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非乳糜泻麸质敏感与肠易激综合征:寻找病因

Non-Celiac Gluten Sensitivity and Irritable Bowel Disease: Looking for the Culprits.

作者信息

Koumbi Lemonica, Giouleme Olga, Vassilopoulou Emilia

机构信息

Department of Nutritional Sciences and Dietetics, International Hellenic University (IHU), Thessaloniki, Greece.

Medical School, Aristotle University, Thessaloniki, Greece.

出版信息

Curr Dev Nutr. 2020 Dec 31;4(12):nzaa176. doi: 10.1093/cdn/nzaa176. eCollection 2020 Dec.


DOI:10.1093/cdn/nzaa176
PMID:33442571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7788486/
Abstract

During the last 30 y, a gluten-free diet has been classified among the most popular fad diets mainly due to the ambiguous notion that gluten avoidance promotes health. Gluten intolerance has been implicated in non-celiac gluten sensitivity (NCGS) and irritable bowel syndrome (IBS), 2 disorders with overlapping symptoms and increasing trend. Together with gluten, other wheat components; fermentable oligo-, di-, monosaccharide, and polyols (FODMAPs); and amylase trypsin inhibitors (ATIs), are implicated in the pathogenesis of both disorders. Gut microflora alterations in IBS and NCGS have been described, while microbiota manipulations have been shown to be promising in some IBS cases. This literature review summarizes our current knowledge on the impact of wheat ingredients (gluten, FODMAPs, and ATIs) in IBS and NCGS. In both disorders, FODMAPs and ATIs trigger gut dysbiosis, suggesting that gluten may not be the culprit, and microbiota manipulations can be applied in diagnostic and intervention approaches.

摘要

在过去30年里,无麸质饮食已被列为最流行的时尚饮食之一,主要是因为人们普遍认为避免摄入麸质有益健康,但这种观念并不明确。麸质不耐受与非乳糜泻性麸质敏感(NCGS)和肠易激综合征(IBS)有关,这两种疾病症状重叠且呈上升趋势。除了麸质,小麦的其他成分,如可发酵的寡糖、二糖、单糖和多元醇(FODMAPs)以及淀粉酶胰蛋白酶抑制剂(ATIs),也与这两种疾病的发病机制有关。已有研究描述了IBS和NCGS患者肠道微生物群的改变,而微生物群调节在一些IBS病例中已显示出前景。这篇文献综述总结了我们目前对小麦成分(麸质、FODMAPs和ATIs)对IBS和NCGS影响的认识。在这两种疾病中,FODMAPs和ATIs都会引发肠道菌群失调,这表明麸质可能并非罪魁祸首,微生物群调节可应用于诊断和干预方法中。

相似文献

[1]
Non-Celiac Gluten Sensitivity and Irritable Bowel Disease: Looking for the Culprits.

Curr Dev Nutr. 2020-12-31

[2]
Gluten and FODMAPS-Sense of a Restriction/When Is Restriction Necessary?

Nutrients. 2019-8-20

[3]
IRRITABLE BOWEL SYNDROME, FOOD INTOLERANCE AND NON- CELIAC GLUTEN SENSITIVITY. A NEW CLINICAL CHALLENGE.

Arq Gastroenterol. 2018

[4]
No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.

Gastroenterology. 2013-5-4

[5]
The Role of a Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet in Nonceliac Gluten Sensitivity.

Gastroenterol Res Pract. 2018-8-6

[6]
The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update.

Nutrients. 2017-11-21

[7]
[Non-celiac gluten sensitivity: a critical review of current evidence].

Gastroenterol Hepatol. 2014

[8]
Sensitivity to wheat, gluten and FODMAPs in IBS: facts or fiction?

Gut. 2015-6-15

[9]
New insights in IBS-like disorders: Pandora's box has been opened; a review.

Gastroenterol Hepatol Bed Bench. 2017

[10]
Fermentable oligo-, di-, monosaccharides, and polyols (FODMAPs), but not gluten, elicit modest symptoms of irritable bowel syndrome: a double-blind, placebo-controlled, randomized three-way crossover trial.

Am J Clin Nutr. 2022-2-9

引用本文的文献

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[2]
Lower Diversity of Amylase-Trypsin Inhibitors and -Released Opioid-Containing Peptides in Ancestral Compared to Modern Wheat Varieties Assessed by Proteomics and Peptidomics.

J Agric Food Chem. 2025-1-29

[3]
Gluten Unraveled: Latest Insights on Terminology, Diagnosis, Pathophysiology, Dietary Strategies, and Intestinal Microbiota Modulations-A Decade in Review.

Nutrients. 2024-10-25

[4]
The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome.

J Clin Med. 2024-8-29

[5]
Efficacy of Different Dietary Patterns in the Treatment of Functional Gastrointestinal Disorders in Children and Adolescents: A Systematic Review of Intervention Studies.

Nutrients. 2023-6-10

[6]
Consumption of Tritordeum Bread Reduces Immunogenic Gluten Intake without Altering the Gut Microbiota.

Foods. 2022-5-16

本文引用的文献

[1]
Gut Microbiota Profiles Differ among Individuals Depending on Their Region of Origin: An Italian Pilot Study.

Int J Environ Res Public Health. 2019-10-23

[2]
Gluten and FODMAPS-Sense of a Restriction/When Is Restriction Necessary?

Nutrients. 2019-8-20

[3]
Irritable Bowel Syndrome and Dietary Interventions.

Gastroenterol Hepatol (N Y). 2019-1

[4]
Tolerability of FODMAP - reduced diet in irritable bowel syndrome - efficacy, adherence, and body weight course.

Z Gastroenterol. 2019-6

[5]
Gut microbiota diversity across ethnicities in the United States.

PLoS Biol. 2018-12-4

[6]
First Insights into the Gut Microbiota of Mexican Patients with Celiac Disease and Non-Celiac Gluten Sensitivity.

Nutrients. 2018-11-2

[7]
The Importance of Energy Balance.

Eur Endocrinol. 2013-8

[8]
Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity.

Clin Nutr. 2018-4-4

[9]
Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients.

Gastroenterol Hepatol (N Y). 2018-2

[10]
Wheat amylase-trypsin inhibitors exacerbate intestinal and airway allergic immune responses in humanized mice.

J Allergy Clin Immunol. 2018-3-21

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