Gluten Sensitivity Research Articles

Celiac disease: Definition, classification, historical and epistemological profiles, anatomopathological aspects, clinical signs, differential diagnosis, treatments and prognosis. Proposed diagnostic scheme for celiac disease (DSCNC)

Celiac disease is an immune-mediated enteropathy, caused (in genetically predisposed or susceptible individuals) by the ingestion of gluten, the complex of water-insoluble proteins found in cereal grains such as wheat, rye and barley. In terms of terminology, it is the complex natural history and extremely polymorphous clinical presentation that has created some confusion. In fact, to date, at least three different forms of celiac disease are known, in addition to the simple non-celiac gluten sensitivity, since in common clinical practice most patients do not present the classic symptoms such as malabsorptive syndrome with diarrhoea, steatorrhoea, weight loss and nutritional deficiency, but rather an anaemia, asthenia, meteorism, abdominal tension, osteoporosis and infertility, thus painting an extremely varied and complex symptomatic picture that is linked to enteric microbiota and microbiome issues. Celiac disease affects the mucosa of the small intestine, while it generally spares the submucosa, muscolaris propria and serosa; if the disease does not involve the whole of the small intestine but only part of it, it is usually more serious in the proximal than the distal tract. The simultaneous presence of shortened villi, crypt hyperplasia, the abnormal cytological appearance of the absorbent surface and increased lamina propria cells is required for the diagnosis of celiac disease. Based on these findings, several forms of celiac disease have been identified in the clinic: typical, atypical (and in turn silent, latent, and potential), and sensitive non-celiac. Based on these considerations a specific diagnostic scheme is suggested to frame the celiac universe more functionally and structurally (so-called Diagnostic Scheme for Celiac Disease and Nonceliac Gluten Sensitivity, DSCNC), identifying at least eight clinical hypotheses based on the serological, genetic, bioptic and allergological tests suggested). From a pharmacological and integrative point of view, the protocols shared by the scientific community remain in place: gluten-free diet, vitamin and salt supplementation if appropriate, pharmacological therapy (antibiotics, antihistamines, corticosteroids and immunosuppressants) if necessary, also in the future with the majority orientation oriented towards oral glutenase able to counteract the effects of gliadin in sensitive subjects, the use of larazotide acetate to remedy the increase in intestinal permeability and tTG inhibitors to reduce the toxic effects of gluten intake. The state of the art on celiac disease is not yet able to explain the precise aetiology and atypical forms of the disease, as well as the real impact of genetic predisposition on clinical manifestations. Research continues and seems to point the way to a complete resolution of this enteropathy that has been so prevalent over the last two decades.

¿Es tiempo de incentivar el diagnóstico de la enfermedad celíaca en Colombia? Resultados de una Encuesta Epidemiológica

Objectives: To estimate the self-reported prevalence of gluten-related disorders (GRDs) and adherence to a gluten-free diet (GFD) in a Colombian population and to obtain the characteristics of GFD followers, gluten avoiders, and non-avoiders. Material and Methods: A survey was conducted using a culturally adapted and validated questionnaire. Results: Considering 850 valid responses (52.12%), the prevalence rates were/95% CI: Recurrent adverse reactions to wheat/gluten (RAR-W/G) 9.29%/7.52-11.43, wheat allergy 0.47%/0.18-1.20, non-celiac gluten sensitivity (NCGS) 2.35%/1.52-3.60, and GFD adherence 6.94%/5.41-8.85. No celiac disease (CD) cases were found. Most GRDs diagnoses were symptom-based (85.71%). Among 79 RAR-W/G or 100 irritable bowel syndrome (IBS) cases, only 8/79 and 5/100 had a physician diagnosis of NCGS, but celiac tests were informed by only one case. Health professionals were instructing the GFD in 49.15% of the GFD cases. GFD adherence motivations included weight control (74.42%) and the perception that a GFD promotes health (46.51%). Conclusions: There is a potential subdiagnosis of CD in Colombia, and even the majority of those with a physician diagnosis of IBS and RAR-W/G do not have undergone CD assessment. Similarly, physician-diagnosed NCGS cases rarely undergo celiac tests, raising questions about the optimal patient’s diagnosis and follow-up. Finally, the Colombian population should be informed about the risks/benefits of following a GFD without professional counseling. Keywords: Gluten, NCGS, Celiac Disease.

Effects of a gluten challenge in patients with irritable bowel syndrome: a randomized single-blind controlled clinical trial

Non-celiac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS) frequently overlap. Although, gluten-free diet (GFD) and low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) improve the IBS clinical picture, many aspects remain unclear. Therefore, we designed a study to evaluate gluten tolerance, anxiety and quality of life in a specific study population. Fifty IBS patients were asked to follow a low FODMAP strict GFD for 6 weeks and were then randomly allocated to the following groups for a further 6 weeks: (A) receiving 8 g/day of gluten for 2 weeks; gluten-tolerating subjects received 16 g/day for 2 weeks and then 32 g/day for a further 2 weeks; (B) continuing to follow a low FODMAP strict GFD; and (C) receiving a gluten-containing diet. After the first 6 weeks, symptom scores significantly improved. Pain severity, bloating and total score were significantly decreased in the GFD and in the high-gluten groups, while the satiety score significantly increased in group C. Between-group analysis revealed significant differences for pain severity (p = 0.02), pain frequency (p = 0.04) and impact on community function (p = 0.02) at the end of the study. Our findings suggest that low FODMAP strict GFD could be prescribed in IBS patients and would reduce anxiety and improve the quality of life.

Feasibility of combined upper and lower gastrointestinal endoscopic biopsy in the common marmoset (Callithrix jacchus) to evaluate gastrointestinal diseases.

Chronic gastroenteropathies, including gluten sensitivity and marmoset wasting syndrome, frequently occur in captive colonies of common marmosets (Callithrix jacchus). Early identification and diagnosis of affected animals are desirable. Endoscopic examination of the colon in marmosets is described, but the small intestine can harbor significant mucosal lesions not representing those in the colon. Evaluating the small intestine currently requires invasive surgical biopsies due to the small patient size, carrying a risk of severe complications. Endoscopic intubation and multisite biopsy of the duodenum/proximal jejunum are demonstrated in 10 marmosets under general anesthesia. Esophagogastroduodenoscopy with colonoscopy efficiently aid in examining the gastrointestinal tract and obtaining an antemortem histologic diagnosis in marmosets with chronic gastrointestinal signs. This minimally invasive technique is feasible in marmosets. Future investigations into the pathogenesis of chronic gastroenteropathies will benefit from these data, leading to improved animal welfare and better individual and colony health management.

Positive Gluten Sensitivity Serologies and the Impact of Gluten-free Diet in Patients With IBD.

Positive Gluten Sensitivity Serologies and the Impact of Gluten-free Diet in Patients With IBD.

Contribution of the Leukocyte Adherence Inhibition Test for the Evaluation of Immunoreactivity against Gluten Extracts in Non—IgE-Mediated / Non-Autoimmune Gluten-Related Disorders

Background: The Non-Celiac Gluten Sensitivity (NCGS) is a category inside the Gluten-Related Disorders (GRD) that groups the patients with unidentified mechanisms responsible for their symptoms.
 Objective: To evaluate the opportunity of an ex vivo challenge immunoassay, the Leukocyte Adherence Inhibition Test (LAIT), to discriminate non—IgE-mediated gluten-specific immunoreactivity in patients with NCGS.
 Methods: Ex vivo challenge tests performed with gluten latex extract, monitored by LAIT, were assayed in an asymptomatic control group of 30 individuals and a group of 52 patients with GRD not related to any identifiable immune mechanism (NCGS).
 Results: The mean Leukocyte Adherence Inhibition (LAI) of the control group was 10.9%. The mean LAI of the NCGS patients’ group was 54.9%. The non-parametric Wilcoxon-Mann-Whitney U test comparing the control group with the NCGS patient’s group showed significance with a p-value < 0.00001.
 Conclusion: The LAIT is an ex vivo challenge test able to discriminate gluten-sensitive and gluten-tolerant individuals, suggesting the participation of an immune Non—IgE-mediated hypersensitivity reaction in patients with the clinical diagnosis of NCGS.

A10 EARLY LIFE SENSITIZATION TO GLUTEN INDUCES SUSTAINED IMMUNOPATHOLOGY IN DR3-DQ2 MICE

Abstract Background Celiac disease (CeD) is an autoimmune T-cell mediated enteropathy, triggered by gluten, a group of proteins found in wheat, barley, and rye. The defined role of gluten as a dietary trigger, necessary genes (HLA-DQ2 and/or DQ8), and tissue transglutaminase (TG2) as the autoantigen together, are unique features of CeD. Although CeD onset can occur at any age, first dietary introduction of gluten during infancy is a critical window of exposure, especially in infants homozygous for the HLA DQ2.5 allele. While adult sensitization studies have been recently performed in DR3-DQ2 mice, the consequences of early life gluten sensitization timing remain unexplored. Aims Our aim was to characterize gluten-immunopathology and CeD-specific serology in specific pathogen free (SPF) DR3-DQ2 transgenic mice sensitized to gluten, 1 week before weaning. Methods Seven-week-old SPF DR3-DQ2 transgenic mice, kept on a gluten-free diet (GFD), were paired for breeding. At post-natal day 3, pups were standardized to 4 per litter (n=2 male, n=2 female) to ensure equal nutrition across litters. At 14 days of age, pups were sensitized with pepsin-trypsin digested gliadin and cholera toxin (CT) three times in one week (n=15). At 21 days of age, pups were weaned and placed either on a gluten-containing diet (n=7), (equivalent of 20g/d of gluten in a human diet -high dose-) or an isocaloric GFD (n=8) until 10 weeks of age. Non-sensitized controls (n=7) received only CT and were kept on the GFD. At sacrifice, serum was collected for anti-TG2 and anti-gliadin antibodies (AGA). Jejunal tissue was collected for histological analysis using villus-to-crypt (V/C) ratios and CD3+ intraepithelial lymphocytes (IEL) counts. Results Gluten-sensitized mice placed on a gluten-containing diet post-weaning had lower V/C ratios and higher CD3+ IEL counts compared with controls (p<0.01). Pre-weaning sensitized mice that were kept on a GFD post-weaning had sustained decreases in V/C ratios and higher CD3+ IEL counts (p<0.01). Out of 15 sensitized mice, 7 developed positive anti-gliadin IgA (p=0.02) and 4 had positive anti-TG2 IgA antibodies (p=0.01) in intestinal contents, irrespective of gluten in the diet. None of the controls had detectable AGA or anti-TG2 antibodies. Conclusions Pre-weaning gluten sensitization of DR3-DQ2 mice induced prolonged gluten immunopathology that did not reverse after 5 weeks on a GFD. Our results indicate that young DR3-DQ2 mice are susceptible to gluten sensitization, with sustained immunopathology, suggesting a critical window of vulnerability in familial carriers of DQ2.5. This novel model will be useful to investigate environmental cofactors at the first time of gluten introduction to the diet. Funding Agencies CIHR

Neuropathic Pain in Neurologic Disorders: A Narrative Review.

Neuropathic pain is defined as a painful condition caused by neurological lesions or diseases. Sometimes, neurological disorders may also be associated with neuropathic pain, which can be challenging to manage. For example, multiple sclerosis (MS) may cause chronic centralized painful symptoms due to nerve damage. Other chronic neuropathic pain syndromes may occur in the form of post-stroke pain, spinal cord injury pain, and other central pain syndromes. Chronic neuropathic pain is associated with dysfunction, disability, depression, disturbed sleep, and reduced quality of life. Early diagnosis may help improve outcomes, and pain control can be an important factor in restoring function. There are more than 100 different types of peripheral neuropathy and those involving sensory neurons can provoke painful symptoms. Accurate diagnosis of peripheral neuropathy is essential for pain control. Further examples are represented by gluten neuropathy, which is an extraintestinal manifestation of gluten sensitivity and presents as a form of peripheral neuropathy; in these unusual cases, neuropathy may be managed with diet. Neuropathic pain has been linked to CoronaVirus Disease (COVID) infection both during acute infection and as a post-viral syndrome known as long COVID. In this last case, neuropathic pain relates to the host’s response to the virus. However, neuropathic pain may occur after any critical illness and has been observed as part of a syndrome following intensive care unit hospitalization.

Gluten sensitivity and irritable bowel syndrome

Gluten sensitivity and irritable bowel syndrome

Genome-Wide Association Study-Guided Exome Rare Variant Burden Analysis Identifies IL1R1 and CD3E as Potential Autoimmunity Risk Genes for Celiac Disease.

Celiac disease (CeD) is a multifactorial autoimmune enteropathy characterized by the overactivation of the immune system in response to dietary gluten. The molecular etiology of CeD is still not well-understood. Therefore, this study aims to identify potential candidate genes involved in CeD pathogenesis by applying multilayered system biology approaches. Initially, we identified rare coding variants shared between the affected siblings in two rare Arab CeD families by whole-exome sequencing (WES). Then we used the STRING database to construct a protein network of rare variants and genome-wide association study (GWAS) loci to explore their molecular interactions in CeD. Furthermore, the hub genes identified based on network topology parameters were subjected to a series of computational validation analyses like pathway enrichment, gene expression, knockout mouse model, and variant pathogenicity predictions. Our findings have shown the absence of rare variants showing classical Mendelian inheritance in both families. However, interactome analysis of rare WES variants and GWAS loci has identified a total of 11 hub genes. The multidimensional computational analysis of hub genes has prioritized IL1R1 for family A and CD3E for family B as potential genes. These genes were connected to CeD pathogenesis pathways of T-cell selection, cytokine signaling, and adaptive immune response. Future multi-omics studies may uncover the roles of IL1R1 and CD3E in gluten sensitivity. The present investigation lays forth a novel approach integrating next-generation sequencing (NGS) of familial cases, GWAS, and computational analysis for solving the complex genetic architecture of CeD.

Histopathology of non-coeliac gluten sensitivity.

Diagnosis of non-coeliac gluten sensitivity (NCGS) remains still problematic due to the subjectiveness and lack of a specific biomarker. We aimed to compare NCGS duodenal mucosae with healthy individuals and Marsh type 1 coeliac disease (CD), to determine whether NCGS has characteristic histological features. A total of 44 healthy controls, 42 NCGS, and 44 type 1 CD patients were selected according to clinical, serological, and laboratory data. Duodenal biopsies were evaluated on H&E, CD, and CD117 for villus/crypt ratio, IEL counts/100 enterocytes, uneven distribution pattern with clusters of IELs in the villous epithelium, linear distribution of T lymphocytes in the basal lamina propria, and eosinophils and mast cells in the lamina propria. IEL counts were within normal range in controls (13 ± 7.65), normal or mildly increased in NCGS (24.7 ± 10.46), and increased in CD (58.79 ± 14.97) on CD3. The presence of uneven distribution pattern of IELs in the villous epithelium was significantly higher in NCGS (90.5%), in contrast to controls (27.3%) and CD (34.1%). The presence of linear distribution of T lymphocytes in the basal lamina propria (68.2%, 76.2%, 78.1%), eosinophil counts (6.85 ± 3.42, 6.21 ± 2.8, 7.62 ± 3.89), and mast cell counts (25.1 ± 5.1, 26 ± 2.9, 30.3 ± 4.4) was similar in controls, NCGS, and CD, respectively. In conclusion, duodenal mucosae in NCGS are characterized by preserved villous architecture, normal or mildly increased IELs with clusters, and eosinophils and mast cells within normal limits. We believe uneven distribution of IELs with clusters in the villous epithelium can be used as a supportive histopathological tool for NCGS in the right clinical setting.

Eating Together - Sharing food brings you closer

When my son was in preschool, he was diagnosed with gluten sensitivity. It’s a mild condition, his pediatrician assured us, one he’d most likely outgrow (and he eventually did). But for the time being, he needed to abstain from gluten. Adjusting my son’s diet was relatively easy, since gluten-free bread and pasta are now ubiquitous. What I didn’t expect was the social toll. He was so frustrated when he couldn’t eat at school birthday parties that I was tempted to pull him out each time before the cake—and his inevitable tears—arrived.

Комплексная оценка эффективности безглютеновой и безказеиновой диеты у детей с задержками психоречевого развития

Objective. To justify the significance of using a gluten-free casein-free diet (GFCF diet) in children with delayed psycho-speech development (DPSD) and to study its effect on the somatic and neuropsychological status of these patients. Patients and methods. This randomized, open-label, prospective trial involved 105 children (71 boys and 34 girls) with DPSD between the ages of 1 year 6 months and 6 years 7 months. Children were divided into two groups: group 1 included 53 children who received the GFCF diet; group 2 – 52 children who ate regular meals. Children were examined at the beginning of observation, after 6 and 12 months. We used the Integrative Medicine Assessment Scale (IMAS) 1 and 2, Childhood Autism Rating Scale, Autism Treatment Evaluation Checklist (ATEC), Integrative Medicine Patients Parent Scale. Laboratory and instrumental examinations included blood tests for antibodies IgA, IgM, IgG, IgE, Anti-tTG IgA, Anti-tTG IgG, Anti-EMA, stool tests for calprotectin and zonulin, ultrasound imaging of the abdomen, kidney, heart, transcranial Doppler ultrasound of brain vessels, and magnetic resonance imaging of the brain if necessary. All children were examined by a neurologist, psychiatrist, geneticist, and surdologist. Results. A significant effectiveness of the GFCF diet in children with DPSD, including autism spectrum disorders, was justified. It was shown that the number of children without stereotypic movement disorders, as well as without digestive problems, increased by 1.5 and 2.3 times in the group of patients receiving diet therapy compared to the group without dietary correction after 6 and 12 months from the beginning of observation; the proportion of highly expressed stereotypies decreased by 2.3 times after 6 months. According to the ATEC scale, the number of children with severe disorders was 2.2 and 2.9 times lower after 6 and 12 months, respectively; according to the somatic status assessment scale (IMAS), the total score was 1.25 times lower. Conclusion. The GFCF diet has a positive effect on the neuropsychological and somatic status of children with DPSD. Children with DPSD have non-celiac gluten sensitivity, in which adherence to the diet allows to alleviate gastrointestinal and neurological manifestations. Key words: anti-tissue transglutaminase antibodies, autism, gluten-free diet, delayed psycho-speech development

Gluten-related disorders

Gluten-related disorders are a heterogeneous group of clinical entities caused by intolerance to wheat, rye, and barley flour components. They occur in 3?5% of genetically predisposed persons and, based on pathogenic and clinical features, are classified into celiac disease, non-celiac gluten sensitivity, and wheat allergy. There are also specific entities such as dermatitis herpetiformis or gluten ataxia, which can occur either within the celiac disease or independently. This article based on the current knowledge shows the basic details of the pathogenesis, clinical expression, diagnosis, and treatment of these disorders.

Assessment of Consumer Knowledge of Gluten-Free Food

The gluten-free food market has become one of the fastest-growing food markets for food intolerances. People with celiac disease, gluten intolerance, non-celiac gluten sensitivity, and other gluten-related diseases should follow a gluten-free diet. The demand for gluten-free products is growing yearly, mainly due to the increasing number of diagnosed cases. The aim of the study was to assess consumers’ knowledge of gluten-free foods and covered people of all ages, and was conducted using a questionnaire. The research results indicate that most consumers have a lot of knowledge concerning gluten-free food. Moreover, most consumers know what gluten is and what products to avoid while on a gluten-free diet. They also know which diseases it causes and that it is necessary to follow a diet, but they have difficulty determining the acceptable gluten content in gluten-free products. Consumers’ most crucial parameter when choosing a gluten-free product is taste. The results of the survey also show that a gluten-free diet is more popular among women than men.

Detection of Gluten in Dishes Offered as Gluten-Free in a Gastronomic Area Located in San José, Costa Rica

Celiac disease, gluten sensitivity and gluten intolerance are health conditions that require consumers to avoid their gluten intake. In Costa Rica, Law 8975 regulates the amount of gluten permitted in prepackaged products labeled as “gluten-free”, but the parameters to be followed are not mandated for food service operations. This study investigated whether restaurants with gluten-free (GF) options in a gastronomic area of the city of San José, Costa Rica, achieved the requirements of the legislation that the dishes offered should contain less than 20 ppm gluten. Using data collected from five restaurants offering GF dishes, two provided dishes with quantities of gluten greater than 20 ppm (restaurant A, four samples and restaurant B, three samples); particularly dishes from the category “meat with sauce”. Although those dishes are naturally gluten-free, when they are handled in areas of shared production, they are exposed to the risk of cross contact, furthermore the adding of misscellaneous such as: marinades, sauces and condiments, which could contain traces of gluten or hidden gluten, a risk associated with the use of ingredients without certification GF (supplier’s practices and label declaration). Therefore improvements in food service procedures should be enforced. The findings of the present study emphasize the need to include restaurant foods in the relevant legislation to ensure that the gluten-intolerant sector of the population remains safe when eating out.

Nutrition in Patients with Lactose Malabsorption, Celiac Disease, and Related Disorders.

Lactose malabsorption (LM), celiac disease (CD), non-celiac gluten sensitivity (NCGS), and irritable bowel syndrome (IBS) are conditions associated with food triggers, improvement after withdrawal, treatment with dietary restriction, and subsequent nutritional detriments. LM occurs when there is incomplete hydrolysis of lactose due to lactase deficiency and frequently produces abdominal symptoms; therefore, it can cause lactose intolerance (LI). A lactose-restricted diet is frequently recommended, although it can potentially lead to nutrient deficiencies. Furthermore, lactose is an essential component of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) and is subsequently associated with intolerance to these compounds, especially in IBS. LM commonly presents in CD. Nutritional deficits are common in CD and can continue even on a gluten-free diet (GFD). Conditions triggered by gluten are known as gluten-related disorders (GRDs), including CD, wheat allergy, and NCGS. IBS can also be associated with a gluten sensitivity. A GFD is the treatment for CD, GRDs, and gluten sensitive IBS, although compliance with this restricted diet can be difficult. Strict dietary therapies can have a negative effect on quality of life. This review aims to provide an overview of the difficult nutritional elements of these disorders, which are critical for medical providers to recognize when managing these patients.

Defining risk reduction strategies for tourists with specific food needs: a qualitative approach

PurposeThis exploratory study aims to identify the main risk reduction strategies when individuals suffer from coeliac disease (CD) or non-coeliac gluten sensitivity (NCGS) travel. Based on Yeung and Yee's (2013; 2019) model, the paper offers a new framework for analysing the main travel risk reduction strategies for people with specific food needs. The empirical work focuses on the perspectives of different stakeholders (CD and NCGS community, restaurant managers/service providers and nutritionists).Design/methodology/approachA qualitative approach based on thematic analysis is adopted. The results of 32 semi-structured in-depth interviews reveal different stakeholders' perspectives in order to understand the various strategies.FindingsThe findings confirm the high level of consensus that the main food risk reducers are: travel information, staff training in safety assurance, legislation and risk prevention protocols. The findings also show significant limitations in the information offered by restaurants, organisations and tourist destinations and the negative repercussions on the tourist experience and the reputation on a particular destination.Practical implicationsThe results will help hospitality business managers and destination management organisations develop food risk reduction strategies to solve some of the most important food-related problems when people in this market segment travel.Originality/valueThis work contributes to the literature by providing a new framework on travel risk reduction strategies for people with specific food needs. The novelty of this research is mainly found in the study of risk reduction strategies related to the travel decision-making process for those with CD and NCGS from different perspectives.

Lack of Effect of Gluten Challenge on Fecal Microbiome in Patients With Celiac Disease and Non-Celiac Gluten Sensitivity.

INTRODUCTION:Celiac disease (CD) may be associated with gut microbial dysbiosis. Whether discrete gluten exposure in subjects with well-controlled disease on a gluten-free diet impacts the gut microbiome is unknown and may have implications for understanding disease activity and symptoms. We conducted a prospective study to evaluate the impact of gluten exposure on the gut microbiome in patients with CD and nonceliac gluten sensitivity (NCGS).METHODS:Subjects with CD (n = 9) and NCGS (n = 8) previously on a gluten-free diet were administered a 14-day gluten challenge (5 g of gluten per day) and compared with controls (n = 8) on a usual gluten-containing diet. Stool was collected for fecal microbiome analysis using 16S rRNA gene and metagenomic sequencing before, during, and after the gluten challenge. Symptoms were assessed using 2 validated clinical scales.RESULTS:Among subjects with CD and NCGS, there were no significant fecal microbial changes in response to gluten challenge. Gut microbiome composition differed among controls, subjects with CD, and subjects with NCGS at baseline, and these differences persisted despite gluten exposure. Gastrointestinal and general health symptoms reported by subjects with CD and NCGS were worst in the middle of gluten challenge and lessened by its end, with no consistent associations with gut microbiome composition.DISCUSSION:Pre-existing fecal microbiome diversity was unaffected by gluten challenge in adult subjects with CD and NCGS. These findings suggest that current microbiome status is unrelated to current disease activity and disease severity.

Assessment of Markers of Gut Integrity and Inflammation in Non-Celiac Gluten Sensitivity After a Gluten Free-Diet.

PurposeMarkers for gut integrity and inflammation have received increasing interest as intestinal permeability and innate immune system activation are suggested as possible pathophysiological mechanisms in non-celiac gluten sensitivity (NCGS). We aimed to assess relevant biomarkers in NCGS by analyzing serum levels of gut integrity and permeability markers, pro-inflammatory cytokines and antigliadin IgG in patients with suspected NCGS on a gluten-free diet (GFD), and compare them to serum levels in patients with irritable bowel syndrome (IBS) and healthy controls (HC).Patients and MethodsSerum samples collected from patients with suspected NCGS on a GFD (n=20, 14 women, 21–62 years), IBS (n=20, 16 women, 24–67 years) and HC (n=20, 14 women, 21–54 years) were analyzed. IBS severity scoring system (IBS-SSS) was applied to evaluate gastrointestinal symptoms.ResultsThe IBS-SSS score was higher in subjects with suspected NCGS and IBS patients compared to HC (p<0.0001). No significant differences were found in the serum levels of any of the gut integrity and permeability markers, cytokines or antigliadin IgG antibodies between the three groups. However, positive correlations were observed between claudin-1 and i-FABP, and between claudin-1 and antigliadin IgG antibodies.ConclusionNo differences in serum levels of gut integrity and permeability markers, pro-inflammatory cytokines or antigliadin IgG antibodies were found among patients with suspected NCGS on a GFD, IBS and HC.