Non‐coeliac gluten sensitivity: piecing the puzzle together

Abstract

The avoidance of wheat-and gluten-containing products is a worldwide phenomenon. While coeliac disease is wellestablished, much remains unknown about whether gluten can be a trigger of gastrointestinal and/or extra-intestinal symptoms in patients without coeliac disease. In this article, we discuss the latest scientific evidence and our current understanding for the possible mechanisms of this largely ambiguous group, termed 'non-coeliac gluten sensitive' (NCGS). We can conclude that NCGS should be regarded as an independent disease outside of coeliac disease and wheat allergy, and that the number of patients affected is likely to be limited. Many questions remain unanswered and it needs to be verified whether the elimination of dietary gluten alone is sufficient for the control of symptoms, and to understand the overlap with other components of wheat.

Successful Pregnancy on a Gluten-Free Diet in a Woman with Seven Miscarriages and Nonceliac Gluten Sensitivity

“…The exact pathophysiology of NCGS is unknown (6)(7)(8). The innate immune system without adaptive immune response may be responsible.…”

“…Undiagnosed celiac disease has been linked to spontaneous abortion (3). Another entity, nonceliac gluten sensitivity (NCGS), refers to individuals whose symptoms improve with gluten withdrawal but in the absence of celiac disease (1,(6)(7)(8). These individuals lack histologic and classically serologic evidence of celiac disease, such as anti-tissue transglutaminase and antiendomysial antibodies, but elevated anti-gliadin immunoglobulin (Ig)G antibodies have been observed (9).…”

Difficulties in establishment of celiac syndrome diagnosis

“…Данная патология может быть заподо-зрена у пациентов с персистирующей кишечной и внеки-шечной симптоматикой, четко ассоциированной с прие-мом продуктов, содержащих Г, при отсутствии серологи-ческих маркеров Ц или подозрения на аллергию к пше-нице [1][2][3][4][5][6][7][8].…”

Successes and unsolved problems in the study of celiac disease

“…Клиническая картина ее складывается из сим-птомов, сходных с синдромом раздраженного кишечника, нару-шений поведения и системных проявлений: усталость, головная боль, фибромиалгия, онемение ног или рук, «туманный ум», дер-матит, депрессия, беспокойство, анемия. Симптомы возникают вскоре после употребления глютена, а улучшение или их полное исчезновение отмечается спустя несколько часов или дней после назначения БГД [35][36][37][38].…”