Diseases caused by gluten

Abstract

Introduction: Gluten is the protein fraction of wheat flour, composed of prolamins and glutenins. Prolamins vary according to the cereal: gliadin in wheat, hordein in barley and secalin in rye, all capable of producing different immune diseases. The peptides of these toxic gluten fractions trigger the following conditions: gluten allergy, non-celiac gluten sensitivity and celiac disease, which present different fundamental characteristics. Non-celiac gluten sensitivity is a disease described in recent years that has caught the attention of the medical community. Objective: Update the most recent criteria on the conditions that can be triggered by gluten, their mechanisms, clinical symptoms and diagnostic elements. Methods: A search related to gluten allergy, non-celiac gluten sensitivity and celiac disease was carried out in publications in PubMed, Scielo and Latindex databases from 2011 to 2017. Results: The fundamental characteristics of gluten allergy, non-celiac gluten sensitivity and celiac disease were reviewed. Their mechanisms, clinical manifestations and diagnostic criteria are updated in the light of the most recent knowledge. Conclusions The participation of gluten as agent responsible for different conditions and its impact on health is evidenced. The different criteria discussed on the pathogenesis, clinical manifestations and the diagnosis of these conditions are analyzed. Attention is drawn to the importance of non-celiac gluten sensitivity as a recently described condition.