Autoimmune Diseases And Serum Anti-Nuclear Antibodies Positivity In Non-Celiac Wheat Sensitivity Patients
Condition: Non-Celiac Wheat Sensitivity
MeSH terms: Hypersensitivity; Autoimmune Diseases
Study type: Observational

Summary: 
      Celiac disease (CD) is an immune-based reaction to dietary gluten (storage protein for wheat,
      barley, and rye) that primarily affects the small intestine in genetically predisposed
      patients and resolves with exclusion of gluten from the diet. Patients with CD show
      circulating autoantibodies (anti-transglutaminase, anti-tTG) and suffer from the destruction
      of a specific tissue cell type (the enterocytes) by CD8+ T cells. Furthermore, other
      autoimmune diseases have been reported in association to CD in 20-30% of the cases. In the
      last few year, a new clinical entity emerged, which seems include patients who consider
      themselves to be suffering from problems caused by wheat and/or gluten ingestion, even though
      they do not have CD or wheat allergy. This clinical condition has been named "Non-Celiac
      Gluten Sensitivity" (6), but, in a recent paper, the investigators suggested the term
      "Non-Celiac Wheat Sensitivity" (NCWS), since, to date, it is not known what component of
      wheat really causes the symptoms. The doubt areas about the NCWS regard also its pathogenesis
      as, despite some papers evidenced an intestinal immunologic activation, others excluded it.
      To explore the presence of autoimmunity in NCWS, the investigators evaluated: a) the
      frequency of autoimmune diseases and b) the frequency of serum anti-nuclear antibodies (ANA)
      positivity in newly diagnosed NCWS, compared to CD patients.
    

Detailed description: 
      Celiac disease (CD) is an immune-based reaction to dietary gluten (storage protein for wheat,
      barley, and rye) that primarily affects the small intestine in genetically predisposed
      patients and resolves with exclusion of gluten from the diet. Although CD is not surely
      placed among the autoimmune diseases, patients with CD show circulating autoantibodies
      (anti-transglutaminase, anti-tTG) and suffer from the destruction of a specific tissue cell
      type (the enterocytes) by CD8+ T cells. Furthermore, other autoimmune diseases have been
      reported in association to CD in 20-30% of the cases. In the last few year, a new clinical
      entity emerged, which seems include patients who consider themselves to be suffering from
      problems caused by wheat and/or gluten ingestion, even though they do not have CD or wheat
      allergy. This clinical condition has been named "Non-Celiac Gluten Sensitivity" (6), but, in
      a recent paper, the investigators suggested the term "Non-Celiac Wheat Sensitivity" (NCWS),
      since, to date, it is not known what component of wheat really causes the symptoms. The doubt
      areas about the NCWS regard also its pathogenesis as, despite some papers evidenced an
      intestinal immunologic activation, others linked NCWS to the dietary FODMAPs (Fermentable
      Oligo-di and Mono-saccharides, And Polyols) load, thus excluding an immunologic involvement
      in the NCWS. To explore the presence of autoimmunity in NCWS, in the present study the
      investigators evaluated: a) the frequency of autoimmune diseases and b) the frequency of
      serum anti-nuclear antibodies (ANA) positivity in newly diagnosed NCWS and CD patients.
    

Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        The study included consecutive adult patients with irritable bowel syndrome (IBS)-like
        clinical presentation, according to Rome II criteria, and a definitive diagnosis of NCWS,
        referred at the Internal Medicine Department of the University Hospital of Palermo, Italy,
        and at the Internal Medicine Department of the Hospital of Sciacca, Agrigento, Italy,
        between July 2011 and July 2013.
      
Biospecimen description: 
      Blood samples
    
Keywords: Non-Celiac Wheat Sensitivity; Autoimmune diseases; Anti-nuclear antibodies; Celiac disease; Irritable bowel syndrome