Investigational therapies for celiac disease.

Celiac disease is an autoimmune condition affecting genetically susceptible individuals. It is produced by the ingestion of gluten contained in wheat, rye, barley, and related products. The only treatment currently available is strict adherence to a gluten-free diet for life. This requirement for dietary compliance is difficult, especially for adolescents and adults, and better alternatives are needed. Recent advances in understanding the pathogenesis of celiac disease indicate that there are several attractive targets for new pharmacologic treatments. These therapies involve oral enzyme supplementation, tissue transglutaminase inhibition, blockage of HLA-DQ presentation, and silencing of gluten-reactive T cells using cytokines or other methods. All of these therapies are in the experimental phase of development, and it is not clear if they will be approved for clinical studies. Meanwhile, a strict gluten-free diet remains a safe and effective treatment for celiac patients.