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Volume 13
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Review

Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity

by
Yakov E. Dunaevsky
1,
Valeriia F. Tereshchenkova
2,
Mikhail A. Belozersky
1,
Irina Y. Filippova
2,
Brenda Oppert
3,* and
Elena N. Elpidina
1
1
A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, 119991 Moscow, Russia
2
Chemical Faculty, Lomonosov Moscow State University, 119991 Moscow, Russia
3
USDA Agricultural Research Service, Center for Grain and Animal Health Research, Manhattan, KS 66502, USA
*
Author to whom correspondence should be addressed.
Pharmaceutics 2021, 13(10), 1603; https://doi.org/10.3390/pharmaceutics13101603
Submission received: 29 August 2021 / Revised: 22 September 2021 / Accepted: 29 September 2021 / Published: 2 October 2021
(This article belongs to the Special Issue Targeted Proteolytic Enzymes as Biomedicals and Biopharmaceutics)
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Abstract

To date, there is no effective treatment for celiac disease (CD, gluten enteropathy), an autoimmune disease caused by gluten-containing food. Celiac patients are supported by a strict gluten-free diet (GFD). However, in some cases GFD does not negate gluten-induced symptoms. Many patients with CD, despite following such a diet, retain symptoms of active disease due to high sensitivity even to traces of gluten. In addition, strict adherence to GFD reduces the quality of life of patients, as often it is difficult to maintain in a professional or social environment. Various pharmacological treatments are being developed to complement GFD. One promising treatment is enzyme therapy, involving the intake of peptidases with food to digest immunogenic gluten peptides that are resistant to hydrolysis due to a high prevalence of proline and glutamine amino acids. This narrative review considers the features of the main proline/glutamine-rich proteins of cereals and the conditions that cause the symptoms of CD. In addition, we evaluate information about peptidases from various sources that can effectively break down these proteins and their immunogenic peptides, and analyze data on their activity and preliminary clinical trials. Thus far, the data suggest that enzyme therapy alone is not sufficient for the treatment of CD but can be used as a pharmacological supplement to GFD.
Keywords: celiac disease; peptidases; gluten; enzyme therapy; gluten-free diet celiac disease; peptidases; gluten; enzyme therapy; gluten-free diet
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MDPI and ACS Style

Dunaevsky, Y.E.; Tereshchenkova, V.F.; Belozersky, M.A.; Filippova, I.Y.; Oppert, B.; Elpidina, E.N. Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity. Pharmaceutics 2021, 13, 1603. https://doi.org/10.3390/pharmaceutics13101603

AMA Style

Dunaevsky YE, Tereshchenkova VF, Belozersky MA, Filippova IY, Oppert B, Elpidina EN. Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity. Pharmaceutics. 2021; 13(10):1603. https://doi.org/10.3390/pharmaceutics13101603

Chicago/Turabian Style

Dunaevsky, Yakov E., Valeriia F. Tereshchenkova, Mikhail A. Belozersky, Irina Y. Filippova, Brenda Oppert, and Elena N. Elpidina. 2021. "Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity" Pharmaceutics 13, no. 10: 1603. https://doi.org/10.3390/pharmaceutics13101603

APA Style

Dunaevsky, Y. E., Tereshchenkova, V. F., Belozersky, M. A., Filippova, I. Y., Oppert, B., & Elpidina, E. N. (2021). Effective Degradation of Gluten and Its Fragments by Gluten-Specific Peptidases: A Review on Application for the Treatment of Patients with Gluten Sensitivity. Pharmaceutics, 13(10), 1603. https://doi.org/10.3390/pharmaceutics13101603

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