Gut microbiome based therapeutic strategies and probiotic perspectives in celiac disease

Celiac disease (CD), globally affecting about 1% of the population, is an autoimmune condition due to an abnormal immune reaction to gluten. This causes inflammation, trouble in nutrient absorption, and damage to the small intestinal villi. This review covers the global prevalence of CD, restrictions of the gluten-free diet (GFD), and novel treatment alternatives. While GFD remains the primary treatment, it faces challenges from contamination and incomplete gluten elimination. New approaches include enzymatic breakdown of gluten, modifying intestinal permeability, sequestering immunogenic gliadin peptides, and targeting mucosal immune responses. Numerous of these approaches are now in phase II and III clinical trials. Furthermore, studies suggest that specific probiotic strains, such as Bifidobacterium and Lactobacillus, can lower pro-inflammatory markers by 20–40% through reduction of inflammatory signals and partially degrading gluten peptides, accompanied by modulating cytokine production. These probiotics may help reduce symptoms by improving gut health and degrading gluten, making them a promising adjunct therapy. This review underlines scientific development that could improve disease management and quality of life for patients with CD.