Advertisement

Virchows Archiv

, Volume 473, Issue 2, pp 229–234 | Cite as

Duodenal histological features in suspected non-celiac gluten sensitivity: new insights into a still undefined condition

  • Barbara Zanini
  • Vincenzo Villanacci
  • Monica Marullo
  • Moris Cadei
  • Francesco Lanzarotto
  • Anna Bozzola
  • Chiara Ricci
Brief Report

Introduction

Since the late seventies, when gluten-related disorders were first described, up to nowadays, non-celiac gluten sensitivity or non-celiac wheat sensitivity (NCGS/NCWS) is still a not well-defined clinical entity.

Epidemiological data are inconsistent providing a wide range of prevalence from 0.5 to 13% in Western countries [1]. The clinical spectrum of this condition is characterized by the presence, in different association, of gastrointestinal (especially bloating and abdominal pain/discomfort with or without alteration in bowel movement) and extra-intestinal symptoms (fatigue, headache, joint pain, foggy mind, and so forth) with a wide overlap of its presentation with irritable bowel syndrome (IBS), other functional gastrointestinal disorders, and other organic etiologies such as bacterial or parasitic infections, autoimmune disorders, and inflammatory bowel diseases (IBD).

In June 2015, Salerno Experts’ criteria were published with the proposal of a double (or...

Notes

Compliance with ethical standards

The authors declare that the study has been done according to ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical responsibilities of authors section

All the authors are qualified for the following criteria:

• Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work;

• Drafting the work or revising it critically for important intellectual content;

• Final approval of the version to be published; and

• Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

References

  1. 1.
    Molina-Infante J, Carroccio A (2017) Suspected nonceliac gluten sensitivity confirmed in few patients after gluten challenge in double-blind, placebo-controlled trials. Clin Gastroenterol Hepatol 15:339–348CrossRefPubMedGoogle Scholar
  2. 2.
    Catassi C, Elli L, Bonaz B, Bouma C, Carroccio A, Castilllejo G et al (2015) Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts’ criteria. Nutrients 7:4966–4977CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Gibson P, Skodje GI, Lundin KEA (2017) Non-coeliac gluten sensitivity. J Gastroenterol Hepatol 32(Suppl 1):86–89CrossRefPubMedGoogle Scholar
  4. 4.
    Uhde M, Ajamian M, Caio G, De Giorgio R, Indart A, Green PH et al (2016) Markers of intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of celiac disease. Gut 63(11):1930–1937CrossRefGoogle Scholar
  5. 5.
    Talley NJ, Walker MM (2017) Celiac disease and nonceliac gluten or wheat sensitivity. The Risks and Benefits of Diagnosis JAMA 177(5):615–616Google Scholar
  6. 6.
    Lanzini A, Lanzarotto F, Villanacci V, Mora A, Bertolazzi S, Turini D et al (2009) Complete recovery of intestinal mucosa occurs very rarely in adult celiac patients despite adherence to gluten free diet. Aliment Pharmacol Ther 29(12):1299–1308CrossRefPubMedGoogle Scholar
  7. 7.
    Zanini B, Baschè R, Ferraresi A, Ricci C, Lanzarotto F, Marullo M, Villanacci V, Hidalgo A, Lanzini A (2015) A randomised clinical study: gluten challenge induces symptom recurrence in only a minority of patients who meet clinical criteria for non-coeliac gluten sensitivity. Aliment Pharmacol Ther 42:968–976CrossRefPubMedGoogle Scholar
  8. 8.
    Ravelli A, Villanacci V (2012) Tricks of the trade: how to avoid histological pitfalls in celiac disease. Pathol Res Pract 208(4):197–202CrossRefPubMedGoogle Scholar
  9. 9.
    Villanacci V, Ceppa P, Tavani E, Vindigni C, Volta U (2011) Coeliac disease: the histology report. Dig Liver Dis 43(Suppl 4):S385–S395CrossRefPubMedGoogle Scholar
  10. 10.
    Walker MM, Murray JA, Ronkainen J, Aro P, Storskrubb T, D’Amato M et al (2010) Detection of celiac disease and lymphocytic enteropathy by parallel serology and histopathology in a population-based study. Gastroenterology 139(1):112–119CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hayat M, Cairns A, Dixon MF, O’Mahony S (2002) Quantitation of intraepithelial lymphocytes in human duodenum: what is normal? J Clin Pathol 55(5):393–394CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Hurrell JM, Genta RM, Meltin SD (2011) Histopathologic diagnosis of eosinophilic conditions in the gastrointestinal tract. Adv Anat Pathol 18(5):335–348CrossRefPubMedGoogle Scholar
  13. 13.
    Corazza GR, Villanacci V, Zambelli C, Milione M, Luinetti O, Vindigni C, Chioda C, Albarello L, Bartolini D, Donato F (2007) Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease. Clin Gastroenterol Hepatol 5:838–843CrossRefPubMedGoogle Scholar
  14. 14.
    Oberhuber G, Granditsch G, Vogelsang H (1999) The histopathology of coeliac disease: time for a standardized report scheme of pathologists. Eur J Gastro Hepatol 11:1185–1194CrossRefGoogle Scholar
  15. 15.
    Bardella MT, Elli L, Ferretti F (2016) Non celiac gluten sensitivity. Curr Gastroenterol Rep 18(12):63CrossRefPubMedGoogle Scholar
  16. 16.
    Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F (2015) Systematic review: nonceliac gluten sensitivity. Aliment Pharmacol Ther 41:807–820CrossRefPubMedGoogle Scholar
  17. 17.
    Watkins RD, Zawahir S (2017) Celiac disease and nonceliac gluten sensitivity. Pediatr Clin N Am 64:563–576CrossRefGoogle Scholar
  18. 18.
    Rothenberg ME, Hogan SP (2006) The eosinophil. Annu Rev Immunol 24:147–174CrossRefPubMedGoogle Scholar
  19. 19.
    Villanacci V, Lanzini A, Lanzarotto F, Ricci C (2013) Observations on the paper of Carroccio et al. “non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity”. Am J Gastroenterol 108:619–620CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Gastroenterology Unit, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
  2. 2.Institute of Pathology Spedali CiviliBresciaItaly

Personalised recommendations