Vaquero Luis, Rodríguez-Martín Laura, León Francisco, Jorquera Francisco, Vivas Santiago
Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, España.
Celimmune, Bethesda, Maryland, Estados Unidos.
Gastroenterol Hepatol. 2018 Mar;41(3):191-204. doi: 10.1016/j.gastrohep.2017.12.002. Epub 2018 Feb 13.
The only accepted treatment for coeliac disease is strict adherence to a gluten-free diet. This type of diet may give rise to reduced patient quality of life with economic and social repercussions. For this reason, dietary transgressions are common and may elicit intestinal damage. Several treatments aimed at different pathogenic targets of coeliac disease have been developed in recent years: modification of gluten to produce non-immunogenic gluten, endoluminal therapies to degrade gluten in the intestinal lumen, increased gluten tolerance, modulation of intestinal permeability and regulation of the adaptive immune response. This review evaluates these coeliac disease treatment lines that are being researched and the treatments that aim to control disease complications like refractory coeliac disease.
乳糜泻唯一被认可的治疗方法是严格遵循无麸质饮食。这种饮食方式可能会降低患者的生活质量,并产生经济和社会影响。因此,饮食违规行为很常见,可能会引发肠道损伤。近年来,针对乳糜泻不同致病靶点开发了几种治疗方法:对麸质进行修饰以产生非免疫原性麸质、腔内疗法以降解肠腔内的麸质、提高麸质耐受性、调节肠道通透性以及调节适应性免疫反应。本综述评估了这些正在研究的乳糜泻治疗方法以及旨在控制难治性乳糜泻等疾病并发症的治疗方法。