Analysis of information sources in references of the Wikipedia article "Sensibilidade ao glúten não-celíaca" in Portuguese language version.
Cereals such as wheat and rye, when consumed in normal quantities, are only minor sources of FODMAPs in the daily diet. (...) Table 1. Sources of FODMAPs (...) Oligosaccharides (fructans and/or galactans). Cereals: wheat and rye when eaten in large amounts (eg, bread, pasta, couscous, crackers, biscuits)
Gluten sensitivity (GS) was originally described in the 1980s [1] and a recently “re-discovered” syndrome entity, characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA).
Since 2010, the definition of NCGS has been discussed at 3 consensus conferences, which led to 3 publications. Given the uncertainties about this clinical entity and the lack of diagnostic biomarkers, all 3 reports concluded that NCGS should be defined by the following exclusionary criteria: a clinical entity induced by the ingestion of gluten leading to intestinal and/or extraintestinal symptoms that resolve once the gluten-containing foodstuff is eliminated from the diet, and when celiac disease and wheat allergy have been ruled out.
According to the diagnostic criteria established by two Consensus Conferences (London 2011 and Munich 2012), the current view to NCGS diagnosis is based on symptom / manifestation evaluation along with the exclusion of CD and WA [5,7].
However, there is a great deal of skepticism within the scientific community questioning the existence of NCGS as a distinct clinical disorder. There are no strict diagnostic criteria and a placebo-controlled rechallenge trial has been recommended for diagnosis
Previous studies have shown that gliadin can cause an immediate and transient increase in gut permeability. This permeating effect is secondary to the binding of specific undigestible gliadin fragments to the CXCR3 chemokine receptor with subsequent release of zonulin, a modulator of intercellular tight junctions. This process takes place in all individuals who ingest gluten.
NCGS is a clinical condition in which intestinal and extraintestinal symptoms are triggered by gluten ingestion, in the absence of coeliac disease and wheat allergy. The symptoms usually occur soon after gluten ingestion, improve or disappear within hours or a few days after gluten withdrawal, and relapse following its reintroduction. ... Unlike coeliac disease and wheat allergy, NCGS is an unclear and controversial entity.
One of the most controversial and highly debated discussions concerns the role of gluten in causing NCGS. Recent reports have indicated that gluten might not be the cause of NCGS, and some investigators still question whether NCGS as a real clinical entity. (...) Cereals such as wheat and rye, when consumed in normal quantities, are only minor sources of FODMAPs in the daily diet (Table 1). Therefore, gluten-containing grains are not likely to induce IBS exclusively via FODMAPs. In contrast, there is growing evidence that other proteins that are unique to gluten-containing cereals can elicit an innate immune response that leads to NCGS, raising a nomenclature issue. For this reason, wheat sensitivity, rather than gluten sensitivity, seems to be a more appropriate term, keeping in mind that other gluten-containing grains such as barley and rye also can trigger the symptoms.
The new syndrome has been named non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS).
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(ajuda)more recent breeding of high yielding and highly pest-resistant wheat […] has led to a drastic increase of ATI content. […] Our finding of ATI as a potent stimulator of TLR4 in the intestine might not only be relevant to celiac disease, but is likely to have implications for patients with so-called gluten sensitivity and possibly for patients with irritable bowel syndrome, inflammatory bowel disease, and even nonintestinal inflammation.
The literature suggests that FODMAPs and not gluten per se are the triggers of gastrointestinal symptoms in patients that fit most of the proposed NCGS definitions
Wheat is a major source of fructans in the diet. (...) Table 1 Food sources of FODMAPs. (...) Oligosaccharides (fructans and/or galactans). Cereals: wheat & rye when eaten in large amounts (e.g. bread, pasta, couscous, crackers, biscuits)
On clinical and biopsy evidence, these patients are sensitive to gluten; therefore making a definition of coeliac disease even more difficult
Cereals such as wheat and rye, when consumed in normal quantities, are only minor sources of FODMAPs in the daily diet. (...) Table 1. Sources of FODMAPs (...) Oligosaccharides (fructans and/or galactans). Cereals: wheat and rye when eaten in large amounts (eg, bread, pasta, couscous, crackers, biscuits)
Gluten sensitivity (GS) was originally described in the 1980s [1] and a recently “re-discovered” syndrome entity, characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA).
Since 2010, the definition of NCGS has been discussed at 3 consensus conferences, which led to 3 publications. Given the uncertainties about this clinical entity and the lack of diagnostic biomarkers, all 3 reports concluded that NCGS should be defined by the following exclusionary criteria: a clinical entity induced by the ingestion of gluten leading to intestinal and/or extraintestinal symptoms that resolve once the gluten-containing foodstuff is eliminated from the diet, and when celiac disease and wheat allergy have been ruled out.
According to the diagnostic criteria established by two Consensus Conferences (London 2011 and Munich 2012), the current view to NCGS diagnosis is based on symptom / manifestation evaluation along with the exclusion of CD and WA [5,7].
However, there is a great deal of skepticism within the scientific community questioning the existence of NCGS as a distinct clinical disorder. There are no strict diagnostic criteria and a placebo-controlled rechallenge trial has been recommended for diagnosis
Previous studies have shown that gliadin can cause an immediate and transient increase in gut permeability. This permeating effect is secondary to the binding of specific undigestible gliadin fragments to the CXCR3 chemokine receptor with subsequent release of zonulin, a modulator of intercellular tight junctions. This process takes place in all individuals who ingest gluten.
NCGS is a clinical condition in which intestinal and extraintestinal symptoms are triggered by gluten ingestion, in the absence of coeliac disease and wheat allergy. The symptoms usually occur soon after gluten ingestion, improve or disappear within hours or a few days after gluten withdrawal, and relapse following its reintroduction. ... Unlike coeliac disease and wheat allergy, NCGS is an unclear and controversial entity.
One of the most controversial and highly debated discussions concerns the role of gluten in causing NCGS. Recent reports have indicated that gluten might not be the cause of NCGS, and some investigators still question whether NCGS as a real clinical entity. (...) Cereals such as wheat and rye, when consumed in normal quantities, are only minor sources of FODMAPs in the daily diet (Table 1). Therefore, gluten-containing grains are not likely to induce IBS exclusively via FODMAPs. In contrast, there is growing evidence that other proteins that are unique to gluten-containing cereals can elicit an innate immune response that leads to NCGS, raising a nomenclature issue. For this reason, wheat sensitivity, rather than gluten sensitivity, seems to be a more appropriate term, keeping in mind that other gluten-containing grains such as barley and rye also can trigger the symptoms.
The new syndrome has been named non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS).
|hdl-access=
requer |hdl=
(ajuda)more recent breeding of high yielding and highly pest-resistant wheat […] has led to a drastic increase of ATI content. […] Our finding of ATI as a potent stimulator of TLR4 in the intestine might not only be relevant to celiac disease, but is likely to have implications for patients with so-called gluten sensitivity and possibly for patients with irritable bowel syndrome, inflammatory bowel disease, and even nonintestinal inflammation.
The literature suggests that FODMAPs and not gluten per se are the triggers of gastrointestinal symptoms in patients that fit most of the proposed NCGS definitions
Wheat is a major source of fructans in the diet. (...) Table 1 Food sources of FODMAPs. (...) Oligosaccharides (fructans and/or galactans). Cereals: wheat & rye when eaten in large amounts (e.g. bread, pasta, couscous, crackers, biscuits)
On clinical and biopsy evidence, these patients are sensitive to gluten; therefore making a definition of coeliac disease even more difficult
However, there is a great deal of skepticism within the scientific community questioning the existence of NCGS as a distinct clinical disorder. There are no strict diagnostic criteria and a placebo-controlled rechallenge trial has been recommended for diagnosis
|hdl-access=
requer |hdl=
(ajuda)Gluten sensitivity (GS) was originally described in the 1980s [1] and a recently “re-discovered” syndrome entity, characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA).
|hdl-access=
requer |hdl=
(ajuda)more recent breeding of high yielding and highly pest-resistant wheat […] has led to a drastic increase of ATI content. […] Our finding of ATI as a potent stimulator of TLR4 in the intestine might not only be relevant to celiac disease, but is likely to have implications for patients with so-called gluten sensitivity and possibly for patients with irritable bowel syndrome, inflammatory bowel disease, and even nonintestinal inflammation.