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  3. Vol. 18 No. 3 (2025): Vol 18, No 3 (2025): Summer
  4. Review Article

Vol. 18 No. 3 (2025)

August 2025

Probiotics: A supplement to the gluten-free diet in celiac disease Probiotics and gluten free diet in celiac disease

  • Hasna AIT SAID
  • Lahcen ELMOUMOU
  • Bouchra RHERISSI
  • Nadia EL KADMIRI

Gastroenterology and Hepatology from Bed to Bench, Vol. 18 No. 3 (2025), 26 August 2025
https://doi.org/10.22037/ghfbb.v18i3.3145 Published: 2025-08-26

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Abstract

Celiac disease is an enteropathy caused by intolerance to gluten, with genetic and environmental factors playing a key part in its pathogenesis. This review addresses the use of the gluten-free diet as the primary treatment for patients with celiac disease and the use of probiotics as an adjunctive therapy. The gluten-free diet is the sole treatment for preventing symptoms and allowing the inflamed intestinal mucosa to recover. The gluten-free diet, however, also has some very significant challenges like its complexity, the need for ongoing monitoring by dieticians, and the risk of contamination with gluten even in gluten-free labelled foods.

At the same time, the growing interest in the use of probiotics as an adjunct therapy in celiac disease management is based on the hypothetical contribution of the gut microbiota to the pathophysiology of the disease. It has been hypothesized that gut dysbiosis could be involved in the development and maintenance of celiac disease symptoms. Probiotics, in particular the genera Lactobacillus and Bifidobacterium, are among the promising adjuvants for the improvement of gut health. These beneficial microorganisms may play an essential important, crucial role in the breakdown or modification of gluten polypeptides and in the reduction of intestinal epithelial cell damage caused by gliadin.

While probiotic use is not a replacement for a gluten-free diet, it can have additive benefits by assisting in the preservation of a healthy balance of gut microbiota and lessening some chronic gastrointestinal symptoms.

Keywords:
  • Celiac disease
  • gluten-free-diet
  • Probiotics
  • review
  • PDF

How to Cite

AIT SAID, H., ELMOUMOU, L., RHERISSI, B., & EL KADMIRI, N. (2025). Probiotics: A supplement to the gluten-free diet in celiac disease: Probiotics and gluten free diet in celiac disease. Gastroenterology and Hepatology from Bed to Bench, 18(3). https://doi.org/10.22037/ghfbb.v18i3.3145
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References

Zingone F, Bai JC, Cellier C, Ludvigsson JF. Celiac disease–related conditions: who to test? Gastroenterology 2024;167:64‑78.

Rossi RE, Masoni B, Zullo A, De Deo D, Hassan C, Repici A. Clinical presentation of celiac disease in adult patients: current real-life experience. Intern Emerg Med 2024;19:1897-1903.

Scherf KA, Catassi C, Chirdo F, Ciclitira PJ, Feighery C, Gianfrani C, et al. Recent progress and recommendations on celiac disease from the Working Group on Prolamin Analysis and Toxicity. Front Nutr 2020;7:29.

Ait Said H, Elmoumou L, Guennouni M, Rherissi B, Oujamaa I, Eddehbi F, et al. Immunoglobulin E-mediated food sensitization in a Moroccan pediatric population with celiac disease. Int Arch Allergy Immunol 2024;185:668‑77.

Fasano A, Catassi C. Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum. Gastroenterology 2001;120:636‑51.

Said HA, Hasna AS, Elmoumou L, Lahcen E, Guennouni M, Morad G, et al. IgE-mediated food allergy and celiac disease: An updated review. Russ J Allergy 2023;20:488‑500.

Verdu EF, Galipeau HJ, Jabri B. Novel players in coeliac disease pathogenesis: role of the gut microbiota. Nat Rev Gastroenterol Hepatol 2015;12:497‑506.

Said HA, Elmoumou L, Guennouni M, Kadmiri NE. Variations in gut microbiota in celiac disease patients: A systematic review: Gut microbiota in celiac disease. Gastroenterol Hepatol Bed Bench 2025;18:147-63.

Olivares M, Neef A, Castillejo G, Palma GD, Varea V, Capilla A, et al. The HLA-DQ2 genotype selects for early intestinal microbiota composition in infants at high risk of developing coeliac disease. Gut 2015;64:406‑17.

de Sousa Moraes LF, Grzeskowiak LM, de Sales Teixeira TF, Gouveia Peluzio M do C. Intestinal microbiota and probiotics in celiac disease. Clin Microbiol Rev 2014;27:482‑9.

Itzlinger A, Branchi F, Elli L, Schumann M. Gluten-free diet in celiac disease—forever and for all? Nutrients 2018;10:1796.

Green PHR, Lebwohl B, Greywoode R. Celiac disease. J Allergy Clin Immunol 2015;135:1099‑106.

Niland B, Cash BD. Health benefits and adverse effects of a gluten-free diet in non–celiac disease patients. Gastroenterol Hepatol 2018;14:82‑91.

Jones AL. The gluten-free diet: fad or necessity? Diabetes Spectr 2017;30:118‑23.

Guennouni M, Admou B, Khoudri NE, Bourrhouat A, Zogaam LG, Elmoumou L, et al. Gluten contamination in labelled gluten-free, naturally gluten-free and meals in food services in low-, middle- and high-income countries: a systematic review and meta-analysis. Br J Nutr 2022;127:1528‑42.

Syage JA, Kelly CP, Dickason MA, Ramirez AC, Leon F, Dominguez R, et al. Determination of gluten consumption in celiac disease patients on a gluten-free diet. Am J Clin Nutr 2018;107:201‑7.

Wahab PJ, Meijer JWR, Mulder CJJ. Histologic follow-up of people with celiac disease on a gluten-free diet: slow and incomplete recovery. Am J Clin Pathol 2002;118:459‑63.

Rubio-Tapia A, Rahim MW, See JA, Lahr BD, Wu TT, Murray JA. Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet. Am J Gastroenterol 2010;105:1412.

Tursi A, Brandimarte G, Giorgetti GM, Elisei W, Inchingolo CD, Monardo E, et al. Endoscopic and histological findings in the duodenum of adults with celiac disease before and after changing to a gluten-free diet: a 2-year prospective study. Endoscopy 2006;38:702‑7.

Hopman EGD, von Blomberg ME, Batstra MR, Morreau H, Dekker FW, Koning F, et al. Gluten tolerance in adult patients with celiac disease 20 years after diagnosis? Eur J Gastroenterol Hepatol 2008;20:423.

Palma GD, Nadal I, Collado MC, Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. Br J Nutr 2009;102:1154‑60.

Nadal I, Donant E, Ribes-Koninckx C, Calabuig M, Sanz Y. Imbalance in the composition of the duodenal microbiota of children with coeliac disease. J Med Microbiol 2007;56:1669‑74.

Bakshi A, Stephen S, Borum ML, Doman DB. Emerging therapeutic options for celiac disease. Gastroenterol Hepatol 2012;8:582‑8.

Morelli L. Probiotics: definition and taxonomy 10 years after the FAO/WHO guidelines. In: Guarino A, Quigley EMM, Walker WA. Probiotic Bacteria and Their Effect on Human Health and Well-Being. Basel, Switzerland: Karger; 2013. P.107.

Vanderpool C, Yan F, Polk BD. Mechanisms of probiotic action: Implications for therapeutic applications in inflammatory bowel diseases. Inflamm Bowel Dis 2008;14:1585‑96.

Angelis MD, Rizzello CG, Fasano A, Clemente MG, Simone CD, Silano M, et al. VSL#3 probiotic preparation has the capacity to hydrolyze gliadin polypeptides responsible for Celiac Sprue probiotics and gluten intolerance. Biochimica et Biophysica Acta 2006;1762:80‑93.

Balakireva AV, Zamyatnin AA. Properties of gluten intolerance: gluten structure, evolution, pathogenicity and detoxification capabilities. Nutrients 2016;8:644.

Olivares M, Castillejo G, Varea V, Sanz Y. Double-blind, randomised, placebo-controlled intervention trial to evaluate the effects of Bifidobacterium longum CECT 7347 in children with newly diagnosed coeliac disease. Br J Nutr 2014;112:30‑40.

Primec M, Klemenak M, Di Gioia D, Aloisio I, Bozzi Cionci N, Quagliariello A, et al. Clinical intervention using Bifidobacterium strains in celiac disease children reveals novel microbial modulators of TNF-α and short-chain fatty acids. Clin Nutr 2019;38:1373‑81.

Klemenak M, Dolinšek J, Langerholc T, Di Gioia D, Mičetić-Turk D. Administration of bifidobacterium breve decreases the production of TNF-α in children with celiac disease. Dig Dis Sci 2015;60:3386‑92.

Pinto-Sánchez MI, Smecuol EC, Temprano MP, Sugai E, González A, Moreno ML, et al. Bifidobacterium infantis NLS super strain reduces the expression of α-Defensin-5, a marker of innate immunity, in the mucosa of active celiac disease patients. J Clin Gastroenterol 2017;51:814.

Smecuol E, Hwang HJ, Sugai E, Corso L, Cherñavsky AC, Bellavite FP, et al. Exploratory, randomized, double-blind, placebo-controlled study on the effects of bifidobacterium infantis natren life start strain super strain in active celiac disease. J Clin Gastroenterol 2013;47:139.

Harnett J, Myers SP, Rolfe M. Probiotics and the microbiome in celiac disease: a randomised controlled trial. Evid Based Complement Alternat Med 2016;2016:9048574.

Kristensen NB, Bryrup T, Allin KH, Nielsen T, Hansen TH, Pedersen O. Alterations in fecal microbiota composition by probiotic supplementation in healthy adults: a systematic review of randomized controlled trials. Genome Med 2016;8:52.

Hempel S, Newberry S, Ruelaz A, Wang Z, Miles JNV, Suttorp MJ, et al. Safety of probiotics used to reduce risk and prevent or treat disease. Evid Rep Technol Assess 2011;1‑645.

Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis 2015;60:S129‑34.

Rizzello CG, De Angelis M, Di Cagno R, Camarca A, Silano M, Losito I, et al. Highly efficient gluten degradation by lactobacilli and fungal proteases during food processing: new perspectives for celiac disease. Appl Environ Microbiol 2007;73:4499‑507.

Duar RM, Clark KJ, Patil PB, Hernández C, Brüning S, Burkey TE, et al. Identification and characterization of intestinal lactobacilli strains capable of degrading immunotoxic peptides present in gluten. J Appl Microbiol 2015;118:515‑27.

Mandile R, Picascia S, Parrella C, Camarca A, Gobbetti M, Greco L, et al. Lack of immunogenicity of hydrolysed wheat flour in patients with coeliac disease after a short-term oral challenge. Aliment Pharmacol Ther 2017;46:440‑6.

Orlando A, Linsalata M, Bianco G, Notarnicola M, D’Attoma B, Scavo MP, et al. Lactobacillus rhamnosus GG protects the epithelial barrier of Wistar rats from the pepsin-trypsin-digested gliadin (PTG)-induced enteropathy. Nutrients 2018;10:1698.

Laparra JM, Olivares M, Gallina O, Sanz Y. Bifidobacterium longum CECT 7347 modulates immune responses in a gliadin-induced enteropathy animal model. PLoS One 2012;7:e30744.

Papista C, Gerakopoulos V, Kourelis A, Sounidaki M, Kontana A, Berthelot L, et al. Gluten induces coeliac-like disease in sensitised mice involving IgA, CD71, and transglutaminase 2,two interactions that are prevented by probiotics. Lab Invest 2012;92:625‑35.

D’Arienzo R, Maurano F, Lavermicocca P, Ricca E, Rossi M. Modulation of the immune response by probiotic strains in a mouse model of gluten sensitivity. Cytokine 2009;48:254‑9.

McCarville JL, Dong J, Caminero A, Bermudez-Brito M, Jury J, Murray JA, et al. A Commensal Bifidobacterium longum Strain Prevents Gluten-Related Immunopathology in Mice through Expression of a Serine Protease Inhibitor. Appl Environ Microbiol 2017;83:e01323-17.

D’Arienzo R, Stefanile R, Maurano F, Mazzarella G, Ricca E, Troncone R, et al. Immunomodulatory effects of Lactobacillus casei administration in a mouse model of gliadin-sensitive enteropathy. Scand J Immunol 2011;74:335‑41.

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