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Inicio Gastroenterología y Hepatología (English Edition) New coeliac disease treatments and their complications
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Vol. 41. Issue 3.
Pages 191-204 (March 2018)
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Vol. 41. Issue 3.
Pages 191-204 (March 2018)
Review in Gastroenterology
DOI: 10.1016/j.gastre.2018.03.007
New coeliac disease treatments and their complications
Nuevas terapias en la enfermedad celiaca y sus complicaciones
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Luis Vaqueroa, Laura Rodríguez-Martína, Francisco Leónb, Francisco Jorqueraa,c, Santiago Vivasa,c,
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svivasa@gmail.com

Corresponding author.
a Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, Spain
b Celimmune, Bethesda, MD, United States
c Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain
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Table 1. Features of coeliac disease, refractory coeliac disease (RCD) and enteropathy-associated T-cell lymphoma (EATL).
Table 2. Non-dietary therapies for coeliac disease (CD) grouped according to targeted pathogenic objective.
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Abstract

The only accepted treatment for coeliac disease is strict adherence to a gluten-free diet. This type of diet may give rise to reduced patient quality of life with economic and social repercussions. For this reason, dietary transgressions are common and may elicit intestinal damage. Several treatments aimed at different pathogenic targets of coeliac disease have been developed in recent years: modification of gluten to produce non-immunogenic gluten, endoluminal therapies to degrade gluten in the intestinal lumen, increased gluten tolerance, modulation of intestinal permeability and regulation of the adaptive immune response. This review evaluates these coeliac disease treatment lines that are being researched and the treatments that aim to control disease complications like refractory coeliac disease.

Keywords:
Coeliac disease
Gluten-free diet
Gluten-sensitive enteropathy
Resumen

El único tratamiento aceptado para la enfermedad celiaca es el seguimiento de forma estricta de la dieta sin gluten. Este tipo de dieta puede ocasionar una disminución de la calidad de vida de los pacientes, dificultades sociales y económicas. Por lo tanto, son frecuentes las transgresiones dietéticas que pueden perpetuar el daño intestinal. En los últimos años se han desarrollado numerosos tratamientos, dirigidos hacia diferentes dianas en la patogenia de la enfermedad celiaca: modificación del gluten para conseguir un gluten no inmunogénico, terapias endoluminales que degraden el gluten en la luz intestinal, favorecer la tolerancia al gluten, modulación de la permeabilidad intestinal o regulación de la respuesta inmune adaptativa. En esta revisión se evalúan estas líneas terapéuticas que se están investigando para la enfermedad celiaca y los tratamientos enfocados al control de las complicaciones de la enfermedad, como la enfermedad celiaca refractaria.

Palabras clave:
Enfermedad celiaca
Dieta sin gluten
Enteropatía sensible al gluten

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