Posted on Wed, 7 Dec 16
Sensitivity to wheat in people without celiac disease is controversial, but a new study has found evidence of intestinal damage and helps us understand why some people develop symptoms.
“Wheat gluten and related proteins can trigger an autoimmune enteropathy, known as coeliac disease, in people with genetic susceptibility,” point out the authors of the new study. “However, some individuals experience a range of symptoms in response to wheat ingestion, without the characteristic serological or histological evidence of coeliac disease.”
To see if they could identify immune system dysfunction and intestinal changes in people with wheat sensitivity, but not celiac disease, the research team analyzed markers of intestinal cell damage and systemic immune response to microbial components to see if there was anything unusual.
They discovered that people with wheat sensitivity had evidence of immune activation (measured with increased serum levels of soluble CD14), leaky gut (lipopolysaccharide-binding protein & antibody reactivity to bacterial LPS and flagellin) and intestinal damage (fatty acid-binding protein 2 [FABP2]).
Furthermore, they also found that FABP2 and immune activation markers started to return to normal in a subgroup of individuals who excluded wheat and related cereals from their diets.
This remarkable study helps to identify objective biomarkers in people with wheat sensitivity, also known as non-celiac gluten sensitivity, as well as some of the mechanisms involved in the development of symptoms.
“Further research is needed to investigate the mechanism responsible for the intestinal damage and breach of the epithelial barrier, assess the potential use of the identified immune markers for the diagnosis of affected individuals and/or monitoring the response to specific treatment strategies, and examine potential therapies to counter epithelial cell damage and systemic immune activation in affected individuals,” said the investigators.
Uhde M, Ajamian M, Caio G, et al. Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. Gut. 2016 Jul 25.