Gut microbiota in Celiac Disease: microbes, metabolites, pathways and therapeutics

Expert Rev Clin Immunol. 2020 Nov;16(11):1075-1092. doi: 10.1080/1744666X.2021.1840354. Epub 2020 Dec 27.

Abstract

Introduction: Current evidence supports a vital role of the microbiota on health outcomes, with alterations in an otherwise healthy balance linked to chronic medical conditions like celiac disease (CD). Recent advances in microbiome analysis allow for unparalleled profiling of the microbes and metabolites. With the growing volume of data available, trends are emerging that support a role for the gut microbiota in CD pathogenesis.

Areas covered: In this article, the authors review the relationship between factors such as genes and antibiotic exposure on CD onset and the intestinal microbiota. The authors also review other microbiota within the human body (like the oropharynx) that may play a role in CD pathogenesis. Finally, the authors discuss implications for disease modification and the ultimate goal of prevention. The authors reviewed literature from PubMed, EMBASE, and Web of Science.

Expert opinion: CD serves as a unique opportunity to explore the role of the intestinal microbiota on the development of chronic autoimmune disease. While research to date provides a solid foundation, most studies have been case-control and thus do not have capacity to explore the mechanistic role of the microbiota in CD onset. Further longitudinal studies and integrated multi-omics are necessary for investigating CD pathogenesis.

Keywords: Celiac disease; dysbiosis; gluten; gut; microbiome; microbiota.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / adverse effects
  • Celiac Disease / metabolism
  • Celiac Disease / microbiology*
  • Celiac Disease / therapy
  • Dysbiosis
  • Gastrointestinal Microbiome / immunology*
  • Gene-Environment Interaction
  • Host Microbial Interactions
  • Humans
  • Signal Transduction

Substances

  • Anti-Bacterial Agents