Marchioni Beery Renée M, Birk John W
Division of Gastroenterology and Hepatology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-1845, USA.
Expert Rev Gastroenterol Hepatol. 2015 Jun;9(6):851-64. doi: 10.1586/17474124.2015.1032252. Epub 2015 Apr 3.
Wheat-related disorders have become a growing area of clinical and scientific interest and can be categorized broadly as: autoimmune-mediated; allergic; and non-autoimmune/non-allergic conditions. Non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) present on this spectrum as disorders associated with adverse gastrointestinal and extra-intestinal manifestations following exposure to gluten and/or other wheat-related constituents. NCGS/NCWS is increasingly considered in patients with unexplained symptoms after the exclusions of celiac disease and wheat allergy. As objective diagnostic data and specific biomarkers are lacking, response to a gluten-free/wheat-free diet can confirm the presence of NCGS/NCWS. An association with irritable bowel syndrome has been detected, and the effects of other food components, such as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, may contribute. Our organization and synthesis of extant knowledge pertaining to wheat-related disorders may advance current practice and research efforts toward an improved understanding of NCGS/NCWS as an evolving clinical entity.
与小麦相关的病症已成为临床和科学领域日益关注的领域，大致可分为：自身免疫介导的；过敏性的；以及非自身免疫/非过敏性病症。非乳糜泻麸质敏感（NCGS）和非乳糜泻小麦敏感（NCWS）在此范围内表现为在接触麸质和/或其他与小麦相关的成分后出现的与不良胃肠道和肠外表现相关的病症。在排除乳糜泻和小麦过敏后，有不明症状的患者越来越多地被考虑患有NCGS/NCWS。由于缺乏客观诊断数据和特定生物标志物，对无麸质/无小麦饮食的反应可证实NCGS/NCWS的存在。已检测到与肠易激综合征有关联，其他食物成分，如可发酵寡糖、双糖、单糖和多元醇的影响可能也起作用。我们对与小麦相关病症的现有知识进行的整理和综合，可能会推动当前的实践和研究工作，以更好地理解NCGS/NCWS这一不断演变的临床实体。
