Diagnosis and therapy of celiac disease: today and tomorrow

Abstract

Increased knowledge of non-invasive markers of čeliac disease activity will hopefully enable better initial diagnosis and monitoring of intestinal damage (serological markers, galectin-10, cytokines). Additional čeliac disease activity markers are being identified and new targets for treatment are being considered (P31-43 peptide, zonulin). Several new therapeutic approaches for čeliac disease are currently under development by targeting its underlying pathogenesis. Alternative therapies range from reproduction of harmless wheat strains to immunomodulatory approaches. Some of these therapies, such as enzymatic cleavage of gluten and permeability inhibitors, have shown promise in clinical studies. Currently, adherence to a gluten-free diet is considered as the first line and indeed only therapy for čeliac disease which has been proven to relieve symptoms in most cases and effectively prevent potential complications.