Abstract
Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s and recently a “re-discovered” disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA). Although NCGS frequency is still unclear, epidemiological data have been generated that can help establishing the magnitude of the problem. Clinical studies further defined the identity of NCGS and its implications in human disease. An overlap between the irritable bowel syndrome (IBS) and NCGS has been detected, requiring even more stringent diagnostic criteria. Several studies suggested a relationship between NCGS and neuropsychiatric disorders, particularly autism and schizophrenia. The first case reports of NCGS in children have been described. Lack of biomarkers is still a major limitation of clinical studies, making it difficult to differentiate NCGS from other gluten related disorders. Recent studies raised the possibility that, beside gluten, wheat amylase-trypsin inhibitors and low-fermentable, poorly-absorbed, short-chain carbohydrates can contribute to symptoms (at least those related to IBS) experienced by NCGS patients. In this paper we report the major advances and current trends on NCGS.
Highlights
Gluten sensitivity (GS) was originally described in the 1980s [1] and a recently “re-discovered”syndrome entity, characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA)
The pooled odds ratio (OR) for irritable bowel syndrome (IBS)-type symptoms was higher in patients with CD than in controls (5.60; 95% CI, 3.23–9.70)
The results showed a less dramatic change between children having been on diet for eight and children in diet for 24 months, possibly reflective of a plateau effect [29]
Summary
Gluten sensitivity (GS) was originally described in the 1980s [1] and a recently “re-discovered”. Following the landmark work by Sapone and coworkers, describing the clinical and diagnostic features of GS in the year 2010 [2], a rapidly increasing number of papers have been published by many independent groups, confirming that GS should definitely be included in the spectrum of gluten-related disorders. Given the recent increase of the gluten-free market worldwide, partially sustained by individuals who claim a medical necessity to undertake a gluten-free diet (GFD), there is a need of “separating the wheat from the chaff” [3] This goal will be achieved by (a) proper scientific information, (b) shared definitions, and (c) prospective, multi-center studies addressing the many unsolved issues on GS. In this paper we report the major advances and current trends on GS, as presented and debated at the Munich meeting
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