Gluten Sensitivity Research Articles

Gluten Unraveled: Latest Insights on Terminology, Diagnosis, Pathophysiology, Dietary Strategies, and Intestinal Microbiota Modulations—A Decade in Review

A decade of research on gluten-related disorders (GRDs) is reviewed in this study, with a particular emphasis on celiac disease (CD) and non-celiac gluten sensitivity (NCGS). GRDs are triggered by the ingestion of gluten and gluten-like proteins found in wheat, barley, and rye. These proteins lead to intestinal damage in celiac disease, an autoimmune condition characterized by villous atrophy and a variety of gastrointestinal and extraintestinal symptoms. More enigmatic and less understood, NCGS involves symptoms similar to CD but without the immunological reaction or intestinal damage. Recent years have seen advances in the understanding of GRDs, particularly in connection to how intestinal microbiota influences disease progression and patient outcomes. The gluten-free diet (GFD) is still the standard therapy recommended for GRDs despite significant challenges, as discussed in this article. Precise diagnostic methods, patient education and dietary counseling are critical for improving patients’ quality of life. The purpose of this review is to provide a more clear and up-to-date understanding of GRDs, and to help further research on this important topic.

Food insecurity and other barriers to adherence to a gluten-free diet in individuals with coeliac disease and non-coeliac gluten sensitivity in the Netherlands: a mixed-methods study

ObjectivesTo determine the prevalence of food insecurity among individuals with coeliac disease (CeD) and non-coeliac gluten sensitivity (NCGS) in the Netherlands and explore its association with diet quality and other...

Exploring the potential of taro (Colocasia esculenta) starch: Recent developments in modification, health benefits, and food industry applications

AbstractTaro is a tropical plant and an underutilized root crop that has a good source of carbohydrate. Taro tuber contains 70%–80% of starch on dry basis. This review highlights the extraction of taro starch, latest advancements in the modification such as physical, chemical and enzymatic modification of taro starch. Furthermore, after modification of taro starch, molecular weight and amylopectin branch chain length distribution, granular shape, percentage crystallinity, swelling and solubilization, pasting and thermal properties and in vitro digestibility of taro starch were significantly affected. Additionally, researchers have explored novel methods to modify the physicochemical characteristics of taro starch, enhancing its functionality as a thickening, gelling, and stabilizing agent in various food formulations. However, fabrication of nanoparticles from taro starch was also studies. Various health benefits of taro starch have been reported in this study. One significant health benefit of taro starch is its potential to improve blood sugar management. Furthermore, the versatility of taro starch in food applications has expanded, ranging from traditional staples to modern convenience foods. Its gluten‐free nature makes it an attractive option for individuals with gluten sensitivity or celiac disease. Taro starch is increasingly incorporated into bakery products, snacks, noodles, and as a thickening agent in soups and sauces. The unique sensory attributes and nutritional profile of taro starch contribute to the development of novel, health‐conscious food products that cater to evolving consumer preferences.

Gluten Sensitivity and Laryngopharyngeal Reflux

Abstract: Gluten is a protein that binds food together and allows foods such as dough to be stretched without ripping apart. It is found in grains such as wheat, rye and barley; but it also is used as a binder in some medications. Gluten intolerance is well-known in people with celiac disease, but non-celiac gluten sensitivity also is common. Gluten sensitivity can mimic or aggravate laryngopharyngeal reflux. Gluten sensitivity should be considered, especially in people with reflux that do not respond well to the usual reflux treatments.

Dietary Interventions and Supplements for Managing Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Efficacy and Recommendations.

Attention-deficit/hyperactivity disorder (ADHD) significantly impacts children's neurological development, behaviour, and overall well-being, affecting academic performance and social interactions. This systematic review investigates the effectiveness of dietary interventions (DASH(Dietary Approaches to Stop Hypertension) diet, Vitamin D3 supplementation, magnesium, and impact of artificial food colors and marine oils) and supplements alongside standard pharmacotherapy in managing ADHD symptoms. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we extensively searched various databases for studies published from 2016 to 2022. Out of an initial pool of 7873 records, 14 randomized controlled trials met our inclusion criteria following rigorous screening. Our findings suggest that gluten-free diets may alleviate ADHD symptoms despite negative celiac serology, highlighting the role of non-celiac gluten sensitivity. Moreover, vitamin and mineral supplements like vitamin D and magnesium showed varying degrees of effectiveness in improving behavioural and emotional symptoms. Innovative treatments, such as combining saffron with methylphenidate and using marine oil extracts, also demonstrated potential in enhancing behaviours associated with ADHD. The review underscores the importance of dietary approaches, such as the DASH diet and specific exclusions (e.g., a few foods diet and an oligoantigenic diet), in managing symptoms by addressing nutritional factors. Studies on probiotics and interventions targeting gut microbiota composition yielded mixed results, necessitating further exploration. Limitations include study diversity and short-term outcome assessments, cautioning against broad generalizations. Integrating personalized dietary assessments and interventions into ADHD treatment strategies could optimize therapeutic outcomes and potentially reduce reliance on pharmacotherapy alone. In summary, this systematic review highlights the potential benefits of dietary modifications and supplements in managing ADHD symptoms. Future research should prioritize long-term efficacy, interactions with conventional medications, and personalized dietary approaches to refine ADHD treatment strategies.

Частота выявления и структура глютензависимых заболеваний среди гастроэнтерологических пациентов детского возраста Республики Узбекистан (когортное проспективное исследование)

Gluten-related disorders (GRDs) are characterized by different pathogenetic development pathways though are having similar clinical manifestations that make its differential diagnosis rather difficult. In the bibliographical sources available currently there were no research works such as a one-time study of the GRDs’ incidence among children. The purpose of this research was to determine the incidence and clinical and laboratory features of celiac disease (CeD), wheat allergy (WA) and non-celiac gluten sensitivity (NCGS) among children with gastroenterological complaints residing in Uzbekistan. Materials and methods used: a single-center cohort prospective study had been carried out in 2021-2022 on the basis of the Uzbekistan Republican Specialized Scientific and Practical Medical Center for Pediatrics of the Ministry of Healthcare of Uzbekistan (Tashkent, Uzbekistan) with 336 children with suspected gluten intolerance aged from 1 to 16 y/o who participated in the study. At the first stage 206 were selected after a short questionnaire developed by the Authors. For the following stage the specific laboratory tests were performed as follows: determination of antibodies (AT) to tissue transglutaminase IgA and total IgA (AT to tissue transglutaminase IgG, total IgG and IgM in IgA deficiency cases), total and specific IgE levels to wheat and gluten, HLA class II genotyping, histological examination of a biopsy specimen of the mucous membrane of the subbulbic part of the duodenum based on indications. The Salerno criteria were used to confirm the NCGS diagnosis. Results: the GRDs incidence among the studied cohort was 17.5% (95% CI: 12.29; 22.6), of which 5.3% (95% CI: 2.27; 8.41) had CeD, 7,3% (95% CI: 3.73; 10.83) had WA and 4.9% (95% CI: 1.92; 7.89) were diagnosed with NCGS. The most significant symptoms in children with GRDs were bloating, diarrhea and abdominal pain. The leading symptom for NCGS was headache. Allergic pinpoint rash with scratching traces were detected in patients with WA. Conclusion: this research was the first to study the GRDs incidence in Central Asia and it had showed that CeD and WA are pretty common among children with gastroenterological complaints in Uzbekistan and that the NCGS incidence does correspond to the average statistical data published priorly.

Nutritional profile, bioactive properties and potential health benefits of buckwheat: A review

AbstractThe present review focuses on the physico‐chemical properties of buckwheat (BW) and shows that its incorporation makes food more nutritious. The bioactive substances included in BW, including vitamins, proteins, flavonoids, phenolic acids, dietary fibre, and fagopyrins are effective in treating chronic illnesses. It is also a rich source of protein of excellent quality as it contains balanced amino acids. Various bioactive compounds like phenolics, flavonoids including orientin, quercetin, rutin, vitexin, isovitexin and isoorientin, tannins and steroids help in providing therapeutic benefits. It has a number of beneficial impacts on health, including anti‐inflammatory, anti‐hemorrhagic, cardiovascular, antioxidant, and blood vessel protective properties. The food sector has experienced an increased interest in producing items based on BW, which boasts advantageous flavor profiles and technical attributes while offering health benefits and accommodating those with gluten sensitivity. BW is a beneficial ingredient for bread, rice, soup, cakes, noodles, cookies, and gluten‐free beer due to its functional properties. This review also emphasizes on the BW as a functional food in numerous industries including agriculture, food, pharmaceutical and as animal fodder. It provides researchers knowledge that could be useful for developing future plans, such as selecting BW as promising bioactive ingredients for functional foods.

The prevalence of self-reported gluten sensitivity (SRGS) in irritable bowel syndrome (IBS)in a Brazilian community. A pilot study

Background – A significant number of irritable bowel syndrome (IBS) patients report onset of symptoms after ingestion of a specific food, including those containing gluten. NCGS includes both intestinal and extra-intestinal symptoms which are related to the ingestion of gluten containing food-after exclusion of celiac disease (CD) and wheat allergy. The overlap between irritable bowel syndrome (IBS) and NCGS has been described but the knowledge of the etiopathogenesis of this clinical entity is incomplete. In Brazil, data on the prevalence of IBS and its association with food intolerance are scarce. Objective – To study the prevalence of SRGS in a group of volunteers diagnosed with IBS in a Brazilian community. Methods – A total of 400 volunteers over 18 years old were selected from students and staff of the Medical School of the Fluminense Federal University, Brazil. Participants completed a questionnaire divided in basic demographic information (age, sex), evaluation of IBS diagnosis in accordance with the Rome III criteria and self-reported food intolerance, including gluten. Results – Eighty-seven (21.7%) (Group I) [mean age 30.4±12.65 (77.4%) females] fulfilling the Rome III criteria for IBS. Twenty-six (32%) reported gastrointestinal symptoms after ingestion of food in general and 28 (32.1%) after gluten ingestion. Within the 313 volunteers non-IBS (78.2%) (Group II) [mean age 30.6±21.77, 215 (68.2%) females] 66 (21%) and 50 (15.9%) reported gastrointestinal symptoms after ingestion of food in general and gluten respectively. Demographic data (mean age and sex) were not statistically different when we compared the two groups of volunteers (p>0.05). Conclusion – The report of gastrointestinal symptoms after ingestion of food in general and gluten-containing foods were statistically different in the two groups (p<0.05). The interaction between IBS, food intolerance and NCGS needs to be better defined, since the role of diet in IBS and its feeding management is an essential condition for the treatment of most of those patients

γδ+ T-Cells Is a Useful Biomarker for the Differential Diagnosis between Celiac Disease and Non-Celiac Gluten Sensitivity in Patients under Gluten Free Diet.

The differential diagnosis between patients with celiac disease (CD) and non-celiac gluten sensitivity (NCGS) is difficult when a gluten-free diet (GFD) has been initiated before the diagnostic work-up. Isolated increases in TCRγδ+ and celiac lymphogram (increased TCRγδ+ plus decreased CD3-) may enable differential diagnosis in this challenging clinical setting. This study evaluated: (1) the accuracy of %TCRγδ+ and celiac lymphogram for diagnosing CD before and after GFD and for differentiation with NCGS; (2) TCRγδ+ kinetics at baseline and after starting GFD in both CD and NCGS. The inclusion criteria were patients with CD (n = 104), NCGS (n = 37), and healthy volunteers (n = 18). An intestinal biopsy for intraepithelial lymphogram by flow cytometry was performed at baseline and after GFD. The optimal cutoff for CD diagnostic accuracy was established by maximizing the Youden index and via logistic regression. %TCRγδ+ showed better diagnostic accuracy than celiac lymphogram for identifying CD before and after GFD initiation. With a cutoff > 13.31, the accuracy for diagnosing CD in patients under GFD was 0.88 [0.80-0.93], whereas the accuracy for diagnosing NCGS (%TCRγδ+ ≤ 13.31) was 0.84 [0.76-0.89]. The percentage of TCRγδ+ cells showed differential kinetics between CD (baseline 22.7% [IQR, 16.4-33.6] vs. after GFD 26.4% [IQR, 17.8-36.8]; p = 0.026) and NCGS (baseline 9.4% [IQR, 4.1-14.6] vs. after GFD 6.4% [IQR, 3.2-11]; p = 0.022). TCRγδ+ T cell assessment accurately diagnoses CD before and after a GFD. Increased TCRγδ+ was maintained in the long term after GFD in CD but not in NCGS. Altogether, this suggests the potential usefulness of this marker for the differential diagnosis of these two entities in patients on a GFD.

Microbiomes for the future of sustainable wheat production

Microbiomes for the future of sustainable wheat production Researchers from the WHEATBIOME project joined forces to address several challenges related to sustainable wheat production and consumption, revealing the role of microbes in shaping the Future of Healthy Food. Food systems are facing unprecedented challenges due to the increase in the world population, climate change, and geopolitical instability, which threaten food security and prices. Additionally, systemic inefficiencies and massive food waste from crop harvest to consumption have been observed. This scenario imposes an urgent unification of different scientific research areas to advance knowledge on a future-proof agrifood system. Wheat is a staple crop facing stagnant production in Europe due to increasing biotic and abiotic stresses exacerbated by climate change. Its nutritional importance spans human and animal consumption, yet its immunogenicity poses health risks like gluten sensitivity and celiac disease.

Association of LPP and ZMIZ1 Gene Polymorphism with Celiac Disease in Subjects from Punjab, Pakistan.

Celiac disease (CD) is a complicated autoimmune disease that is caused by gluten sensitivity. It was commonly believed that CD only affected white Europeans, but recent findings show that it is also prevailing in some other racial groups, like South Asians, Caucasians, Africans, and Arabs. Genetics plays a profound role in increasing the risk of developing CD. Genetic Variations in non-HLA genes such as LPP, ZMIZ1, CCR3, and many more influence the risk of CD in various populations. This study aimed to explore the association between LPP rs1464510 and ZMIZ1 rs1250552 and CD in the Punjabi Pakistani population. For this, a total of 70 human subjects were selected and divided into healthy controls and patients. Genotyping was performed using an in-house-developed tetra-amplification refractory mutation system polymerase chain reaction. Statistical analysis revealed a significant association between LPP rs1464510 (χ2 = 4.421, p = 0.035) and ZMIZ1 rs1250552 (χ2 = 3.867, p = 0.049) and CD. Multinomial regression analysis showed that LPP rs1464510 A allele reduces the risk of CD by ~52% (OR 0.48, CI: 0.24-0.96, 0.037), while C allele-carrying subjects are at ~2.6 fold increased risk of CD (OR 3.65, CI: 1.25-10.63, 0.017). Similarly, the ZMIZ1 rs1250552 AG genotype significantly reduces the risk of CD by 73% (OR 0.26, CI: 0.077-0.867, p = 0.028). In summary, Genetic Variations in the LPP and ZMIZ1 genes influence the risk of CD in Punjabi Pakistani subjects. LPP rs1464510 A allele and ZMIZ1 AG genotype play a protective role and reduce the risk of CD.

Effect of food processing on the immunoreactivity of gliadin

SummaryWheat is the most important crop in the world mainly because of the feature of its storage protein, gluten, such as stretching and extending, that can hold the produced gas. However, some people have immunoreactivity against wheat gluten, which is generally called gluten disorder. Coeliac disease (CD) and non‐coeliac gluten sensitivity are types of gluten disorders. Several food processing techniques have been used to reduce gliadin immunoreactivity such as using thermal processing, fermentation, high‐pressure processing and pulsed light with different wheat products such as wheat flour, flatbread and gluten suspension. CD is the most known gluten disorder; therefore, this review will focus on the reduction effect of food processing on it. Gluten consists of gliadins and glutenin; the allergic effect of gliadins is well known, and several epitopes were identified, which are usually used to follow gluten immunoreactivity. Till now, consuming a gluten‐free diet is the only way for people who are suffering from gluten disorder. Up to now, all the attempts to reduce the immunoreactivity of gliadin (IRG) by food processing have not fully succeeded. The main techniques used to follow the target epitopes are enzyme‐linked immunosorbent assay (ELISA), western blot, LC–MS/MS, etc. The fermentation process and adding enzymes are the most promising food processing in terms of reducing IRG. Worth mentioning that using different techniques gave different gliadin reductions; beyond that, using different ELISA kits gave different reductions. Combining different techniques is recommended to monitor the IRG reduction by using the most effective method till now.

Celiac disease and nonceliac enteropathies.

This review highlights recent research in the field of celiac disease. Epidemiological studies continue to identify celiac disease-associated diseases such as inflammatory arthritis, irritable bowel syndrome, and cardiovascular disease. Recently published consensus guidelines provide recommendations for the long-term management and monitoring of patients with celiac disease. There are multiple pharmaceutical therapies for celiac disease under investigation, and recent phase I and phase II trials are reviewed here. Finally, a recent trial of patients with nonceliac gluten sensitivity demonstrates a significant nocebo effect in this condition. Recent advances in celiac disease include the development of new clinical guidelines as well as promising new therapeutics. Continued high-quality research is needed to improve the outcomes of patients with celiac disease and nonceliac enteropathies.

Self-Reported Nonceliac Gluten Sensitivity in Italian Young Adults: A Cross-Sectional Study. A Dietary Fad?

In different countries, the exact prevalence of people that refer symptoms after gluten ingestion is increasing and the unavailability of reliable laboratory tests to diagnose the condition known as nonceliac gluten sensitivity (NCGS) has opened the door to the spread of survey-based studies to hypothesize a prevalence of this condition with highly discordant results. We aim to describe the attitude toward gluten consumption in a large population of young adults in Italy. A questionnaire-based cross-sectional study was conducted in 13 Italian cities to investigate the dietary attitudes of more than 9,400 people distributed throughout the country about gluten consumption. Only those referring to gluten-related symptoms with a frequency equal to "always" or "most of the time" were considered self-reported NCGS (SR-NCGS) patients. Five thousand two hundred thirty-four of 9,432 eligible participants (55.5%) fully completed the questionnaire. Excluding those with previous gastrointestinal diagnoses of celiac disease and wheat allergy, we have finally analyzed 4,987 questionnaires. Four hundred eighty-seven participants indicated gluten-related symptoms always or most of the time (SR-NCGS subjects), while 121 already had a medical diagnosis of NCGS. The minimum prevalence figure of SR-NCGS is 6.4% (95% confidence interval 6.0-6.9), with a higher prevalence in women (79.9%). The most frequent gluten-related symptoms were bloating, abdominal pain, and tiredness. The high prevalence of people reporting symptoms after gluten ingestion requires that the diagnosis of NCGS should be ascertained with a double-blind controlled study to limit the number of people who improperly approach a gluten-free diet.

Celiac Disease, Gluten Sensitivity, and Diet Management.

Celiac disease is a common chronic inflammatory condition of the small bowel triggered by gluten in wheat, rye and barley in the diet. Non-celiac gluten sensitivity presents with symptoms similar to celiac disease with the ingestion of gluten or other components of wheat. In this article, we review challenges presented by a gluten free diet for the treatment of both disorders. Wheat is ubiquitous in the diet and medications/products. A registered dietitian is mandatory for patient education on the gluten free diet. Naturally gluten free foods provide a healthy diet for those with celiac disease. Whole grains labelled gluten free, including oats, are encouraged in the diet as refined grains may be deficient in fiber, protein, and micronutrients, particularly folate. Gluten contamination is the most common cause of persistent symptoms in celiac disease though shared equipment of food preparation may not be as large a problem as suspected. Most with celiac disease on a gluten free diet will fully recover and gain weight that poses a problem for those overweight to start. The gluten free diet may have a negative impact on quality of life for both celiac patients and their families. Those with hypervigilance of the gluten free diet and avoidance of dining out have the lowest quality of life. The gluten free diet is currently the only effective treatment for celiac disease. A registered dietitian is needed to educate patients on the complexity of the gluten free diet with a goal of healthy eating, maintaining a healthy weight, and avoiding disordered eating or diet hypervigilance; key to a good quality of life.

Novel probiotic preparation with in vivo gluten-degrading activity and potential modulatory effects on the gut microbiota.

The untapped potential of gluten-degrading bacteria and their application in addressing the recognized limitations of gluten-related disorder management and the ongoing risk of cross-contamination even when people follow a gluten-free diet (GFD) emphasizes the significance of the work. Because gluten, a common protein found in many cereals, must be strictly avoided to stop autoimmune reactions and related health problems, celiac disease and gluten sensitivity present difficult hurdles. However, because of the hidden presence of gluten in many food products and the constant danger of cross-contamination during food preparation and processing, total avoidance is frequently challenging. Our study presents a novel probiotic preparation suitable for people suffering from gluten-related disorders during GFD and for healthy individuals because it enhances gluten digestion and promotes gut microbiota functionality.

Wheat-Related Disorders in Children: A 360-Degree View.

Immunological illnesses related to wheat represent an epidemiologically relevant phenomenon at a pediatric age. The term "Wheat-related disorders" involves a spectrum of diseases: celiac disease, IgE-mediated wheat allergy, non-IgE mediated wheat allergy, wheat-related eosinophilic esophagitis, and non-celiac gluten sensitivity. Their pathogenesis is different. At the same time, wheat represents their common point. This article aims to the state-of-the-art and new clinical evidence in pediatric age.

Utilizing Telemedicine Applications in Celiac Disease and Other Gluten-Free-Diet-Dependent Conditions: Insights from the COVID-19 Pandemic.

Globally, approximately 1.4% of people have celiac disease (CD), induced by gluten sensitivity. If left untreated, it causes small intestinal inflammation and villous atrophy, which can result in failure to thrive, anemia, osteoporosis, malabsorption, and even malignancy. The only treatment option available is a gluten-free diet (GFD). Few studies have looked at the role and perception of telehealth in relation to CD and selective nutrition both before and after the COVID-19 pandemic. Our goal was to screen and investigate the research conducted both before and after the COVID-19 pandemic concerning the utilization of telehealth applications and solutions in CD and other GFD-dependent circumstances. We employed a narrative review approach to explore articles that were published in scholarly journals or organizations between the years 2000 and 2024. Only English-language publications were included. PubMed and Google Scholar searches were mainly conducted using the following keywords: telemedicine, telehealth, telecare, eHealth, m-health, COVID-19, SARS-CoV-2, celiac disease, and gluten-free diet (GFD). Manual searches of the references in the acquired literature were also carried out, along with the authors' own personal contributions of their knowledge and proficiency in this field. Only a few studies conducted prior to the COVID-19 outbreak examined the viewpoints and experiences of adult patients with CD with relation to in-person clinic visits, as well as other options such as telehealth. The majority of patients believed that phone consultations were appropriate and beneficial. Video conferencing and telemedicine became more popular during the COVID-19 pandemic, demonstrating the effectiveness of using these technologies for CD on a global basis. In recent years, urine assays for gluten identification have become accessible for use at home. These tests could be helpful for CD monitoring with telemedicine assistance. The extended knowledge gathered from the COVID-19 pandemic is expected to complement pre-COVID-19 data supporting the usefulness of telemedicine even after the emergent pandemic, encouraging its wider adoption in standard clinical practice. The monitoring and follow-up of CD patients and other GFD-dependent conditions can greatly benefit from telemedicine.

Severe hypothyroidism due to thyroxine malabsorption in a patient with non-celiac gluten sensitivity after thyroidectomy: a rare case report

Severe hypothyroidism due to thyroxine malabsorption in a patient with non-celiac gluten sensitivity after thyroidectomy: a rare case report

Autoantibodies related to ataxia and other central nervous system manifestations of gluten enteropathy

Gluten ataxia and other central nervous system disorders could be linked to gluten enteropathy and related autoantibodies. In this narrative review, we focus on the various neuro-logical manifestations in patients with gluten sensitivity/celiac disease, immunological and autoimmune mechanisms of ataxia in connection to gluten sensitivity and the autoantibodies that could be used as a biomarker for diagnosing and following. We focused on the anti-gliadin antibodies, antibodies to different isoforms of tissue transglutaminase (TG) (anti-TG2, 3, and 6 antibodies), anti-glycine receptor antibodies, anti-glutamine acid decarboxylase antibodies, anti-deamidated gliadin peptides antibodies, etc. Most studies found a higher prevalence of these antibodies in patients with gluten sensitivity and neurological dysfunction, presented as different neurological disorders. We also discuss the role of a gluten-free diet on the clinical improvement of patients and also on imaging of these disorders.