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Intestinal, Systemic, and Oral Gluten-related Alterations in Patients With Nonceliac Gluten Sensitivity
- Source :
- Journal of clinical gastroenterology. 50(10)
- Publication Year :
- 2016
-
Abstract
- Background: Nonceliac gluten sensitivity (NCGS) is an emergent condition, the framework of which is yet unclear, whereas the diagnosis is suggested only by gluten-dependent symptoms after excluding wheat allergy and celiac disease (CD). Our goal was to highlight intestinal, systemic, and oral alterations to clarify the NCGS pathogenesis and identify new diagnostic tools. Study: A total of 60 NCGS patients, 20 untreated CD, 20 treated CD, and 20 healthy volunteers were recruited. The differential diagnosis among gluten-related disorders was performed by serological, allergy, and histologic tools. NCGS patients were also subjected to antigliadin antibody (AGA) detection and HLA typing. All participants underwent an oral mucosa patch test for gluten (GOMPT), whereas an oral provocation test (OPT) for gluten was performed in 26 NCGS patients. Results: About 6/60 (10%) NCGS patients showed IgG AGA-positive results, whereas 45/60 (75%) patients carried HLA-DQ2 and/or HLA-DQ8 genes. GOMPT showed positive results in 45/60 (75%) NCGS patients, 3/20 (15%) untreated CD patients, 5/20 (25%) treated CD patients, and in no healthy volunteers. No significant difference was found between the severity of symptoms reported by NCGS patients subjected to OPT with gluten-containing croissants and those who underwent OPT with gluten-free croissants. Conclusions: GOMPT seems to be a specific tool for NCGS diagnosis, although further investigations are needed to overcome limits due to the small population studied and to contextualize GOMPT false-positive results.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Allergy
Adolescent
Glutens
Gastrointestinal Diseases
Population
Gastroenterology
Severity of Illness Index
03 medical and health sciences
Diet, Gluten-Free
Young Adult
0302 clinical medicine
Internal medicine
Severity of illness
medicine
Humans
Oral mucosa
education
Aged
chemistry.chemical_classification
education.field_of_study
business.industry
Case-control study
nutritional and metabolic diseases
Middle Aged
medicine.disease
Gluten
Immunohistochemistry
Abdominal Pain
030104 developmental biology
medicine.anatomical_structure
chemistry
Case-Control Studies
Immunology
030211 gastroenterology & hepatology
Gluten free
Female
business
Wheat allergy
Food Hypersensitivity
Subjects
Details
- ISSN :
- 15392031
- Volume :
- 50
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Journal of clinical gastroenterology
- Accession number :
- edsair.doi.dedup.....cd67c546147111b6a9eae32a0d2ca057