Mäki Markku
Tampere Center for Child Health Research, University of Tampere and Tampere, University Hospital, Tampere, Finland.
J Pediatr Gastroenterol Nutr. 2014 Jul;59 Suppl 1:S15-7. doi: 10.1097/01.mpg.0000450397.76521.f9.
The basis for celiac disease (CD) treatment is a strict lifelong gluten-free diet. On the diet, the small intestinal mucosal injury heals and gluten-induced symptoms and signs disappear. The mucosal healing is a prerequisite for sustaining health and is also obtained with a diet containing oats and trace amounts of gluten, industrially purified wheat starch-based gluten-free products. The small intestinal mucosa does not heal in noncompliant people, nor when a patient is inadvertently ingesting gluten. Development of adjunctive or alternative therapies is on its way. There are several novel treatment pipelines within academy and industry. Examples are the ideas of using glutenases as a drug to degrade the ingested gluten, polymers to bind and sequester the gluten to the feces, and also vaccine development for an immunotherapy to induce tolerance towards gluten. Clinical drug trials are to be foreseen in CD, soon also in children.
乳糜泻（CD）治疗的基础是终身严格遵循无麸质饮食。在这种饮食方式下，小肠黏膜损伤会愈合，麸质诱发的症状和体征也会消失。黏膜愈合是维持健康的先决条件，食用含燕麦和微量麸质的饮食、基于工业纯化小麦淀粉的无麸质产品也能实现黏膜愈合。不遵守饮食规定的人，以及不经意摄入麸质的患者，其小肠黏膜不会愈合。辅助或替代疗法的研发正在进行中。学术界和产业界有几个新的治疗方案。例如，使用谷氨酰胺酶作为药物降解摄入的麸质、用聚合物将麸质结合并隔离到粪便中，以及开发用于免疫疗法以诱导对麸质产生耐受性的疫苗等想法。预计在乳糜泻领域将会开展临床药物试验，儿童患者的试验也将很快进行。
