How the Microbiota May Affect Celiac Disease and What We Can Do

Area of Science:

• Gastroenterology
• Immunology
• Microbiology

Background:

• Celiac disease (CeD) is an autoimmune disorder linked to human leukocyte antigen (HLA) and triggered by gluten.
• The exact mechanism of gluten intolerance loss in the intestinal mucosa remains unclear.
• Gut microbiota dysbiosis, characterized by a loss of protective bacteria, precedes CeD onset in genetically susceptible individuals.

Purpose of the Study:

• To review current knowledge on the gut microbiota dysbiosis associated with celiac disease.
• To explore potential preventative and therapeutic strategies targeting microbiota imbalances in CeD.

Main Methods:

• A literature review was conducted using PubMed.gov (2010-March 2024).
• Search terms included 'celiac disease and microbiota', 'celiac disease and microbiome', and 'celiac disease and probiotics'.
• Included article types were Clinical Trials, Meta-Analyses, Reviews, and Systematic Reviews, totaling 364 papers.

Main Results:

• Quantitative and qualitative alterations in gut microbiota are consistently observed in CeD patients.
• Microbiota interactions influence gluten immune response, loss of tolerance, and CeD pathogenesis.
• A gluten-free diet does not fully restore gut microbial balance and can negatively impact it.

Conclusions:

• Gut dysbiosis plays a significant role in the development and progression of celiac disease.
• Targeted microbiota therapies, such as precision probiotics (e.g., *B. vulgatus* strain 20220303-A2), offer potential for CeD management.
• Further research into microbiota modulation is crucial for preventing and counteracting CeD.