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Was ist gesichert in der Therapie der Zöliakie?

What is established in the management of celiac disease?

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Zöliakie ist als eine durch Gluten als Krankheitstrigger induzierte Autoimmunerkrankung inzwischen gut in der Inneren Medizin etabliert. Fraglos genauso gut etabliert ist die glutenfreie Diät als bislang einzig anerkannte Therapie der Zöliakie. Diese bietet in ihrer Durchführung allerdings einige Fallstricke, auf die im vorliegenden Beitrag eingegangen wird. Zudem werden aktuelle Entwicklungen beschrieben, die das Potenzial haben, sowohl die Diagnostik als auch die Therapie der Zöliakie deutlich zu verändern. Ein solcher Ausblick ist einerseits angezeigt, weil die Kollegen vorbereitet sein wollen, wenn solche Entwicklungen in den klinischen Alltag integriert werden. Andererseits hat die Erkenntnis, dass sich das Feld der mukosalen Immunologie bewegt, das Potenzial, die Stimmung des Lesers zu heben.


Nowadays, celiac disease is well-established in internal medicine as an autoimmune disease induced by gluten as a trigger. Undoubtedly similarly well-established is the gluten-free diet. It is the only recognized therapy for celiac disease to date. However, this presents some pitfalls in its implementation, which will be discussed in the following review. In addition, current developments that have the potential to significantly change both diagnosis and treatment of celiac disease are discussed. On the one hand, such an outlook was chosen since colleagues want to be “ready” when such developments are integrated into daily clinical routine. On the other hand, the realization that the field of mucosal immunology is moving forward has the potential to lift the spirits of the reader.

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Correspondence to Michael Schumann.

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D. Studerus und M. Schumann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Hermann Haller, Hannover

Kai Schmidt-Ott, Hannover

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Studerus, D., Schumann, M. Was ist gesichert in der Therapie der Zöliakie?. Innere Medizin 64, 1162–1170 (2023).

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