Non-coeliac gluten/wheat sensitivity: advances in knowledge and relevant questions. (2nd January 2017)

• Record Type: Journal Article
• Authors: Volta, Umberto; Caio, Giacomo; Karunaratne, Tennekoon B.; Alaedini, Armin; De Giorgio, Roberto
• Is Part Of: Expert review of gastroenterology & hepatology. Volume 11:Number 1(2017)
• Page Start: 9
• Page End: 18
• Publication Date: 2017-01-02
• Subjects: Biomarkers -- gut microbiome -- innate immunity -- adaptive immunity -- intestinal epithelial barrier -- non-coeliac gluten sensitivity -- wheat sensitivity; Gastroenterology -- Periodicals; Liver -- Diseases -- Periodicals; 616.3
• DOI: 10.1080/17474124.2017.1260003
• Languages: English
• ISSNs: 1747-4124

Abstract

ABSTRACT: Introduction : Non-coeliac gluten/wheat sensitivity (NCG/WS) is a syndrome characterized by intestinal and extra-intestinal symptoms occurring a few hours or days after the ingestion of gluten and wheat proteins in patients testing negative for coeliac disease and wheat allergy. Areas covered : The present review deals with recent scientific acquisitions of this gluten-related syndrome, including pathogenetic mechanisms, clinical picture, symptom score, biomarkers and double-blind placebo-controlled trial for diagnosis, and treatment. The methodology used was a literature search on NCG/WS using Medline and Premedline from 1970 to August 2016. Expert commentary : We discussed the pathogenesis of symptom generation and altered gut physiology in NCG/WS. Possible mechanisms include innate and adaptive immune activation, impaired intestinal epithelial barrier and changes in gut microbiome. These interlinked factors may be exploited for their clinical relevance as possible biomarkers. A systemic immune response to microbial and wheat antigens, together with intestinal cell damage, occurs in patients with NCG/WS. Due to the lack of established biomarkers, it is mandatory to validate the diagnosis of the syndrome by means of a well-defined work-up involving dietary challenge. Finally, dietary and other therapeutic indications have been thoroughly reviewed.