Non-celiac gluten sensitivity: clinical relevance and recommendations for future research.

Abstract

"BACKGROUND:

There has been increasing interest in the entity of Non-Celiac Gluten Sensitivity(NCGS) in recent years; however, it still remains a controversial topic and its pathogenesis is not well understood. Celiac Disease, in contrast, is a well-studied condition that has become increasingly recognized as a prevalent condition arising from a heightened immunological response to gluten. Wheat allergy is an IgE-mediated condition capable of causing a variety of gastrointestinal symptoms. However, the number of patients who have neither celiac disease nor wheat allergy, but appear to derive benefit from a gluten-free diet, is also increasing substantially. The use of the term NCGS as a way of describing this condition has become increasingly prevalent in recent years.

PURPOSE:

In this review, we will focus on gastrointestinal manifestations of NCGS and discuss the evidence for the condition and its putative pathogenesis. We will discuss areas of controversy and areas for potential future research."

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Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness.

Abstract

"Recently, the increasing number of patients worldwide who are sensitive to dietary gluten without evidence of celiac disease or wheat allergy has contributed to the identification of a new gluten-related syndrome defined as non-celiac gluten sensitivity. Our knowledge regarding this syndrome is still lacking, and many aspects of this syndrome remain unknown. Its pathogenesis is heterogeneous, with a recognized pivotal role for innate immunity; many other factors also contribute, including low-grade intestinal inflammation, increased intestinal barrier function and changes in the intestinal microbiota. Gluten and other wheat proteins, such as amylase trypsin inhibitors, are the primary triggers of this syndrome, but it has also been hypothesized that a diet rich in fermentable monosaccharides and polyols may elicit its functional gastrointestinal symptoms. The epidemiology of this condition is far from established; its prevalence in the general population is highly variable, ranging from 0.63% to 6%. From a clinical point of view, non-celiac gluten sensitivity is characterized by a wide array of gastrointestinal and extraintestinal symptoms that occur shortly after the ingestion of gluten and improve or disappear when glutenis withdrawn from the diet. These symptoms recur when gluten is reintroduced. Because diagnostic biomarkers have not yet been identified, a double-blind placebo-controlled gluten challenge is currently the diagnostic method with the highest accuracy. Future research is needed to generate more knowledge regarding non-celiac glutensensitivity, a condition that has global acceptance but has only a few certainties and many unresolved issues."

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Non-celiac gluten sensitivity: the new frontier of gluten related disorders.

Abstract

"Non Celiac Gluten sensitivity (NCGS) was originally described in the 1980s and recently a "re-discovered" disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease (CD) or wheat allergy (WA). Although NCGS frequency is still unclear, epidemiological data have been generated that can help establishing the magnitude of the problem. Clinical studies further defined the identity of NCGS and its implications in human disease. An overlap between the irritable bowel syndrome (IBS) and NCGS has been detected, requiring even more stringent diagnostic criteria. Several studies suggested a relationship between NCGS and neuropsychiatric disorders, particularly autism and schizophrenia. The first case reports of NCGS in children have been described. Lack of biomarkers is still a major limitation of clinical studies, making it difficult to differentiate NCGS from other gluten related disorders. Recent studies raised the possibility that, beside gluten, wheat amylase-trypsin inhibitors and low-fermentable, poorly-absorbed, short-chain carbohydrates can contribute to symptoms (at least those related to IBS) experienced by NCGS patients. In this paper we report the major advances and current trends on NCGS."

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Comparative evaluation of 0.1% turmeric mouthwash with 0.2% chlorhexidine gluconate in prevention of plaque and gingivitis: A clinical and microbiological study

Abstract

"Background:

The aim of our clinical trial was to assess the efficacy of 0.1% turmeric mouthwash as an anti-plaque agent and its effect on gingival inflammation and to compare it with 0.2% chlorhexidine gluconate by evaluating the effect on plaque and gingival inflammation and on microbial load.

Materials and Methods:

60 subjects, 15 years and above, with mild to moderate gingivitis were recruited. Study population was divided into two groups. Group A-30 subjects were advised chlorhexidine gluconate mouthwash. Group B-30 subjects were advised experimental (turmeric) mouthwash. Both the groups were advised to use 10 ml of mouthwash with equal dilution of water for 1 min twice a day 30 min after brushing. Parameters were recorded for plaque and gingival index at day 0, on 14 th day, and 21 st day. Subjective and objective criteria were assessed after 14th day and 21st day. The N-benzoyl-l-arginine-p- nitroanilide (BAPNA) assay was used to analyze trypsin like activity of red complex microorganisms.

Results:

On comparison between chlorhexidine and turmeric mouthwash, percentage reduction of the Plaque Index between 0 and 21 st day were 64.207 and 69.072, respectively (P=0.112), percentage reduction of Gingival Index between 0 and 21st day were 61.150 and 62.545 respectively (P=0.595) and percentage reduction of BAPNA values between 0 and 21st day were 42.256 and 48.901 respectively (P=0.142).

Conclusion:

Chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. Both the mouthwashes have comparable anti-plaque, anti-inflammatory and anti-microbial properties."

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