Coeliac disease is a disease of the small intestine that atrophies the intestinal villi and causes malabsorption of nutrients when eating gluten, the protein fraction of some cereals such as wheat, barley and rye. It affects 1-3% of the world's population and has a genetic predisposition marked by the HLA-DQ2 or HLA-DQ8 genes. Currently, there is no treatment, so coeliacs must maintain a gluten-free diet for life, which affects both their diet and their social relationships. 

The recent study proposes a possible therapy for coeliac disease based on the editing of cells called regulatory T cells or Tregs. A few years ago, gluten tolerance strategies, similar to the immunotherapy used to treat allergy, were already being explored. The idea is that B cells and regulatory T cells limit the response of effector T cells, which are responsible for the destruction of intestinal tissue. The novelty of this study is that they modify Tregs specifically against gluten to make them work better, and show that these modified Tregs can stop the activation and migration of effector T cells into the intestine in mouse models. 

Although it looks promising, the study has several limitations: 1) it only studies the action of Tregs against the wheat protein gliadin, so in the future it should be studied if they work against barley and rye proteins; 2) it is not determined when Tregs should be used as therapy (before developing the disease or once it has been diagnosed? 3) the mice used are not coeliac, so gluten does not damage their gut, and are only offered once, so the long-term effect of gluten cannot be studied; 4) it is known from other studies that the number of Tregs is limited in coeliac patients and, in some, they have been found to be non-functional. 

Even so, the study shows the potential of modified Tregs to treat coeliac disease and helps us to better understand this disease and to continue looking for alternatives to the gluten-free diet.