Khalid Ayesha N, McMains Kevin C
aDepartment of Otolaryngology, Harvard Medical School, Boston, Massachusetts bDepartment of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA.
Curr Opin Otolaryngol Head Neck Surg. 2016 Jun;24(3):238-40. doi: 10.1097/MOO.0000000000000263.
In recent years, the concern over food sensitivities in general and gluten intolerance in particular has sharply increased. Patients and medical providers are awash in various claims about the potential implications of including or excluding gluten from the diet.
Three main conditions are described with respect to gluten: wheat allergy, celiac disease, and nonceliac gluten sensitivity (NCGS). Wheat allergy is a type 1 hypersensitivity reaction to nongluten proteins within wheat. Celiac disease is an autoimmune reaction to the gluten protein resulting in damage to the small intestine with genetic associations. NCGS is a diagnosis of exclusion and, to date, no biomarkers have been identified for this condition.
When evaluating and treating patients with potential reactions to gluten, it is important to distinguish among wheat allergy, celiac disease, and NCGS. Each condition has distinct dietary and treatment implications.
近年来，人们对食物过敏尤其是麸质不耐受的关注急剧增加。患者和医疗服务提供者被关于饮食中包含或排除麸质的潜在影响的各种说法所淹没。
关于麸质描述了三种主要情况：小麦过敏、乳糜泻和非乳糜泻性麸质敏感（NCGS）。小麦过敏是对小麦中非麸质蛋白的1型超敏反应。乳糜泻是对麸质蛋白的自身免疫反应，导致小肠损伤并与遗传因素相关。NCGS是一种排除性诊断，迄今为止，尚未确定该病症的生物标志物。
在评估和治疗可能对麸质有反应的患者时，区分小麦过敏、乳糜泻和NCGS很重要。每种情况都有不同的饮食和治疗意义。
