Efficacy of probiotics supplementation in amelioration of celiac disease symptoms and enhancement of immune system

Abstract

Patients with celiac disease (CD) have a mucosal layer that is unable to regulate the gut microbiota, leaving the host vulnerable to dangerous infections and antigens. When compared to healthy people, this dysbiosis is marked by a decrease in intra- and intergeneric biodiversity, which demonstrates an imbalance between helpful bacteria and possibly harmful or proinflammatory species. The early gut microbiota is influenced by the genotype of newborns with the HLA-DQ2 haplotypes, and this may modify how gluten is handled in the intestinal lumen, polarize innate or adaptive immune responses, and result in glutensensitive enteropathy. The outcome of gluten digestion can vary depending on the composition of the intestinal gut bacteria and the partial conversion of gluten into peptides larger than ten amino acids in the small intestines, which can be immunogenic. In the small intestine, 114 different bacterial strains belonging to 32 different species have 27 of them exhibiting peptidolytic activity. Thus, the individual risk of developing a gluten-related illness is further influenced by microbial composition and gluten degrading capacity. The conclusion that lactobacilli and Bifidobacterium spp. may be used as a probiotic supplement in CD patients is based on their shared possession of the most extensive peptidolytic and proteolytic activity thought to be engaged in the breakdown of gluten among all potential bacterial genera present in the gut microbiota. In children with CD autoimmunity, daily oral dose of Lactobacillus. plantarum HEAL9 and Lactobacillus. paracasei 8700:2 was found to modify the peripheral immune response. Bifidobacterium. breve strains have demonstrated a beneficial effect on reducing pro-inflammatory cytokine TNF- production in CD children on gluten-free diets.

Keywords: Celiac disease; Gut microbiota; Probiotics; Probiotics supplementation; Efficacy; Immune system

Core Tip: In the context of celiac disease (CD), probiotics emerge as a multifaceted therapeutic approach with promising implications. Clinical trials demonstrate their potential to modulate immune responses, alleviate gastrointestinal symptoms, and reshape the gut microbiota in CD patients. Notably, specific probiotic strains have shown the ability to enzymatically break down immunotoxic gluten peptides, addressing a central challenge in CD pathogenesis. This dual-pronged role positions probiotics as a holistic means of CD management, offering immunomodulation and symptom relief to patients while potentially mitigating the toxicity of gluten peptides. Probiotics thus represent an encouraging avenue for enhancing the quality of life for individuals living with CD, underscoring their significance in the evolving landscape of CD treatment.