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乳糜泻2015年最新进展:新疗法

Celiac disease 2015 update: new therapies.

作者信息

Veeraraghavan Gopal, Leffler Daniel A, Kaswala Dharmesh H, Mukherjee Rupa

机构信息

Department of Medicine, Celiac Center, Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.

出版信息

Expert Rev Gastroenterol Hepatol. 2015 Jul;9(7):913-27. doi: 10.1586/17474124.2015.1033399. Epub 2015 Apr 12.

Abstract

Celiac disease (CD) is a chronic, small intestinal, immune-mediated enteropathy triggered by exposure to dietary gluten in genetically susceptible individuals. Currently, lifelong adherence to a gluten-free diet (GFD) is the only available treatment. However, GFD alone is not sufficient to relieve symptoms, control small intestinal inflammation and prevent long-term complications in many patients. The GFD has its challenges including issues related to adherence, lifestyle restrictions and cost. As a result, there is growing interest in and a need for non-dietary therapies to manage this condition. In recent years, different targets in the immune-mediated cascade of CD have been identified in clinical and pre-clinical trials for potential therapies. This review will discuss the latest non-dietary therapies in CD, including endopeptidases, modulators of enterocyte tight junctions and agents involved in gluten tolerization and immunomodulation. We will also discuss the potential implications of approved therapeutics on CD clinical practice.

摘要

乳糜泻(CD)是一种慢性小肠免疫介导性肠病,由遗传易感性个体摄入膳食麸质引发。目前,终身坚持无麸质饮食(GFD)是唯一可用的治疗方法。然而,仅靠GFD不足以缓解许多患者的症状、控制小肠炎症和预防长期并发症。GFD存在诸多挑战,包括依从性、生活方式限制和成本等问题。因此,人们对管理这种疾病的非饮食疗法的兴趣日益浓厚且需求不断增加。近年来,在临床和临床前试验中已确定了免疫介导的CD级联反应中的不同靶点,用于潜在治疗。本综述将讨论CD中最新的非饮食疗法,包括内肽酶、肠上皮细胞紧密连接调节剂以及参与麸质耐受和免疫调节的药物。我们还将讨论已批准的治疗方法对CD临床实践的潜在影响。

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