Available literature supports the theory that modification in GM is related to many chronic inflammatory diseases, including obesity, diabetes, inflammatory bowel disease, and CD ( 3). The gold standard in CD treatment relies on a gluten-free diet (GFD) that needs to be strict and lifelong and should be directed by a specialist nutritionist ( 2) although novel nondietetic treatments are under study, GFD is the only available therapy for CD at present.ĬD is a polygenic disease with a strict gene environmental interaction, and recently, the role of gut microbiota (GM) has become of primary interest. The prevalence of this condition, estimated at around 1%, is increasing worldwide. The present review aims to summarize the current knowledge on the ability of probiotic strain (single or mixtures) to digest gliadin peptides in vitro and to modulate the inflammatory response in the gut.Ĭeliac disease (CD) is an autoimmune enteropathy that occurs in genetically predisposed individuals who develop an immune response after gluten ingestion ( 1). Several studies have been performed to assess the effectiveness of various specific probiotic strains, showing positive effects on immune-modulation (inhibition of pro-inflammatory cytokine TNF-α) restoring gut microbiota and decrease of immunogenic peptides. Therefore, probiotic supplementation is an attractive therapy because of its possible anti-inflammatory and immunomodulatory properties. The proteolytic mechanism of lactic acid bacteria comprises an extracellular serine protease, di- and oligopeptide-specific transport systems, and several intracellular peptidases that might affect gluten degradation. Probiotics are viable microorganisms thought to have a healthy effect on the host. Several research groups and pharmaceutical companies are developing new nondietetic therapeutic strategies for CD. Currently, a gluten-free diet (GFD) is the unique proven therapy for celiac disease (CD). Gluten is a mixture of proteins highly resistant to hydrolysis, resulting in the emergence of toxic peptides responsible for gluten-related disorders. 2Department of Public Health and Infectious Disease, Università La Sapienza di Roma, Rome, Italy.1Interdisciplinary Department of Medicine-Pediatric Section, Università di Bari Aldo Moro, Bari, Italy.Fernanda Cristofori 1, Ruggiero Francavilla 1*, Daniela Capobianco 2, Vanessa Nadia Dargenio 1, Simone Filardo 2 and Paola Mastromarino 2
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