A new proposal for the pathogenic mechanism of non-coeliac/non-allergic gluten/wheat sensitivity: Piecing together the puzzle of recent scientific evidence

Valentina Leccioli, Mara Oliveri, Marcello Romeo, Massimiliano Berretta, Paola Rossi

Research output: Contribution to journalReview articlepeer-review

Abstract

Non-coeliac/non-allergic gluten/wheat sensitivity (NCG/WS) is a gluten-related disorder, the pathogenesis of which remains unclear. Recently, the involvement of an increased intestinal permeability has been recognized in the onset of this clinical condition. However, mechanisms through which it takes place are still unclear. In this review, we attempt to uncover these mechanisms by providing, for the first time, an integrated vision of recent scientific literature, resulting in a new hypothesis about the pathogenic mechanisms involved in NCG/WS. According to this, the root cause of NCG/WS is a particular dysbiotic profile characterized by decreased butyrate-producing-Firmicutes and/or Bifidobacteria, leading to low levels of intestinal butyrate. Beyond a critical threshold of the latter, a chain reaction of events and vicious circles occurs, involving other protagonists such as microbial lipopolysaccharide (LPS), intestinal alkaline phosphatase (IAP) and wheat α-amylase trypsin inhibitors (ATIs). NCG/WS is likely to be a multi-factor-onset disorder, probably transient and preventable, related to quality and balance of the diet, and not to the presence of gluten in itself. If future studies confirm our proposal, this would have important implications both for the definition of the disease, as well as for the prevention and therapeutic-nutritional management of individuals with NCG/WS.

Original languageEnglish
Article number1203
Number of pages25
JournalNutrients
Volume9
Issue number11
DOIs
Publication statusPublished - Nov 1 2017

Keywords

  • Amylase trypsin inhibitors
  • Butyrate
  • Intestinal alkaline phosphatase
  • Lipopolysaccharide
  • Microbiota
  • Non-coeliac gluten/wheat sensitivity
  • Pathogenic mechanism

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

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