columbia | A new study may explain why people who do not have celiac disease or
wheat allergy nevertheless experience a variety of gastrointestinal and
extra-intestinal symptoms after ingesting wheat and related cereals. The
findings suggest that these individuals have a weakened intestinal
barrier, which leads to a body-wide inflammatory immune response.
Findings from the study, which was led by researchers from Columbia
University Medical Center (CUMC), were reported in the journal Gut.
“Our study shows that the symptoms reported by individuals with this
condition are not imagined, as some people have suggested,” said study
co-author Peter H. Green, MD, the Phyllis and Ivan Seidenberg Professor
of Medicine at CUMC and director of the Celiac Disease Center. “It
demonstrates that there is a biological basis for these symptoms in a
significant number of these patients.”
Celiac disease is an autoimmune disorder in which the immune system
mistakenly attacks the lining of the small intestine after someone who
is genetically susceptible to the disorder ingests gluten from wheat,
rye, or barley. This leads to a range of gastrointestinal symptoms,
including abdominal pain, diarrhea, and bloating.
Researchers have struggled to determine why some people, who lack the
characteristic blood, tissue, or genetic markers of celiac disease,
experience celiac-like GI symptoms, as well as certain extra-intestinal
symptoms, such as fatigue, cognitive difficulties, or mood disturbance,
after ingesting foods that contain wheat, rye, or barley. One
explanation for this condition, known as non-celiac gluten or wheat
sensitivity (NCWS), is that exposure to the offending grains somehow
triggers acute systemic immune activation, rather than a strictly
localized intestinal immune response. Because there are no biomarkers
for NCWS, accurate figures for its prevalence are not available, but it
is estimated to affect about 1 percent of the population, or 3 million
Americans, roughly the same prevalence as celiac disease.
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