Non-celiac gluten sensitivity: Time for sifting the grain

Table 1 Non-celiac gluten sensitivity identikit

Name and definition	Pathogenesis	Prevalence	Diagnosis	Treatment
Non-celiac gluten/wheat sensitivity is an intestinal/extraintestinal syndrome responsive to gluten withdrawal in absence of CD and WA	Multi-factorial, including innate immunity and direct cytotoxic effects of gluten	Ranging from 3% to 5%, though specific studies are lacking	Via placebo-controlled blind gluten challenge	No data are available for guidance
	Other molecules are potentially involved: Amylase trypsin inhibitor, FODMAPs		Prior exclusion of celiac disease and allergy	An on-demand gluten-free regimen should be considered
			AGA IgG, IELs, basophil activation and eosinophil duodenal/colon infiltration are potential biomarkers

AGA: Anti-gliadin antibodies; CD: Celiac disease; FODMAP: Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols; IELs: Intraepithelial lymphocytes; WA: Wheat allergy.