Nijeboer Petula, Mulder Chris J J, Bouma Gerd
VU medisch centrum, afd. Maag-, Darm- en Leverziekten, Amsterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2013;157(21):A6168.
Coeliac disease is an immune-mediated inflammation of the small intestine caused by sensitivity to dietary gluten and related proteins in genetically sensitive individuals. Recently, a novel gluten-related disorder has gained significant interest from the scientific community and mass media. This condition, known as non-coeliac gluten sensitivity, is characterised by gastrointestinal or extra-intestinal symptoms that respond to gluten withdrawal without evidence of underlying coeliac disease. Its symptoms overlap considerably with those of irritable bowel syndrome and the number of individuals embracing a gluten-free diet is rapidly growing. No discriminative markers to support a diagnosis of gluten sensitivity have been identified; the perceived response to a gluten-free diet after exclusion of coeliac disease is currently the best diagnostic and therapeutic marker. Its pathogenesis remains obscure but may be related to non-gliadin molecules in grains that stimulate the innate immune system of the intestine. Here, we summarise the current knowledge on this novel condition.
乳糜泻是一种免疫介导的小肠炎症，由遗传敏感个体对饮食中的麸质及相关蛋白质敏感所致。最近，一种新型麸质相关疾病引起了科学界和大众媒体的极大关注。这种疾病被称为非乳糜泻性麸质敏感，其特征是胃肠道或肠外症状在戒食麸质后有所缓解，且无潜在乳糜泻的证据。其症状与肠易激综合征有很大重叠，采用无麸质饮食的人数正在迅速增加。目前尚未发现支持麸质敏感诊断的鉴别标志物；排除乳糜泻后对无麸质饮食的明显反应是目前最佳的诊断和治疗标志物。其发病机制尚不清楚，但可能与谷物中的非麦醇溶蛋白分子刺激肠道固有免疫系统有关。在此，我们总结了关于这种新疾病的现有知识。
