PDF(Pubmed)
Abstract：
In our editorial, we want to comment on the article by Stefanolo et al titled \"Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet\". Celiac disease is an immune-mediated disorder triggered by dietary gluten in genetically predisposed individuals. Although avoiding gluten can permit patients to live symptom-free, ongoing voluntary or involuntary exposure to gluten is common and associated with persistent villous atrophy in small bowel mucosa. As villous atrophy predisposes patients to life threatening complications, such as osteoporotic fractures or malignancies, therapeutic adjuncts to gluten-free diet become important to improve patients\' quality of life and, if these adjuncts can be shown to improve villous atrophy, avoid complications. Oral administration of enzyme preparations, such as endopeptidases that digest gluten and mitigate its antigenicity to trigger inflammation, is one clinical strategy under investigation. The article is about the utility of one endopeptidase isolated from Aspergillus niger. We critique findings of this clinical trial and also summarize endopeptidase-based as well as other strategies and how they can complement gluten-free diet in the management of celiac disease.
摘要：
在我们的社论中，我们想评论Stefanolo等人的文章，标题为“长期无麸质饮食的乳糜泻患者中黑曲霉氨酰内肽酶的影响”。乳糜泻是一种免疫介导的疾病，由遗传易感个体的饮食麸质引发。虽然避免麸质可以让患者生活无症状，持续自愿或非自愿接触麸质是常见的，并且与小肠粘膜持续的绒毛萎缩有关。由于绒毛萎缩使患者容易出现危及生命的并发症，如骨质疏松性骨折或恶性肿瘤，无麸质饮食的治疗辅助手段对于改善患者的生活质量和，如果这些附属物可以改善绒毛萎缩，避免并发症。口服酶制剂，例如消化谷蛋白并减轻其抗原性以引发炎症的内肽酶，是正在研究的一种临床策略。本文是关于从黑曲霉中分离出的一种内肽酶的用途。我们批评了这项临床试验的发现，并总结了基于内肽酶的方法以及其他策略，以及它们如何在乳糜泻的治疗中补充无麸质饮食。
