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Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity.

Caio G, Volta U, Tovoli F, De Giorgio R - BMC Gastroenterol (2014)

Bottom Line: Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers.There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition.In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical and Surgical Sciences, St, Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, 40138 Bologna, Italy. umberto.volta@aosp.bo.it.

ABSTRACT

Background: Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to characterize the effect of the gluten-free diet on anti-gliadin antibodies of IgG class in patients with non-celiac gluten sensitivity.

Methods: Anti-gliadin antibodies of both IgG and IgA classes were assayed by ELISA in 44 non-celiac gluten sensitivity and 40 celiac disease patients after 6 months of gluten-free diet.

Results: The majority of non-celiac gluten sensitivity patients (93.2%) showed the disappearance of anti-gliadin antibodies of IgG class after 6 months of gluten-free diet; in contrast, 16/40 (40%) of celiac patients displayed the persistence of these antibodies after gluten withdrawal. In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response.

Conclusions: Anti-gliadin antibodies of the IgG class disappear in patients with non-celiac gluten sensitivity reflecting a strict compliance to the gluten-free diet and a good clinical response to gluten withdrawal.

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Related in: MedlinePlus

IgG antigliadin antibodies before and after GFD in NCGS patients: anti-gliadin antibodies (AGA) of IgG class before and after gluten free diet (GFD) in patients with non-celiac gluten sensitivity (NCGS). Only three of the 44 patients studied showed persistence of AGA IgG at a low titre after gluten withdrawal.
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Figure 1: IgG antigliadin antibodies before and after GFD in NCGS patients: anti-gliadin antibodies (AGA) of IgG class before and after gluten free diet (GFD) in patients with non-celiac gluten sensitivity (NCGS). Only three of the 44 patients studied showed persistence of AGA IgG at a low titre after gluten withdrawal.

Mentions: AGA IgG persisted positive only in 3 (6.8%) out of the 44 NCGS patients tested after 6 months of gluten withdrawal (Figure 1). AGA IgG persistence after GFD was significantly correlated with the low degree of compliance with gluten-free diet and with a mild clinical response (P = 0.009 and P = 0.00075, two-tailed Fisher’s exact test, respectively) (Table 1). AGA IgG disappeared in 40 out of the 41 NCGS patients who followed a strict GFD and remained positive in 2 out of the 3 low compliers admitting frequently dietary lapses. Of the 39 NCGS patients classified as good responders to the diet on the basis of the disappearance or significant improvement of intestinal and extra-intestinal symptoms, none maintained the positivity for AGA IgG. On the contrary, these antibodies were still detected in 3 out of the 5 patients assessed as mild responders to gluten withdrawal due to a partial resolution of clinical symptoms. In the CD group the persistence of AGA IgG after 6 months of GFD did not show any correlation either with the compliance to the diet or the clinical response following the gluten-free regimen (Figure 2). AGA IgG persistence was detected in 13 (40.6%) out of the 32 strict compliers and in 3 (37.5%) out of the 8 low compliers. There was no significant difference for AGA IgG persistence in treated CD between good (43.3%) and mild responders (30%).


Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity.

Caio G, Volta U, Tovoli F, De Giorgio R - BMC Gastroenterol (2014)

IgG antigliadin antibodies before and after GFD in NCGS patients: anti-gliadin antibodies (AGA) of IgG class before and after gluten free diet (GFD) in patients with non-celiac gluten sensitivity (NCGS). Only three of the 44 patients studied showed persistence of AGA IgG at a low titre after gluten withdrawal.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3926852&req=5

Figure 1: IgG antigliadin antibodies before and after GFD in NCGS patients: anti-gliadin antibodies (AGA) of IgG class before and after gluten free diet (GFD) in patients with non-celiac gluten sensitivity (NCGS). Only three of the 44 patients studied showed persistence of AGA IgG at a low titre after gluten withdrawal.
Mentions: AGA IgG persisted positive only in 3 (6.8%) out of the 44 NCGS patients tested after 6 months of gluten withdrawal (Figure 1). AGA IgG persistence after GFD was significantly correlated with the low degree of compliance with gluten-free diet and with a mild clinical response (P = 0.009 and P = 0.00075, two-tailed Fisher’s exact test, respectively) (Table 1). AGA IgG disappeared in 40 out of the 41 NCGS patients who followed a strict GFD and remained positive in 2 out of the 3 low compliers admitting frequently dietary lapses. Of the 39 NCGS patients classified as good responders to the diet on the basis of the disappearance or significant improvement of intestinal and extra-intestinal symptoms, none maintained the positivity for AGA IgG. On the contrary, these antibodies were still detected in 3 out of the 5 patients assessed as mild responders to gluten withdrawal due to a partial resolution of clinical symptoms. In the CD group the persistence of AGA IgG after 6 months of GFD did not show any correlation either with the compliance to the diet or the clinical response following the gluten-free regimen (Figure 2). AGA IgG persistence was detected in 13 (40.6%) out of the 32 strict compliers and in 3 (37.5%) out of the 8 low compliers. There was no significant difference for AGA IgG persistence in treated CD between good (43.3%) and mild responders (30%).

Bottom Line: Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers.There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition.In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical and Surgical Sciences, St, Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 9, 40138 Bologna, Italy. umberto.volta@aosp.bo.it.

ABSTRACT

Background: Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to characterize the effect of the gluten-free diet on anti-gliadin antibodies of IgG class in patients with non-celiac gluten sensitivity.

Methods: Anti-gliadin antibodies of both IgG and IgA classes were assayed by ELISA in 44 non-celiac gluten sensitivity and 40 celiac disease patients after 6 months of gluten-free diet.

Results: The majority of non-celiac gluten sensitivity patients (93.2%) showed the disappearance of anti-gliadin antibodies of IgG class after 6 months of gluten-free diet; in contrast, 16/40 (40%) of celiac patients displayed the persistence of these antibodies after gluten withdrawal. In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response.

Conclusions: Anti-gliadin antibodies of the IgG class disappear in patients with non-celiac gluten sensitivity reflecting a strict compliance to the gluten-free diet and a good clinical response to gluten withdrawal.

Show MeSH
Related in: MedlinePlus