乳糜泻与可能的饮食干预:从酶和益生菌到后生元和病毒。

Celiac Disease and Possible Dietary Interventions: From Enzymes and Probiotics to Postbiotics and Viruses.

机构信息

Department of Organic and Bioorganic Chemistry, Bielefeld University, 33615 Bielefeld, Germany.

Department of Biochemistry, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad 431004, India.

出版信息

Int J Mol Sci. 2022 Oct 4;23(19):11748. doi: 10.3390/ijms231911748.

Abstract

Celiac Disease (CeD) is a chronic small intestinal immune-mediated enteropathy caused by the ingestion of dietary gluten proteins in genetically susceptible individuals. CeD is one of the most common autoimmune diseases, affecting around 1.4% of the population globally. To date, the only acceptable treatment for CeD is strict, lifelong adherence to a gluten-free diet (GFD). However, in some cases, GFD does not alter gluten-induced symptoms. In addition, strict adherence to a GFD reduces patients' quality of life and is often a socio-economic burden. This narrative review offers an interdisciplinary overview of CeD pathomechanism and the limitations of GFD, focusing on current research on possible dietary interventions. It concentrates on the recent research on the degradation of gluten through enzymes, the modulation of the microbiome, and the different types of "biotics" strategies, from probiotics to the less explored "viromebiotics" as possible beneficial complementary interventions for CeD management. The final aim is to set the context for future research that may consider the role of gluten proteins and the microbiome in nutritional and non-pharmacological interventions for CeD beyond the sole use of the GFD.

摘要

乳糜泻(CeD)是一种由遗传易感个体摄入膳食 gluten 蛋白引起的慢性小肠免疫介导的肠病。CeD 是最常见的自身免疫性疾病之一,影响全球约 1.4%的人口。迄今为止,CeD 的唯一可接受的治疗方法是严格的、终生的无麸质饮食(GFD)。然而,在某些情况下,GFD 并不能改变麸质引起的症状。此外,严格遵守 GFD 会降低患者的生活质量,并且常常是社会经济负担。本综述提供了对 CeD 发病机制和 GFD 局限性的跨学科概述,重点介绍了目前关于可能的饮食干预的研究。它集中在最近关于通过酶降解 gluten、调节微生物组以及不同类型“生物制剂”策略的研究上,从益生菌到较少探索的“病毒微生物组学”,作为 CeD 管理的可能有益的补充干预措施。最终目的是为未来的研究提供背景,这些研究可能会考虑 gluten 蛋白和微生物组在 CeD 的营养和非药物干预中的作用,而不仅仅是单独使用 GFD。

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