaceted nature of the disease, aiming to improve patient quality of life beyond the limitations of a strict gluten-free diet.