麸质特异性肽酶对麸质及其片段的有效降解:关于治疗麸质敏感患者应用的综述

Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity.

作者信息

Dunaevsky Yakov E, Tereshchenkova Valeriia F, Belozersky Mikhail A, Filippova Irina Y, Oppert Brenda, Elpidina Elena N

机构信息

A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119991 Moscow, Russia.

Chemical Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia.

出版信息

Pharmaceutics. 2021 Oct 2;13(10):1603. doi: 10.3390/pharmaceutics13101603.

Abstract

To date, there is no effective treatment for celiac disease (CD, gluten enteropathy), an autoimmune disease caused by gluten-containing food. Celiac patients are supported by a strict gluten-free diet (GFD). However, in some cases GFD does not negate gluten-induced symptoms. Many patients with CD, despite following such a diet, retain symptoms of active disease due to high sensitivity even to traces of gluten. In addition, strict adherence to GFD reduces the quality of life of patients, as often it is difficult to maintain in a professional or social environment. Various pharmacological treatments are being developed to complement GFD. One promising treatment is enzyme therapy, involving the intake of peptidases with food to digest immunogenic gluten peptides that are resistant to hydrolysis due to a high prevalence of proline and glutamine amino acids. This narrative review considers the features of the main proline/glutamine-rich proteins of cereals and the conditions that cause the symptoms of CD. In addition, we evaluate information about peptidases from various sources that can effectively break down these proteins and their immunogenic peptides, and analyze data on their activity and preliminary clinical trials. Thus far, the data suggest that enzyme therapy alone is not sufficient for the treatment of CD but can be used as a pharmacological supplement to GFD.

摘要

迄今为止,对于乳糜泻(CD,麸质肠病)尚无有效的治疗方法,这是一种由含麸质食物引起的自身免疫性疾病。乳糜泻患者依靠严格的无麸质饮食(GFD)来维持。然而,在某些情况下,无麸质饮食并不能消除麸质引起的症状。许多乳糜泻患者尽管遵循了这种饮食,但由于对即使是微量麸质也高度敏感,仍保留着活动性疾病的症状。此外,严格遵守无麸质饮食会降低患者的生活质量,因为在职业或社交环境中往往难以维持。正在开发各种药物治疗方法来补充无麸质饮食。一种有前景的治疗方法是酶疗法,即与食物一起摄入肽酶以消化免疫原性麸质肽,由于脯氨酸和谷氨酰胺氨基酸的高含量,这些肽对水解具有抗性。这篇叙述性综述考虑了谷物中主要富含脯氨酸/谷氨酰胺的蛋白质的特征以及导致乳糜泻症状的条件。此外,我们评估了来自各种来源的肽酶的信息,这些肽酶可以有效分解这些蛋白质及其免疫原性肽,并分析了它们的活性数据和初步临床试验。到目前为止,数据表明仅酶疗法不足以治疗乳糜泻,但可作为无麸质饮食的药物补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/920e/8541236/878dbc9176b4/pharmaceutics-13-01603-g001.jpg

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