Probiotics in Celiac Disease: Current Evidence and Future Directions

Celiac disease is often associated with gut microbiome alterations, which may play a role in autoimmunity to gluten peptides and upregulation of other autoinflammatory pathways. Probiotics of various formulations have been evaluated in attempts to normalize the gut microbiome and/or improve symptoms in Celiac disease, and even to potentially prevent Celiac disease in at-risk individuals. These studies have shown mixed results at best, and conclusions about the effectiveness of probiotics to these ends are limited by the variations across studies' probiotic formulation, dietary regimen, and clinical outcome markers. This leaves many encouraging future directions for further investigation into the potential beneficial role of probiotics on a pathophysiological and clinical level in Celiac disease.