Probiotics in celiac disease

Celiac disease (CD) is a common chronic lifelong autoimmune enteropathy triggered by gluten intake in genetically predisposed individuals. Several studies have hypothesized a role of gut microbiota in the pathophysiology of CD although they are still in their early stages. Comparisons between children with CD and controls show that their microbiota profiles differ. In fact CD patients have fewer Lactobacilli and Bifidobacteria that could exert protective properties on epithelial cells from damage caused by gliadin. Also several studies in vitro have further expanded on the potential anti-inflammatory effects of Bifidobacteria. The dysbiosis of microbiota has also been associated with persistent gastrointestinal symptoms in celiac patients on a long-term gluten-free diet. Abnormalities in the celiac gut microbiome have led to the use of probiotics as a promising targets for probiotic therapy. Possible targets of probiotic use include the opportunity to degrade gluten polypeptides throughout bacteria-derived peptidases. This chapter summarizes the current knowledge of the intestinal microbiota in CD subjects and the use of probiotics as an adjunctive therapeutic approach in trying to improve the effects of a gluten-free diet (GFD) in CD patients.