NON CELIAC GLUTEN SENSIVITY- DIAGNOSTIC AND THERAPEUTIC CHALLENGES
DOI:
https://doi.org/10.46793/PP180314002MKeywords:
non celiac gluten sensitivity, gluten-induced diseases, mechanisms of pathogenesis, gluten free dietAbstract
Non celiac gluten sensitivity (NCGS) is a gluten-mediated disease which has, from recently, pays great attention due to an increasing number of a patients with hypersensitivity to gluten-containing food. NCGS is a condition in which ingestion of gluten-containing food leads to immunological, morphological and symptomatic manifestations, in persons with excluded the existence of celiac disease or wheat allergy. Epidemiological data vary from study to study, so the prevalence ranges from 0.6 to 6%. The pathogenesis is heterogeneous and still not well-known. The dominant role has an innate immune response, along with other factors, such as intestinal inflammation with changes in intestinal microbiota and permeability. It is characterized by gastrointestinal and extra-intestinal symptoms that occur shortly after consuming gluten-containig food, and withdraw after the beginning of use of a gluten-free diet. A lack of biomarkers is still the main limiting factor in clinical studies, which makes it difficult to differentiate NCGS from other gluten related disorders. Future studies should define guidelines and provide answers to questions related to pathogenesis, diagnosis and therapeutic approach to NCGS.
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