# Pro-Pre and Postbiotic in Celiac Disease
## 7 Post-Biotics  
Post-biotics have been used in in vitro experiments in CaCo-2 cells daily to study their ability to prevent gliadin and gliadin peptides effects on CaCo-2 cells. [PERSON] et al. have showed that _LP CBA L74_ post-biotic was able to reduce gliadin peptides entrance in CaCo-2 cells [40]. Using 16S rRNA analysis of duodenal and oropharyngeal samples from CD patients and control subjects (Ctr), previously identified a peculiar _Neisseria flavescens_ strain in adults affected by CD [13; 44]. This bacterial strain, isolated from the above samples, induced an immune-inflammatory response in human and murine dendritic cells, in CaCo-2 cells, and in ex vivo duodenal mucosal explants of Ctr subjects, thereby suggesting that it could play a role in CD [13]. [PERSON] et al. (2019) have evaluated if metabolism and trafficking was altered in CD-_N. flavescens_-infected CaCo-2 cells and if any alteration could be mitigated by pretreating cells with _LP CBA L74_ supernatant, despite the presence of P31-43. CD-_N. flavescens_ colocalised more than control _N. flavescens_ with early endocytic vesicles and more escaped autophagy thereby surviving longer in infected cells. P31-43 increased colocalisation of _N. flavescens_ with early vesicles. Mitochondrial respiration was lower in CD-_N. flavescens_-infected cells versus not-treated CaCo-2 cells, whereas pretreatment with _LP CBA L74_ reduced CD-_N. flavescens_ viability and improved cell bioenergetics and trafficking. CD-_N. flavescens_ induces metabolic imbalance in CaCo-2 cells [45]. [PERSON] et al. have observed that _LP CBA L74_ was able to ferment several different cereals. Fermented oats, rice and wheat were used to test the effect of _LP CBA L74_ on P31-43 entrance after fermentation. P31-43-liss entrance was reduced after treatment with fermented oat (FI reduction 56%), rice (FI reduction 35%) and wheat (FI reduction 24%). These data suggest that _LP CBA L74_ effect on P31-43-liss entrance was still present after fermentation of different cereals and that could be linked to compounds produced during the fermentation process and not to alive bacteria [40]. [PERSON] et al. have investigated if pH control during fermentation process of rice with probiotic _LP CBA L74_, could improve the bacterial growth and the lactic acid production and also the ability to interfere P31-43 entrance in the CaCo-2 cells. During rice fermentation process pH control greatly improved the lactic acid production. Both rice fermented with and without pH control, were able to prevent P31-43-liss entrance even after they were washed away from the cells, triggering into the cells a sort of memory that could prevent the entrance of P31-43-liss for several hours. This information could be useful in the field of nutrition; it suggests that the effect of certain post-biotics could last also after they have left the intestine [46] (See Table 4). Recently, [PERSON] et al. using intestinal organoids developed from duodenal biopsies from both non-celiac (NC) and celiac (CD) patients, they analyzed the role of microbiota-derived molecules in modulating the epithelium's response to gluten. Therefore, the authors selected three bacterial bioproducts: Butyrate, lactate, and PSA derived from _Bacteroides fragilis_. The authors analyzed the expression of genes related to gut barrier function, found altered in CD. Butyrate significantly upregulated the expression of MUC5 AC, MUC6, TFF1 and CLDN18, in CD organoids. PSA significantly increased the expression of CLDN18 only, while lactate did not alter the expression of the analyzed gut barrier function-associated genes. Similar regulation of genes was observed in NC organoids. Moreover, they have analyzed the effect of the bacterial bioproducts on cytokines released by the CD monolayers challenged with gliadin, all bioproducts exerted a global protective effect by reducing the pro-inflammatory cytokine secretion triggered by PTG.