Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity

Gastroenterology

Volumn 154, Issue 3, 2018, Pages 529-539.e2

  Skodje, Gry I ^a,b   Sarna, Vikas K ^b,c   Minelle, Ingunn H ^b   Rolfsen, Kjersti L ^b   Muir, Jane G ^d   Gibson, Peter R ^d   Veierød, Marit B ^b   Henriksen, Christine ^b   Lundin, Knut E A ^a,b,c  

^a OSLO UNIVERSITY HOSPITAL   (Norway)

^b UNIVERSITY OF OSLO   (Norway)

^c OSLO UNIVERSITY HOSPITAL   (Norway)

^d MONASH UNIVERSITY   (Australia)

Author keywords

Challenge; FODMAP; Intestine; NCGS; Wheat

Indexed keywords

FRUCTAN; GLUTEN; HLA DQ2 ANTIGEN; HLA DQ8 ANTIGEN; PLACEBO; THYROTROPIN;

ADULT; ARTICLE; BLOATING; CELIAC DISEASE; CONTROLLED STUDY; CROSSOVER PROCEDURE; DIARRHEA; DIGESTIVE SYSTEM DISEASE ASSESSMENT; DOUBLE BLIND PROCEDURE; DUODENUM BIOPSY; FEMALE; GASTROINTESTINAL DISEASE; GASTROINTESTINAL SYMPTOM RATING SCALE IRRITABLE BOWEL SYNDROME; GASTROSCOPY; GENOTYPE; GLUTEN FREE DIET; HUMAN; MAJOR CLINICAL STUDY; MALE; NON CELIAC GLUTEN SENSITIVITY; PAIN; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SATIETY; SELF REPORT; SHORT FORM 36; THYROID DISEASE; DIET THERAPY; IMMUNOLOGY; IRRITABLE COLON; MIDDLE AGED; NORWAY; PREDICTIVE VALUE; TIME FACTOR; UNIVERSITY HOSPITAL; WHEAT ALLERGY;

ADULT; CELIAC DISEASE; CROSS-OVER STUDIES; DIET, GLUTEN-FREE; DOUBLE-BLIND METHOD; FEMALE; FRUCTANS; GLUTENS; HOSPITALS, UNIVERSITY; HUMANS; IRRITABLE BOWEL SYNDROME; MALE; MIDDLE AGED; NORWAY; PREDICTIVE VALUE OF TESTS; SELF REPORT; TIME FACTORS; WHEAT HYPERSENSITIVITY;

EID: 85041506095     PISSN: 00165085     EISSN: 15280012     Source Type: Journal    
DOI: 10.1053/j.gastro.2017.10.040     Document Type: Article

References (44)

1. Lebwohl, B., Leffler, D.A., Exploring the strange new world of non-celiac gluten sensitivity. Clin Gastroenterol Hepatol 13 (2015), 1613–1615.
2. Lundin, K.E., Alaedini, A., Non-celiac gluten sensitivity. Gastrointest Endosc Clin N Am 22 (2012), 723–734.
3. Ludvigsson, J.F., Leffler, D.A., Bai, J.C., et al. The Oslo definitions for celiac disease and related terms. Gut 62 (2013), 43–52.
4. Catassi, C., Elli, L., Bonaz, B., et al. Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts' Criteria. Nutrients 7 (2015), 4966–4977.
5. Asero, R., Fernandez-Rivas, M., Knulst, A.C., et al. Double-blind, placebo-controlled food challenge in adults in everyday clinical practice: a reappraisal of their limitations and real indications. Curr Opin Allergy Clin Immunol 9 (2009), 379–385.
6. Gibson, P.R., Skodje, G.I., Lundin, K.E.A., Non-celiac gluten sensitivity. J Gastroenterol Hepatol 32 (2017), 86–89.
7. Sapone, A., Lammers, K.M., Casolaro, V., et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med, 9, 2011, 23.
8. Brottveit, M., Beitnes, A.C., Tollefsen, S., et al. Mucosal cytokine response after short-term gluten challenge in celiac disease and non-celiac gluten sensitivity. Am J Gastroenterol 108 (2013), 842–850.
9. Carroccio, A., Mansueto, P., Iacono, G., et al. Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Am J Gastroenterol 107 (2012), 1898–1906 quiz 1907.
10. Biesiekierski, J.R., Newnham, E.D., Irving, P.M., et al. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol 106 (2011), 508–514 quiz 515.
11. Shahbazkhani, B., Sadeghi, A., Malekzadeh, R., et al. Non-celiac gluten sensitivity has narrowed the spectrum of irritable bowel syndrome: a double-blind randomized placebo-controlled trial. Nutrients 7 (2015), 4542–4554.
12. Biesiekierski, J.R., Peters, S.L., Newnham, E.D., et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology 145 (2013), 320–328 e1-e3.
13. Di Sabatino, A., Volta, U., Salvatore, C., et al. Small amounts of gluten in subjects with suspected nonceliac gluten sensitivity: a randomized, double-blind, placebo-controlled, cross-over trial. Clin Gastroenterol Hepatol 13 (2015), 1604–1612.e3.
14. Elli, L., Tomba, C., Branchi, F., et al. Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: results from a multicenter randomized double-blind placebo-controlled gluten challenge. Nutrients, 8, 2016, 84.
15. Zanini, B., Baschè, R., Ferraresi, A., et al. Randomised clinical study: gluten challenge induces symptom recurrence in only a minority of patients who meet clinical criteria for non-celiac gluten sensitivity. Aliment Pharmacol Ther 42 (2015), 968–976.
16. Junker, Y., Zeissig, S., Kim, S.J., et al. Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. J Exp Med 209 (2012), 2395–2408.
17. Halmos, E.P., Power, V.A., Shepherd, S.J., et al. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 146 (2014), 67–75.e5.
18. Longstreth, G.F., Thompson, W.G., Chey, W.D., et al. Functional bowel disorders. Gastroenterology 130 (2006), 1480–1491.
19. Cox, J., Mann, M., MaxQuant enables high peptide identification rates, individualized p.p.b.-range mass accuracies and proteome-wide protein quantification. Nat Biotechnol 26 (2008), 1367–1372.
20. Shan, L., Molberg, O., Parrot, I., et al. Structural basis for gluten intolerance in celiac sprue. Science 297 (2002), 2275–2279.
21. Wiklund, I.K., Fullerton, S., Hawkey, C.J., et al. An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol 38 (2003), 947–954.
22. Mykletun, A., Stordal, E., Dahl, A.A., Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatry 179 (2001), 540–544.
23. Loge, J.H., Kaasa, S., Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scand J Soc Med 26 (1998), 250–258.
24. Spangenberg, L., Brähler, E., [The Giessen-Test – new norm values in a representative German sample (14–92 years)]. Psychotherapie Psychosomatik medizinische Psychologie 61 (2011), e15–e18 [Article in German].
25. Brottveit, M., Vandvik, P.O., Wojniusz, S., et al. Absence of somatization in non-celiac gluten sensitivity. Scand J Gastroenterol 47 (2012), 770–777.
26. Senn, S., Statistics in Practice. Cross-over Trials in Clinical Research. Ch 5: Normal Data from Designs with Three or More Treatments. Ed 2, 2002, John Wiley & Sons Ltd, West Sussex, England, 157–185.
27. Oberhuber, G., Granditsch, G., Vogelsang, H., The histopathology of celiac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol 11 (1999), 1185–1194.
28. Sarna, V.K., Skodje, G.I., Reims, H.M., et al. HLA-DQ:gluten tetramer test in blood gives better detection of celiac patients than biopsy after 14-day gluten challenge. Gut, 2017 [Epub ahead of print].
29. Molina-Infante, J., Carroccio, A., Suspected nonceliac gluten sensitivity confirmed in few patients after gluten challenge in double-blind, placebo-controlled trials. Clin Gastroenterol Hepatol 15 (2017), 339–348.
30. Shepherd, S.J., Parker, F.C., Muir, J.G., et al. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastroenterol Hepatol 6 (2008), 765–771.
31. Erickson, J., Korczak, R., Wang, Q., et al. Gastrointestinal tolerance of low FODMAP oral nutrition supplements in healthy human subjects: a randomized controlled trial. Nutr J, 16, 2017, 35.
32. de Punder, K., Pruimboom, L., The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients 5 (2013), 771–787.
33. Halmos, E.P., Christophersen, C.T., Bird, A.R., et al. Diets that differ in their FODMAP content alter the colonic luminal microenvironment. Gut 64 (2015), 93–100.
34. Ostgaard, H., Hausken, T., Gundersen, D., et al. Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome. Mol Med Rep 5 (2012), 1382–1390.
35. Aziz, I., Trott, N., Briggs, R., et al. Efficacy of a gluten-free diet in subjects with irritable bowel syndrome-diarrhea unaware of their HLA-DQ2/8 genotype. Clin Gastroenterol Hepatol 14 (2016), 696–703.e1.
36. Vazquez-Roque, M., Oxentenko, A.S., Nonceliac gluten sensitivity. Mayo Clin Proc 90 (2015), 1272–1277.
37. Yao, C.K., Gibson, P.R., Shepherd, S.J., Design of clinical trials evaluating dietary interventions in patients with functional gastrointestinal disorders. Am J Gastroenterol 108 (2013), 748–758.
38. Laatikainen, R., Koskenpato, J., Hongisto, S.M., et al. Randomised clinical trial: low-FODMAP rye bread vs. regular rye bread to relieve the symptoms of irritable bowel syndrome. Aliment Pharmacol Ther 44 (2016), 460–470.
39. Tavakkoli, A., Lewis, S.K., Tennyson, C.A., et al. Characteristics of patients who avoid wheat and/or gluten in the absence of Celiac disease. Dig Dis Sci 59 (2014), 1255–1261.
40. Volta, U., Bardella, M.T., Calabro, A., et al. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med, 12, 2014, 85.
41. Aziz, I., Lewis, N.R., Hadjivassiliou, M., et al. A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur J Gastroenterol Hepatol 26 (2014), 33–39.
42. Zingone, F., Bartalini, C., Siniscalchi, M., et al. Alterations in diets of patients with nonceliac gluten sensitivity compared with healthy individuals. Clin Gastroenterol Hepatol 15 (2017), 63–68.e2.
43. Skodje, G.I., Henriksen, C., Salte, T., et al. Wheat challenge in self-reported gluten sensitivity: a comparison of scoring methods. Scand J Gastroenterol 52 (2017), 185–192.
44. Muir, J.G., Rose, R., Rosella, O., et al. Measurement of short-chain carbohydrates in common Australian vegetables and fruits by high-performance liquid chromatography (HPLC). J Agric Food Chem 57 (2009), 554–565.