Non-Celiac Gluten sensitivity: the new frontier of gluten related disorders

Nutrients 2013, 5(10), 3839-3853; doi:10.3390/nu5103839

Review

Carlo Catassi ¹, Julio C. Bai ², Bruno Bonaz ³, Gerd Bouma ⁴, Antonio Calabrò ⁵, Antonio Carroccio ⁶, Gemma Castillejo ⁷, Carolina Ciacci ⁸,Fernanda Cristofori ⁹, Jernej Dolinsek ¹⁰, Ruggiero Francavilla ⁹, Luca Elli ¹¹, Peter Green ¹², Wolfgang Holtmeier ¹³, Peter Koehler ¹⁴, Sibylle Koletzko ¹⁵, Christof Meinhold ¹⁶, David Sanders ¹⁷, Michael Schumann ¹⁸, Detlef Schuppan ^19,20, Reiner Ullrich ¹⁸, Andreas Vécsei ²¹,Umberto Volta ²², Victor Zevallos ¹⁹, Anna Sapone ²³ and Alessio Fasano ^24,* 

+ Authors' affiliations

Received: 20 August 2013; in revised form: 17 September 2013 / Accepted: 18 September 2013 / Published: 26 September 2013

(This article belongs to the Special Issue Nutrition and Celiac Disease)

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Abstract: Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s 

and recently a “re-discovered” disorder characterized by intestinal and extra-intestinal symptoms 

related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac 

disease (CD) or wheat allergy (WA). Although NCGS frequency is still unclear, epidemiological data 

have been generated that can help establishing the magnitude of the problem. Clinical studies 

further defined the identity of NCGS and its implications in human disease. An overlap between the 

irritable bowel syndrome (IBS) and NCGS has been detected, requiring even more stringent 

diagnostic criteria. Several studies suggested a relationship between NCGS and neuropsychiatric 

disorders, particularly autism and schizophrenia. The first case reports of NCGS in children have been 

described. Lack of biomarkers is still a major limitation of clinical studies, making it difficult to 

differentiate NCGS from other gluten related disorders. Recent studies raised the possibility that, 

beside gluten, wheat amylase-trypsin inhibitors and low-fermentable, poorly-absorbed, short-chain 

carbohydrates can contribute to symptoms (at least those related to IBS) experienced by NCGS 

patients. In this paper we report the major advances and current trends on NCGS.

Keywords: gluten sensitivity; celiac disease; wheat allergy; gluten-related disorders; gluten-free diet