Microbial Profile Alteration as a Potential Biomarker and Therapeutic Target in Children with Celiac Disease: A Narrative Review.

Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion in genetically susceptible individuals. While gluten exposure is a necessary environmental trigger, its interaction with the intestinal microbiota has recently been recognized as a critical factor in modulating the onset and progression of the disease. Emerging evidence suggests that compositional and functional alterations in the microbial community may contribute to CD's pathogenesis by influencing intestinal barrier integrity, antigen presentation, and the balance between pro- and anti-inflammatory immune responses. Consequently, detailed characterization of microbial signatures holds promise for the identification of biomarkers for early diagnosis and development of microbiota-targeted interventions. This narrative review comprehensively analyzed observational human studies and controlled clinical trials to assess the role of microbiota in pediatric CD. Moreover, dysbiosis patterns across gastrointestinal niches in children with CD were compared and discussed. These findings have the potential for use in novel diagnostic and therapeutic strategies.