Oral proteases: a new approach to managing coeliac disease
Oral proteases: a new approach to managing coeliac disease
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DOI：
10.1136/gut.2005.090498
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发表时间：
2007-02-01
期刊：
影响因子：
24.5
通讯作者：
Heyman, Martine
中科院分区：
文献类型：
--
作者：
Cerf-Bensussan, Nadine;Matysiak-Budnik, Tamara;Heyman, Martine
终生限制无麸质饮食是目前治疗乳糜泻的唯一方法。人类胃肠道不具备酶的设备来有效地切割谷蛋白衍生的富含脯氨酸的肽，驱动乳糜泻患者的异常免疫肠道反应。因此，外源性脯氨酸多肽酶能够消化摄入的面筋，作为一种替代饮食的治疗方法被提出。本文通过回顾麦胶蛋白肽肠转运的最新数据、可用酶的性质和初步临床分析，讨论了这种方法的可行性。新酶或酶混合物的开发提供了潜在的更有效的治疗工具，然而，需要根据临床，生物学和组织学标准进行细致的评估。
A life-long but constraining gluten-free diet is the only treatment currently available for coeliac disease. The human gastrointestinal tract does not possess the enzymatic equipment to efficiently cleave the gluten-derived proline-rich peptides driving the abnormal immune intestinal response in patients with coeliac disease. Oral therapy by exogenous prolylendopeptidases able to digest ingested gluten was therefore propounded as an alternative treatment to the diet. The feasibility of this approach is discussed by reviewing recent data on the intestinal transport of gliadin peptides, properties of available enzymes and preliminary clinical assays. Development of new enzymes or enzymatic cocktails offers potentially more potent therapeutic tools that, however, need meticulous evaluation based on clinical, biological and histological criteria.