Abstract
BackgroundNon-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to characterize the effect of the gluten-free diet on anti-gliadin antibodies of IgG class in patients with non-celiac gluten sensitivity.MethodsAnti-gliadin antibodies of both IgG and IgA classes were assayed by ELISA in 44 non-celiac gluten sensitivity and 40 celiac disease patients after 6 months of gluten-free diet.ResultsThe majority of non-celiac gluten sensitivity patients (93.2%) showed the disappearance of anti-gliadin antibodies of IgG class after 6 months of gluten-free diet; in contrast, 16/40 (40%) of celiac patients displayed the persistence of these antibodies after gluten withdrawal. In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response.ConclusionsAnti-gliadin antibodies of the IgG class disappear in patients with non-celiac gluten sensitivity reflecting a strict compliance to the gluten-free diet and a good clinical response to gluten withdrawal.
Highlights
Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers
anti-gliadin antibodies (AGA) IgG persisted positive only in 3 (6.8%) out of the 44 Non celiac gluten sensitivity (NCGS) patients tested after 6 months of gluten withdrawal (Figure 1)
AGA IgG persistence after GFD was significantly correlated with the low degree of compliance with gluten-free diet and with a mild clinical response (P = 0.009 and P = 0.00075, two-tailed Fisher’s exact test, respectively) (Table 1)
Summary
Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to characterize the effect of the gluten-free diet on anti-gliadin antibodies of IgG class in patients with non-celiac gluten sensitivity. The spectrum of gluten-related disorders has recently acquired a new entity represented by non-celiac gluten sensitivity (NCGS) [1,2,3]. This is an emerging syndrome evoked by gluten ingestion in patients in whom both celiac disease (CD) and wheat allergy have been excluded [4,5,6]. A double-blind, placebo controlled challenge is suggested to confirm diagnosis, since no biomarker is so far available for establishing a firm diagnosis of NCGS [11,12]
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