PT  - JOURNAL ARTICLE
AU  - Nadine Cerf-Bensussan
AU  - Tamara Matysiak-Budnik
AU  - Christophe Cellier
AU  - Martine Heyman
TI  - Oral proteases: a new approach to managing coeliac disease
AID  - 10.1136/gut.2005.090498
DP  - 2007 Feb 01
TA  - Gut
PG  - 157--160
VI  - 56
IP  - 2
4099  - http://gut.bmj.com/content/56/2/157.1.short
4100  - http://gut.bmj.com/content/56/2/157.1.full
SO  - Gut2007 Feb 01; 56
AB  - A life-long but constraining gluten-free diet is the only treatment currently available for coeliac disease. The human gastrointestinal tract does not possess the enzymatic equipment to efficiently cleave the gluten-derived proline-rich peptides driving the abnormal immune intestinal response in patients with coeliac disease. Oral therapy by exogenous prolylendopeptidases able to digest ingested gluten was therefore propounded as an alternative treatment to the diet. The feasibility of this approach is discussed by reviewing recent data on the intestinal transport of gliadin peptides, properties of available enzymes and preliminary clinical assays. Development of new enzymes or enzymatic cocktails offers potentially more potent therapeutic tools that, however, need meticulous evaluation based on clinical, biological and histological criteria.