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World J Gastroenterol. Oct 14, 2024; 30(38): 4194-4210
Published online Oct 14, 2024. doi: 10.3748/wjg.v30.i38.4194
Beyond the gluten-free diet: Innovations in celiac disease therapeutics
Sara Massironi, Marianna Franchina, Alessandra Elvevi, Donatella Barisani
Sara Massironi, Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Monza 20900, Italy
Marianna Franchina, Alessandra Elvevi, Department of Gastroenterology, IRCCS San Gerardo dei Tintori, Monza 20900, Lombardy, Italy
Donatella Barisani, School of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
Author contributions: Massironi S contributed to the conceptualization, methodology, supervision, and writing-review & editing of this manuscript; Franchina M participated in the data curation and writing-original draft preparation; Elvevi A managed the logistical aspects of accessing scientific resources and literature; Barisani D contributed to the visualization and validation including developing visual content (e.g., figures and tables) to support and clarify the research data, performing validation of the study findings and contributing to the final review and editing of the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: Sara Massironi, MD, PhD, Adjunct Professor, Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, Via Pergolesi 33, Monza 20900, Italy. sara.massironi@libero.it
Received: May 17, 2024
Revised: August 23, 2024
Accepted: September 6, 2024
Published online: October 14, 2024
Processing time: 134 Days and 22.6 Hours
Core Tip

Core Tip: The landscape of celiac disease treatment is evolving beyond the traditional gluten-free diet due to the challenges of strict adherence to the diet and incomplete resolution of symptoms. This review highlights emerging therapeutic strategies, including gluten sequestration and degradation, gluten tolerance induction, tight junction modulators, transglutaminase inhibitors, lymphocyte trafficking, and homing inhibitors. These novel therapies, which target specific molecular and immune signaling pathways, promise to improve patient outcomes and quality of life by reducing dietary restrictions and addressing persistent inflammation and symptoms. Further research and multidisciplinary collaboration are critical to integrate these advances into standard clinical practice.