Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2024; 30(35): 3932-3941
Published online Sep 21, 2024. doi: 10.3748/wjg.v30.i35.3932
Advances in understanding and managing celiac disease: Pathophysiology and treatment strategies
Hao-Jie Ge, Xu-Lin Chen
Hao-Jie Ge, Xu-Lin Chen, Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Ge HJ wrote the original draft, prepared the figure, and revised the manuscript; Chen XL conducted conceptualization and supervision.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xu-Lin Chen, MD, Director, Doctor, Department of Burns, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. okcxl@126.com
Received: March 6, 2024
Revised: August 12, 2024
Accepted: August 26, 2024
Published online: September 21, 2024
Processing time: 190 Days and 10.6 Hours
Abstract

In this editorial, we comment on an article published in the recent issue of the World Journal of Gastroenterology. Celiac disease (CeD) is a disease occurring in genetically susceptible individuals, which is mainly characterized by gluten intolerance in the small intestine and clinical symptoms such as abdominal pain, diarrhea, and malnutrition. Therefore, patients often need a lifelong gluten-free diet, which greatly affects the quality of life and expenses of patients. The gold standard for diagnosis is intestinal mucosal biopsy, combined with serological and genetic tests. At present, the lack of safe, effective, and satisfactory drugs for CeD is mainly due to the complexity of its pathogenesis, and it is difficult to find a perfect target to solve the multi-level needs of patients. In this editorial, we mainly review the pathological mechanism of CeD and describe the current experimental and improved drugs for various pathological aspects.

Keywords: Celiac disease; Gluten-free diet; Pathology; Human leukocyte antigen; Immunotherapy; Treatment; Aspergillus niger prolyl endoprotease

Core Tip: This editorial provides a comprehensive review of the pathophysiological mechanisms underlying celiac disease and explores emerging therapeutic strategies, including the potential role of Aspergillus niger-derived prolyl endopeptidase. The discussion emphasizes the need for new treatments that address the multifaceted nature of the disease, aiming to improve patient quality of life beyond the limitations of a strict gluten-free diet.