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World J Gastrointest Pharmacol Ther. Nov 6, 2013; 4(4): 108-112
Published online Nov 6, 2013. doi: 10.4292/wjgpt.v4.i4.108
Non-dietary forms of treatment for adult celiac disease
Hugh James Freeman
Hugh James Freeman, Department of Medicine (Gastroenterology), University of British Columbia Hospital, Vancouver, BC V6T 1W5, Canada
Author contributions: Freeman HJ contributed all to this work.
Correspondence to: Hugh James Freeman, Professor, Department of Medicine (Gastroenterology), University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC V6T 1W5, Canada. hugfree@shaw.ca
Telephone: +1-604-8227216 Fax: +1-604-8227236
Received: June 12, 2013
Revised: July 8, 2013
Accepted: July 17, 2013
Published online: November 6, 2013
Processing time: 145 Days and 1.4 Hours
Core Tip

Core tip: Non-dietary forms of treatment for adult celiac disease are currently being evaluated and some have reached clinical trials. Some novel approaches being investigated include hydrolysis of gliadin peptides, inhibition of intestinal permeability, blockade of T lymphocytes and transglutaminase 2/human leukocyte antigen-DQ2 functions as well as induction of immune tolerance. Future evaluations will need to define effects on specific endpoints and ensure an improvement in symptoms, laboratory test results and, most important, mucosal inflammatory changes. Therapeutic trials with novel agents will be difficult from an ethical perspective as the current form of management with a gluten-free diet already provides an excellent result for most compliant patients with celiac disease. Finally, effects on other known superimposed diseases will need close evaluation (i.e., lymphoproliferative and other malignancies).