title: Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders.
abstract: Non-celiac gluten sensitivity is an undefined syndrome with gastrointestinal and extra-intestinal manifestations triggered by gluten in patients without celiac disease and wheat allergy. The pathogenesis involves immune-mediated mechanisms requiring further research. Symptoms disappear in a few hours or days after gluten withdrawal and recur rapidly after gluten ingestion. Besides gluten, other wheat proteins as well as fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may contribute to this syndrome. This syndrome occurs mainly in young women, being rare in children. Its prevalence ranges from 0.6% to 6%, based on primary or tertiary care center estimates. No biomarker is available, but half of patients tests positive for IgG anti-gliadin antibodies, which disappear quickly after gluten-free diet together with symptoms. Also, genetic markers are still undefined. Although currently limited to a research setting, double-blind, placebo-controlled, cross-over trial strategy is recommended to confirm the diagnosis. Treatment is based on dietary restriction with special care to nutrient intake.
authors.affiliation: Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: umberto.volta@aosp.bo.it.
authors.forename: Umberto
authors.initials: U
authors.lastname: Volta
authors.affiliation: Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: gpi.caio@gmail.com.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caio
authors.affiliation: Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: roberto.degiorgio@unibo.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: De Giorgio
authors.affiliation: Department of Nutrition, University of Oslo, Oslo, Norway. Electronic address: Christine.henriksen@medisin.uio.no.
authors.forename: Christine
authors.initials: C
authors.lastname: Henriksen
authors.affiliation: Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway. Electronic address: gry.skodje@ous-hf.no.
authors.forename: Gry
authors.initials: G
authors.lastname: Skodje
authors.affiliation: Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Centre for Immune Regulation, University of Oslo, Oslo, Norway. Electronic address: knut.lundin@medisin.uio.no.
authors.forename: Knut E
authors.initials: KE
authors.lastname: Lundin
mesh_terms: D002446:Celiac Disease / Q000175:diagnosis; D006801:Humans; D021182:Wheat Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology
keywords: Anti-gliadin antibodies; Celiac disease; Duodenal biopsy; Innate/adaptive immunity; Irritable bowel syndrome; Wheat allergy