以麸质蛋白为靶向的乳糜泻治疗方法研究进展

Research advances in gluten-targeted therapies of celiac disease

乳糜泻(celiac disease,CD)是携带遗传易感基因人群的自身免疫疾病,其特点是摄入含麸质蛋白的小麦或大麦和黑麦产品后,小肠会受到炎症性损伤。乳糜泻患者必须终生坚持无麸质饮食,这是目前唯一有效的治疗方法。然而,严格遵守无麸质饮食是困难的,需要新的治疗方法来补充甚至替代饮食治疗。尽管迄今为止,还没有技术允许乳糜泻患者无限制地安全食用含麸质的产品,但随着对乳糜泻发病机制认识的不断深入,在无麸质饮食替代疗法方面已经取得了有希望的进展。本文综述了以麸质蛋白为靶向的乳糜泻治疗方法研究进展,如下调麦醇溶蛋白的表达、麦醇溶蛋白的隔离、谷氨酰胺残基的转酰胺化和免疫显性肽的酶解,批判性地讨论了这些治疗方法的实用性和获得的结果。

Celiac disease(CD)is an autoimmune disease in the population carrying genetically susceptible genes,which is characterized by an inflammatory damage in the small intestine after ingestion of wheat or barley and rye products containing gluten proteins.Celiac disease patients must follow a lifelong gluten-free diet,which is currently the only effective therapy.However,strict adherence to a gluten-free diet is difficult,and new therapies are needed to supplement or even replace dietary therapy.Although so far none of the technologies allow the safe consumption of gluten without limitations,promising advances have been made in the search for an alternative to the gluten-free diet based on increasing knowledge of the pathogenesis of celiac disease.This article reviewed the advances in gluten-targeted therapies of celiac disease,such as down-regulation of gliadin expression,sequestering of gliadin,transamidation of glutamine residues and proteolysis of immunodominant peptides,and discussed the usefulness and the results obtained of these therapies.