Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy.
Nutrients. 2018 Jul 16;10(7):910. doi: 10.3390/nu10070910.
The ingestion of gluten has been associated with gastrointestinal symptoms even in the absence of detectable immune responses. Little is known about the pathophysiological effects of gluten on the upper gastrointestinal tract. We aimed to assess whether the ingestion of gluten leads to an impairment of the physiological mechanisms of gastric emptying, gallbladder contraction and relaxation. A total of 17 healthy subjects underwent ultrasound evaluation of gastric emptying dynamics and gallbladder contractions at baseline and every 30 min after a standard gluten-containing and gluten-free meal (250 kcal, 70% carbohydrates). The pattern of gastric emptying was similar after a standard meal with or without gluten, but differed in terms of the peak of the antral filling curve, which was wider (mean area 5.69, median 4.70, range 3.71‒9.27 cm² vs. mean 4.89, median 4.57, 2.27‒10.22 cm², = 0.023) after the gluten-containing meal. The pattern of gallbladder contractions was different after the gluten-free meal ( < 0.05), with higher gallbladder volumes in the late refilling phases. The results of this study show that gluten ingestion exerts objective effects on gastric and gallbladder motility. Although the underlying pathophysiological mechanism remains unknown, these results could account for some of the gluten-related symptoms reported by patients with celiac disease and non-celiac gluten sensitivity.
即使在没有检测到免疫反应的情况下，摄入麸质也与胃肠道症状有关。关于麸质对上消化道的病理生理影响知之甚少。我们旨在评估摄入麸质是否会导致胃排空、胆囊收缩和松弛的生理机制受损。共有 17 名健康受试者在基线和标准含麸质和无麸质餐（250 卡路里，70%碳水化合物）后每 30 分钟进行一次超声胃排空动力学和胆囊收缩评估。标准餐中有无麸质的胃排空模式相似，但在胃窦充盈曲线的峰值方面存在差异，含麸质餐的峰值较宽（平均面积 5.69，中位数 4.70，范围 3.71-9.27 cm² 与均值 4.89，中位数 4.57，范围 2.27-10.22 cm²， = 0.023）。无麸质餐后胆囊收缩模式不同（ < 0.05），在后期充盈阶段胆囊体积较高。这项研究的结果表明，摄入麸质对胃和胆囊动力有客观影响。尽管潜在的病理生理机制尚不清楚，但这些结果可以解释乳糜泻和非乳糜泻麸质敏感性患者报告的一些与麸质相关的症状。
