Transglutaminase 2 is a multifunctional calcium-dependent enzyme that catalyzes protein cross-linking. In celiac disease, TG2 deamidates gluten peptides, enhancing their affinity for HLA-DQ2/8 molecules and triggering a strong adaptive immune response. Additionally, extracellular TG2 contributes to inflammation and tissue remodeling. By selectively inhibiting TG2, zampilimab aims to block these key steps in the disease pathogenesis, potentially offering a targeted therapy for celiac disease.