Di Liberto Diana, Carlisi Daniela, D'Anneo Antonella, Emanuele Sonia, Giuliano Michela, De Blasio Anna, Calvaruso Giuseppe, Lauricella Marianna
Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), CLADIBIOR, University of Palermo, 90127 Palermo, Italy.
Department of Biomedicine, Neurosciences and Advanced Diagnostics (BIND), Institute of Biochemistry, University of Palermo, 90127 Palermo, Italy.
Healthcare (Basel). 2020 Oct 14;8(4):400. doi: 10.3390/healthcare8040400.
A lifelong adherence to a gluten-free (GF) diet is currently the only treatment for Celiac disease (CD), an autoimmune disorder that arises after gluten ingestion in individuals who are genetically predisposed. The gluten intake exerts toxic effects through several pathways involving gut barrier integrity, intestinal microbiota composition and immune system stimulation. However, despite the great benefit of GF diet for CD patients, its use has been debated. Indeed, individuals who adopt this diet regime may be at risk of nutrient deficiencies. Emerging evidence supports a beneficial effect of a GF diet also for other pathological conditions, including gluten-related disorders (GRD) often associated to CD, such as Non celiac gluten sensitivity (NCGS) and Dermatitis Herpetiforme (DH) as well as Irritable bowel syndrome (IBS) and Diabetes. This suggests a pathogenic role of gluten in these conditions. Despite the growing popularity of GF diet among consumers, to date, there are limited evidences supporting its use for the management of non-celiac diseases. Therefore, in this review, we discuss whether the GF diet could really improve the general quality of life of patients with GRD and non-GRD conditions, keeping in mind its sensorial limitations and nutritional inadequacies. In addition, we discuss the current motivations, leading to the use of a GF diet, despite the inferior quality of GF products respect to those containing gluten.
目前,终身坚持无麸质(GF)饮食是治疗乳糜泻(CD)的唯一方法,乳糜泻是一种自身免疫性疾病,在具有遗传易感性的个体摄入麸质后引发。麸质的摄入通过涉及肠道屏障完整性、肠道微生物群组成和免疫系统刺激的多种途径产生毒性作用。然而,尽管GF饮食对CD患者有很大益处,但其使用一直存在争议。事实上,采用这种饮食方式的个体可能有营养缺乏的风险。新出现的证据支持GF饮食对其他病理状况也有有益作用,包括常与CD相关的麸质相关疾病(GRD),如非乳糜泻麸质敏感(NCGS)和疱疹样皮炎(DH)以及肠易激综合征(IBS)和糖尿病。这表明麸质在这些病症中具有致病作用。尽管GF饮食在消费者中越来越受欢迎,但迄今为止,支持其用于治疗非乳糜泻疾病的证据有限。因此,在本综述中,我们讨论GF饮食是否真的能改善GRD和非GRD病症患者的总体生活质量,同时牢记其感官局限性和营养不足。此外,我们还讨论了尽管GF产品质量不如含麸质产品,但目前导致人们使用GF饮食的动机。
Healthcare (Basel). 2020-10-14
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