Plain language summary
Coeliac disease (CD) an immune-mediated intestinal disease that is primarily treated by a strict gluten-free diet. While only a small percentage of individuals develop CD by exposure to gluten, there is increasing research into the role of the gut microbiota in CD. The aim of this review was to discuss the association of the gut microbiota in patients with CD and explore if probiotics can modulate the gut microbiota in these patients. Based on the studies reviewed, the authors found there are common patterns in the gut microbiota composition among patients with CD. Studies also indicate that probiotics can modulate the gut microbiota in these patients. However, at this time, the exact function of the gut microbiota in the onset of CD remains unclear and further studies are needed to better understand its role in prevention, treatment and remission of CD.
Abstract
Celiac disease (CeD) is an immune-mediated enteropathy, and unique in that the specific trigger is known: gluten. The current mainstay of therapy is a gluten-free diet (GFD). As novel therapies are being developed, complementary strategies are also being studied, such as modulation of the gut microbiome. The gut microbiota is involved in the initiation and perpetuation of intestinal inflammation in several chronic diseases. Intestinal dysbiosis has been reported in CeD patients, untreated or treated with GFD, compared to healthy subjects. Several studies have identified differential bacterial populations associated with CeD patients and healthy subjects. However, it is still not clear if intestinal dysbiosis is the cause or effect of CeD. Probiotics have also been considered as a strategy to modulate the gut microbiome to an anti-inflammatory state. However, there is a paucity of data to support their use in treating CeD. Further studies are needed with therapeutic microbial formulations combined with human trials on the use of probiotics to treat CeD by restoring the gut microbiome to an anti-inflammatory state.
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