Interdisciplinary Department of Medicine, Section of Microbiology and Virology, University of Bari "Aldo Moro", Bari 70124, Italy.
Area of Molecular Pathology, Anatomic Pathology Unit, Fabrizio Spaziani Hospital, Frosinone 03100, Italy.
World J Gastroenterol. 2024 Jun 28;30(24):3044-3047. doi: 10.3748/wjg.v30.i24.3044.
We comment here on the article by Stefanolo entitled "Effect of prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet", published in the . Celiac disease is a well-recognized systemic autoimmune disorder. In genetically susceptible people, the most evident damage is located in the small intestine, and is caused and worsened by the ingestion of gluten. For that reason, celiac patients adopt a gluten-free diet (GFD), but it has some limitations, and it does not prevent re-exposure to gluten. Research aims to develop adjuvant therapies, and one of the most studied alternatives is supplementation with prolyl endopeptidase protease (AN-PEP), which is able to degrade gluten in the stomach, reducing its concentration in the small intestine. The study found a high adherence to the GFD, but did not address AN-PEP as a gluten immunogenic peptide reducer, as it was only tested in patients following a GFD and not in gluten-exposing conditions. This study opens up new research perspectives in this area and shows that further study is needed to clarify the points that are still in doubt.
我们在此评论发表在《》上的 Stefanolo 题为“在长期无麸质饮食中,对乳糜泻患者中脯氨酰内肽酶的影响”的文章。乳糜泻是一种公认的系统性自身免疫性疾病。在遗传易感人群中,最明显的损伤位于小肠,由摄入麸质引起和加重。因此,乳糜泻患者采用无麸质饮食(GFD),但它有一些局限性,不能防止再次接触麸质。研究旨在开发辅助疗法,其中研究最多的替代方法之一是补充脯氨酰内肽酶蛋白酶(AN-PEP),它能够在胃中降解麸质,减少其在小肠中的浓度。该研究发现对 GFD 的高度坚持,但没有将 AN-PEP 作为减少谷蛋白免疫原性肽的方法,因为它仅在遵循 GFD 的患者中进行了测试,而不是在暴露于谷蛋白的情况下进行了测试。这项研究为该领域开辟了新的研究视角,并表明需要进一步研究以澄清仍存在疑问的问题。