RECENT ADVANCE IN BASIC SCIENCE
Amylase-trypsin inhibitors in the development of non-celiac gluten sensitivity: does the term “gluten-free diet” need an update?
Chiara Monachesi1, Anil K. Verma1, Elena Lionetti2, Carlo Catassi2,3
1Celiac Disease Research Laboratory, Polytechnic University of Marche, Ancona, Italy; 2Division of Pediatrics, DISCO Department, Polytechnic University of Marche, Ancona, Italy; 3Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, US
The pathogenesis of non-celiac gluten sensitivity (NCGS) is still unclear. It was previously assumed that gluten was the only wheat component responsible of triggering this disorder. However, multiple studies have shown that wheat components other than gluten, particularly amylasetrypsin inhibitors (ATI), may elicit symptoms of NCGS. Therefore, though a gluten-free diet is essentially ATI-free, in the management of NCGS, the “gluten-free diet” should be termed “gluten and ATI-free diet”.