Prevalenza ignota della sensibilità al glutine non celiaca
Sull’incidenza della sensibilità al glutine non celiaca al momento esistono solo stime che oscillano tra l’uno e il sei per cento della popolazione: un dato che supera quello della celiachia. La “cifra nera”, come nel caso della celiachia, è verosimilmente molto alta.
Si ritiene che la sensibilità al glutine non celiaca sia la più frequente tra le patologie indotte dal glutine come la celiachia e l’allergia al grano. Gli studi epidemiologici condotti sinora non sono stati in grado di confermare queste stime supportate, tra l’altro, dai risultati di un’indagine condotta in un centro di ricerca sulla celiachia negli Stati Uniti (Center for Celiac Research, University of Maryland). Tra il 2004 e il 2010 il sei per cento dei quasi 9.000 pazienti trattati rientravano nel quadro della sensibilità al glutine non celiaca e ne lamentavano i sintomi, senza che fosse diagnosticata una celiachia o un’allergia al grano.
Risultato della consensus conference sulle patologie correlate al glutine
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Opuscolo "La sensibilità al glutine non celiaca"
Questo opuscolo fornisce una panoramica sul glutine e sulla sensibilità al glutine, un argomento relativamente nuovo. Oltre alla definizione, alla sintomatologia, all'algoritmo diagnostico e al decorso vengono illustrate le diverse indicazioni terapeutiche e vengono presentati studi di casi pratici.
Opuscolo "La sensibilità al glutine non celiaca"
Questo opuscolo fornisce una panoramica sul glutine e sulla sensibilit...
Systematic review: non coeliac gluten sensitivity
Background
Non coeliac gluten sensitivity (NCGS) is a controversial emerging disorder. Despite reported symptoms related to the ingestion of gluten, NCGS remains a diagnosis based on the exclusion of coeliac disease, given the absence of reliable biomarkers.
Aim
To evaluate the prevalence, diagnostic exclusion of coeliac disease and the efficacy of a gluten-free diet (GFD) for NCGS patients.
Methods
A PubMed search was performed up to December 2014. According to consensus diagnostic criteria, NCGS was defined as self-reported gluten intolerance, negative coeliac serology and absence of villous atrophy. Studies evaluating the impact of a GFD on patients with irritable bowel syndrome (IBS) were also included.
Results
Prevalence rates of NCGS (0.5–13%) differed widely. Seventeen studies, including 1561 patients (26 children), met the inclusion criteria for NCGS. HLA haplotypes could not be linked to histology [normal or lymphocytic enteritis (LE)] in 1123 NCGS patients. HLADQ2/DQ8 haplotypes were present in 44% of NCGS patients. After advanced diagnostic techniques in 189 NCGS patients combining LE and HLADQ2/DQ8 haplotypes, 39 (20%) were reclassified as coeliac disease. There was a higher than expected family history of coeliac disease and autoimmune disorders in NCGS patients. A GFD resulted in variable results for variable, but significantly improved stool frequency in HLADQ2 positive diarrhoea-predominant IBS patients.
Conclusions
Prevalence rates for NCGS are extremely variable. A subset of NCGS patients might belong in the so-called ‘coeliac-lite’ disease. The benefit of a GFD for NCGS patients is currently controversial. HLADQ2 positive diarrhoea- type IBS patients might gain symptom improvement from a GFD.
Resource: Aliment Pharmacol Ther. 2015 May;41(9):807-20. doi: 10.1111/apt.13155. Epub 2015 Mar 6.
Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F.
Non coeliac gluten sensitivity (NCGS) is a controversial emerging disorder. Despite reported symptoms related to the ingestion of gluten, NCGS remains a diagnosis based on the exclusion of coeliac disease, given the absence of reliable biomarkers.
Aim
To evaluate the prevalence, diagnostic exclusion of coeliac disease and the efficacy of a gluten-free diet (GFD) for NCGS patients.
Methods
A PubMed search was performed up to December 2014. According to consensus diagnostic criteria, NCGS was defined as self-reported gluten intolerance, negative coeliac serology and absence of villous atrophy. Studies evaluating the impact of a GFD on patients with irritable bowel syndrome (IBS) were also included.
Results
Prevalence rates of NCGS (0.5–13%) differed widely. Seventeen studies, including 1561 patients (26 children), met the inclusion criteria for NCGS. HLA haplotypes could not be linked to histology [normal or lymphocytic enteritis (LE)] in 1123 NCGS patients. HLADQ2/DQ8 haplotypes were present in 44% of NCGS patients. After advanced diagnostic techniques in 189 NCGS patients combining LE and HLADQ2/DQ8 haplotypes, 39 (20%) were reclassified as coeliac disease. There was a higher than expected family history of coeliac disease and autoimmune disorders in NCGS patients. A GFD resulted in variable results for variable, but significantly improved stool frequency in HLADQ2 positive diarrhoea-predominant IBS patients.
Conclusions
Prevalence rates for NCGS are extremely variable. A subset of NCGS patients might belong in the so-called ‘coeliac-lite’ disease. The benefit of a GFD for NCGS patients is currently controversial. HLADQ2 positive diarrhoea- type IBS patients might gain symptom improvement from a GFD.
Resource: Aliment Pharmacol Ther. 2015 May;41(9):807-20. doi: 10.1111/apt.13155. Epub 2015 Mar 6.
Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F.
Systematic review: non coeliac gluten sensitivity
Background
Non coeliac gluten sensitivity (NCGS) is a controversial e...
Sensibilità al glutine – Le dimensioni epidemiologiche del fenomeno
Conferenza internazionale sulla sensibilità al glutine 2012 a Monaco, Germania
Sensibilità al glutine – Le dimensioni epidemiologiche del fenomeno
Conferenza internazionale sulla sensibilità al glutine 2012 a Monaco, ...
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