Non-celiac wheat sensitivity is a newly described clinical entity characterized by symptoms, which can involve the gastrointestinal tract, the nervous system, the skin, and other organs.
There is little data on the pathogenesis of non-celiac wheat sensitivity and it is probable that different pathogenic mechanisms are involved in the different clinical manifestations of the disease.
The only common denominator of non-celiac wheat sensitivity “syndrome” is wheat consumption: the symptoms disappear on exclusion of wheat from the diet, and reappear on wheat consumption.
Dr Antonio Carroccio and colleagues from Italy reviewed our prior data regarding non-celiac wheat sensitivity and relevant medical literature regarding non-celiac wheat sensitivity, with particular attention to the hypothesis that non-celiac wheat sensitivity patients could suffer from non-immunoglobulin E (IgE)-mediated wheat allergy.
The researchers reviewed data on 276 patients diagnosed with non-celiac wheat sensitivity by means of double-blind placebo-controlled (DBPC) wheat challenge.
The data indicating a possible wheat allergy diagnosis were examined and other data in the literature were reviewed.
The research team reviewed the role of serum immunoglobulin G antibodies and the basophil activation assay in food allergy, and the histology findings in the food allergy diagnosis.
The comparison between patients suffering from non-celiac wheat sensitivity and presenting with irritable bowel syndrome (IBS) and controls with IBS not due to non-celiac wheat sensitivity showed that non-celiac wheat sensitivity was characterized by a personal history of food allergy in the pediatric age, coexistent atopic diseases, positive serum anti-gliadin, and anti-betalactoglobulin antibodies, positive cytofluorimetric assay revealing in vitro basophil activation by food antigens, and a presence of eosinophils in the intestinal mucosa biopsies.
Dr Carroccio's team concludes, "Patients with non-celiac wheat sensitivity and multiple food sensitivity show several clinical, laboratory, and histological characteristics that suggest they might be suffering from non-IgE-mediated food allergy."
"However, other pathogenic mechanisms need to be considered."