NECELIJAČNA GLUTENSKA SENZITIVNOST – DIJAGNOSTIČKI I TERAPIJSKI IZAZOV
DOI:
https://doi.org/10.46793/PP180314002MKljučne reči:
necelijačna glutenska senzitivnost, glutenom izazvane bolesti, patogenetski mehanizmi, bezglutenska dijetaApstrakt
Necelijačna glutenska senzitivnost (NCGS) predstavlja glutenom posredovano oboljenje kojem se, u poslednje vreme, pridaje velika pažnja zbog sve većeg broja pacijenata sa preosetljivošću na hranu koja sadrži gluten. Ovo je stanje kod kojeg ingestija hrane koja sadrži gluten, dovodi do imunoloških, morfoloških i simptomatskih manifestacija kod osoba kod kojih je isključeno postojanje celijakije i alergije na gluten. Epidemiološki podaci variraju od studije do studije, tako da se prevalenca kreće u rasponu od 0,6-6 %. Patogeneza je heterogena i još nedovoljno poznata. Dominantnu ulogu ima urođeni imunski odgovor uz druge faktore kao što su intestinalna inflamacija sa promenama u intestinalnoj mikrobioti i permeabilnosti. Karakteriše se gastrointestinalnim i ekstraintestinalnim simptomima koji se javljaju ubrzo nakon konzumiranja glutena, a povlače nakon uvođenja bezglutenske dijete. Nedostatak biomarkera je još uvek glavni ograničavajući faktor kliničkih studija, što otežava razlikovanje NCGS od drugih stanja izazvanih konzumacijom glutena. Buduće studije bi trebale definisati smernice i dati odgovore na pitanja vezana za patogenezu, dijagnostiku i terapijski pristup NCGS.
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