Nonceliac Gluten Sensitivity
Nonceliac Gluten Sensitivity
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DOI：
10.1053/j.gastro.2014.12.049
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发表时间：
2015-05-01
期刊：
影响因子：
29.4
通讯作者：
Schuppan, Detlef
中科院分区：
文献类型：
--
作者：
Fasano, Alessio;Sapone, Anna;Schuppan, Detlef
在过去的十年里，无麸质饮食（GFD）的流行程度令人印象深刻，现在是美国和其他国家最流行的饮食习惯。根据最近的调查，多达1亿美国人将在一年内消费无麸质产品。在GFD只对患有乳糜泻的人有益的概念下运作，医疗保健专业人员一直在努力将小麦与谷壳分开;有人声称，从饮食中消除麸质可以增加健康并有助于减肥，甚至麸质可能对每个人都有害。然而，除了毫无根据的趋势，与摄入面筋或含面筋的谷物有关的疾病，即非乳糜泻面筋敏感性（NCGS），在文献中重新出现，引发了关于GFD是否适合无乳糜泻患者的争论。虽然GFD的流行显然有时尚的成分，但也有无可争议的越来越多的证据表明NCGS。然而，我们需要更好地了解NCGS的临床表现，以及它的发病机制，流行病学，管理和条件，如肠易激综合征，慢性疲劳和自身免疫的作用。在我们能够开始识别和管理NCGS之前，必须基于适当的同行评审科学信息，就该疾病的命名和定义达成一致。我们回顾了NCGS的最新研究结果，并概述了消除与这种疾病有关的一些混乱的方向。
During the past decade there has been an impressive increase in popularity of the gluten-free diet (GFD)-now the most trendy alimentary habit in the United States and other countries. According to recent surveys, as many as 100 million Americans will consume gluten-free products within a year. Operating under the concept that the GFD benefits only individuals with celiac disease, health care professionals have struggled to separate the wheat from the chaff; there are claims that eliminating gluten from the diet increases health and helps with weight loss, or even that gluten can be harmful to every human being. However, apart from unfounded trends, a disorder related to ingestion of gluten or gluten-containing cereals, namely nonceliac gluten sensitivity (NCGS), has resurfaced in the literature, fueling a debate on the appropriateness of the GFD for people without celiac disease. Although there is clearly a fad component to the popularity of the GFD, there is also undisputable and increasing evidence for NCGS. However, we require a better understanding of the clinical presentation of NCGS, as well as its pathogenesis, epidemiology, management, and role in conditions such as irritable bowel syndrome, chronic fatigue, and autoimmunity. Before we can begin to identify and manage NCGS, there must be agreement on the nomenclature and definition of the disorder based on proper peer-reviewed scientific information. We review the most recent findings on NCGS and outline directions to dissipate some of the confusion related to this disorder.