Gluten: do only celiac patients benefit from its removal from the diet?

ABSTRACT

Gluten is the most common protein in wheat and is related to different pathogeneses. There are three main gluten-related disorders: celiac disease (CD), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS). Clinical manifestations are strictly related in all of them, such as abdominal pain and distention, however the development pathways may differ. The diagnosis criteria are also different, in CD features immunological markers such as IgA, while WA presents IgE markers, and NCGS does not have any specific immunological marker. The consumption of wheat, and consequently gluten-related products, is historical and it has grown over human evolution, which leads us to question what role this component plays in other diseases, and the consequence of a gluten-free diet (GFD). GFD is the treatment with major efficacy in CD and, likewise, is related with improvements in neuropathologies (autism spectrum disorder, anxiety, depression and schizophrenia), obesity, and the gut microbiome. Further investigation is required. GFD studies in people who do not present CD seem to be safe, especially when products containing gluten are not replaced by processed gluten-free products but by minimally processed foods, and also when the food strategy is accompanied by a qualified professional.

KEYWORDS:

• Gluten
• celiac disease
• wheat allergy
• non-celiac gluten sensitivity
• gluten free diet

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

L.R.d.S.F. was responsible for reviewing the literature and writing—original draft preparation of the article; A.C.P.M.d.S. was responsible for reviewing the literature and elaboration of the figures; F.E.D.A.F was responsible for reviewing the literature and writing; I.G.V. was responsible for reviewing the literature and elaboration of the figures; writing, review and editing; D.G.N. writing, review and editing; C.E.d.F.J. writing, review and editing; M.V.C.d.A. writing, review and editing; J.K.F. writing, review and editing; R.G.L. writing, review and editing; G.F. was responsible for the study design, supervision and drafted the manuscript. All authors have read and agreed to the published version of the manuscript.

Additional information

Funding

The published author (s) did not receive the following financial support for the research, authorship and/or publication of this article.