Advances in understanding the potential therapeutic applications of gut microbiota and probiotic mediated therapies in celiac disease

Expert Rev Gastroenterol Hepatol. 2020 May;14(5):323-333. doi: 10.1080/17474124.2020.1745630. Epub 2020 Mar 27.


Introduction: Celiac Disease (CD) is an autoimmune enteropathy caused by exposure to gluten in genetically predisposed people. While gluten is the main driving force in CD, evidence has shown that microbiota might be involved in the pathogenesis, development, and clinical presentation of CD. Microbiota manipulation may modify its functional capacity and may be crucial for setting-up potential preventive or therapeutic application. Moreover, probiotics are an excellent source of endopeptidases for digesting gluten.

Areas covered: In this narrative review we illustrate all the recent scientific discoveries in this field including CD pathogenetic mechanism where gut microbiota might be involved and possible use of probiotics in CD prevention and treatment.

Expert opinion: In the future, probiotics could be used as an add-on medication for strengthening/facilitating the gluten-free diet (GFD) and improving symptoms; the prospect of using it for therapeutic purposes is to be sought in a more distant future.

Keywords: celiac disease; gastro-intestinal symptoms; gluten free diet; gut microbiota; irritable bowel syndrome.; probiotics; wheat deglutination.

Publication types

  • Review

MeSH terms

  • Celiac Disease / genetics
  • Celiac Disease / immunology
  • Celiac Disease / microbiology
  • Celiac Disease / therapy*
  • Diet, Gluten-Free
  • Dysbiosis / immunology
  • Dysbiosis / metabolism
  • Dysbiosis / microbiology
  • Dysbiosis / therapy*
  • Endopeptidases / analysis
  • Endopeptidases / metabolism
  • Endopeptidases / therapeutic use
  • Fermentation
  • Gastrointestinal Microbiome / genetics
  • Gastrointestinal Microbiome / immunology
  • Gastrointestinal Microbiome / physiology*
  • Gene-Environment Interaction
  • Genetic Predisposition to Disease
  • Glutens / adverse effects
  • Glutens / immunology
  • Glutens / metabolism
  • Humans
  • Probiotics / chemistry
  • Probiotics / therapeutic use*
  • Risk Factors
  • Triticum / metabolism


  • Glutens
  • Endopeptidases