Published online Jun 28, 2024. doi: 10.3748/wjg.v30.i24.3044
Revised: May 10, 2024
Accepted: May 27, 2024
Published online: June 28, 2024
Processing time: 98 Days and 0.8 Hours
We comment here on the article by Stefanolo et al entitled “Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet”, published in the World Journal of Gastroenterology. 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 Aspergillus niger 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.
Core Tip: Involuntary or voluntary exposure to gluten can lead to severe and persistent symptoms in celiac patients on long-term gluten-free diets. Aspergillus niger prolyl endopeptidase metabolizes gluten before it reaches the small intestine, reducing the celiac disease-specific symptoms. That was demonstrated by the decrease in the concentration of gluten immunogenic peptide.