Urinary Gluten Immunogenic Peptides Detection in Non-celiac Gluten/Wheat Sensitivity
Urinary Gluten Immunogenic Peptides Detection in Non-celiac Gluten/Wheat Sensitivity
Non-celiac gluten/wheat sensitivity (NCGS/NCWS) is a syndrome characterized by both
 intestinal (irritable bowel syndrome [IBS]-like presentation) and extraintestinal symptoms
 (headache, migraine, "foggy mind", depression, anxiety, fibromyalgia, joint and muscle pain,
 leg or arm numbness, eczema or skin rash), which occur after the ingestion of gluten/wheat in
 subjects in which celiac disease (CD) and wheat allergy diagnosis has been previously
 excluded. NCGS/NCWS symptoms generally occur after the ingestion of gluten/wheat, disappear
 within a few days of a gluten-free diet (GFD) and quickly reappear when gluten/wheat is
 reintroduced. A new assay, recently available on the Italian market, allows to ascertain the
 presence of immunogenic peptides of gluten (Gluten Immunogenic Peptides, GIP) in the urine
 and stool. The test might allow to ascertain if the NCGS/NCWS patients, on GFD, eat, even
 accidentally, gluten. Of the 2 available assays, the urinary one allows the patient himself
 to test the presence of GIP in relation to symptoms/signs appearing and/or social activities
 (e.g. meal in a restaurant). The aims of the present study are: 1) to test, in patients with
 NCGS/NCWS on GFD, the adherence to the elimination diet; 2) to evaluate the correlation
 between the symptoms' reappearance and the presence of GIP in the urine.
Non-celiac gluten/wheat sensitivity (NCGS/NCWS) is a syndrome characterized by both
 intestinal (irritable bowel syndrome [IBS]-like presentation) and extraintestinal symptoms
 (headache, migraine, "foggy mind", depression, anxiety, fibromyalgia, joint and muscle pain,
 leg or arm numbness, eczema or skin rash), which occur after the ingestion of gluten/wheat in
 subjects in which celiac disease (CD) and wheat allergy diagnosis has been previously
 excluded. Recent data suggest that NCGS affect up to 3-6% of the general population, a higher
 prevalence than that reported for CD. NCGS/NCWS symptoms generally occur after the ingestion
 of gluten/wheat, disappear within a few days of a gluten-free diet (GFD) and quickly reappear
 when gluten/wheat is reintroduced. GDF is very difficult and onerous from a social (presence
 of gluten in many industrial food products and "contamination", both domestic and
 extra-domestic), psychological (e.g. for adolescents, exclusion from the "peer group", with
 difficulty in accepting the diagnosis) and economic point of view. A new assay, recently
 available on the Italian market, allows to ascertain the presence of immunogenic peptides of
 gluten (gluten immunogenic peptides, GIP) in the urine and stool. The test might allow to
 ascertain if the NCGS/NCWS patients, on GFD, eat even accidentally gluten. Of the 2 available
 assays, the urinary one allows the patient himself to test the presence of GIP in relation to
 symptoms/signs appearing and/or social activities (e.g. meal in a restaurant). The other one
 involves collecting a stool sample and allows to identify the gluten taken in the previous
 week, but it requires a laboratory, specifically equipped. To date, there are no
 observational studies that indicate the performance of the test in patients with NCGS/NCWS.
 The aims of the present study are: 1) to test, in patients with NCGS/NCWS on GFD, the
 adherence to the elimination diet; 2) to evaluate the correlation between the symptoms'
 reappearance and the presence of GIP in the urine.
Inclusion Criteria:

 -  patients suffering from NCGS/NCWS on Gluten-Free Diet (GFD).

 Exclusion Criteria:

 -  celiac patients or those suffering from IgE-mediated gluten/wheat allergy.