RT Journal Article
SR Electronic
T1 Oral proteases: a new approach to managing coeliac disease
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 157
OP 160
DO 10.1136/gut.2005.090498
VO 56
IS 2
A1 Nadine Cerf-Bensussan
A1 Tamara Matysiak-Budnik
A1 Christophe Cellier
A1 Martine Heyman
YR 2007
UL http://gut.bmj.com/content/56/2/157.1.abstract
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.