HP and Cowden disease: Even if gluten can trigger zonulin release in both healthy individuals and CD subjects, the amount and duration of zonulin produced are much higher in the latter group, leading to a significant increase in gut permeability, as shown by the capability of the zonulin inhibitor AT1001 (now named larazotide acetate) to prevent the zonulin permeating activity both inex vivo models43,44 and in a transgenic animal model of CD in which it prevented gluten-dependent inflammation and intestinal damage38.