Non-celiac gluten sensitivity: literature review

Area of Science:

• Gastroenterology
• Immunology
• Dietary Science

Background:

• A significant portion of the population experiences adverse effects from wheat/gluten ingestion without having celiac disease (CD) or wheat allergy (WA).
• These individuals report both gastrointestinal and non-gastrointestinal symptoms, which improve on a gluten-free diet, leading to the definition of non-celiac gluten sensitivity (NCGS).

Purpose of the Study:

• To define the pathogenic, clinical, and diagnostic criteria for non-celiac gluten sensitivity (NCGS).
• To provide a practical framework for evaluating, diagnosing, and managing patients with NCGS.

Main Methods:

• A comprehensive review of international literature was conducted using PubMed and Medline.
• Search terms included "wheat (hyper)sensitivity," "wheat allergy," "wheat intolerance," "gluten (hyper)sensitivity," and "gluten intolerance."

Main Results:

• NCGS patients represent a heterogeneous group with varied pathogenesis and clinical presentations.
• Diagnosis of NCGS is established by excluding CD and WA.
• Potential diagnostic indicators include a history of food allergy, atopy, positive immunoglobulin G (IgG) antigliadin antibodies, and specific eosinophil counts.

Conclusions:

• Further research is needed to identify reliable biomarkers for NCGS diagnosis.
• Defining distinct NCGS subgroups is crucial for better understanding and management.
• Current diagnostic approaches rely on the exclusion of celiac disease and wheat allergy.