МНОГОЛИКАЯ ПРОБЛЕМА НЕПЕРЕНОСИМОСТИ ГЛЮТЕНА

Рост распространенности различных вариантов непереносимости глютена связан с изменениями: пищевого поведения во многих странах мира, технологии выращивания и обработки злаков, новыми кулинарными технологиями. До недавнего времени целиакия, герпетиформный дерматит и пшеничная аллергия были единственными известными заболеваниями с подтвержденной ролью глютена в их патогенезе. Чувствительность к глютену, не связанная с целиакией (ЧГНЦ) - новый синдром глютеновой непереносимости. Данная патология может быть заподозрена у пациентов с персистирующей кишечной и внекишечной симптоматикой, четко ассоциированной с приемом продуктов, содержащих глютен, при отсутствии серологических маркеров целиакии или подозрения на аллергию к пшенице. В статье представлены современные данные по эпидемиологии, этиопатогенезу, особенностям клиники и диагностики ЧГНЦ.

чувствительность к глютену не связанная с целиакией (ЧГНЦ), глютен-ассоциированные заболевания, СРК-подобные симптомы, аmylase-|trypsin inhibitors (ATIs), антиглиадиновые антитела класса IgG (IgG-AGA), безглютеновая диета

1. Valenti S, Corica D, Ricciardi L, Romano C. Gluten-related disorders: certainties, questions and doubts. Ann Med. 2017 May 11:1-13.

2. Catassi C., Cobellis G. Coeliac disease epidemiology is alive and kicking, especially in the developing world. Dig. Liver Dis. 2007; 39: 908-910.

3. Molberg O., Uhlen A. K., Jensen T., et al. Mapping of gluten T-cell epitopes in the bread wheat ancestors: implications for celiac disease. Gastroenterology. 2005; 128: 393-401.

4. Gobbetti M., Giuseppe Rizzello C., Di Cagno R., De Angelis M. Sourdough lactobacilli and celiac disease. Food Microbiol. 2007; 24: 187-196.

5. Catassi C. Gluten Sensitivity. Ann. Nutr. Metab. 2015; 67 (Suppl. 2):16-26.

6. Cabrera-Chávez F, Dezar G.V, Islas-Zamorano A.P, et al. Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population. Nutrients. 2017 Jan 21; 9(1). pii: E 81.

7. Francesco Tovoli, Chiara Masi, Elena Guidetti, et al. Clinical and diagnostic aspects of gluten related disorders. W. J.C.C. 2015; March 16; 3(3): 275-284.

8. Vasagar B, Cox J, Herion JT, Ivanoff E. World epidemiology of non-celiac gluten sensitivity. Minerva Gastroenterol Dietol. 2017 Mar;63(1):5-15.

9. Ludvigsson J. F., Leffler D. A., Bai J. C., Biagi F., et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013; 62: 43-52.

10. Mastrototaro L., Castellaneta S., Gentile A. Gluten sensitivity in children: clinical, serological, genetic and histological description of the first pediatric series. Dig. Liver Dis.2012; 44: 254-255.

11. Cooper B. T.; Holmes G. K.; Ferguson R.; et al. Gluten-sensitive diarrhea without evidence of celiac disease. Gastroenterology. 1981; 81: 192-194.

12. Krosgaard, L.R.; Engsbro, A.L.; Bytzer, P. The epidemiology of irritable bowel syndrome in Denmark. A population-based survey in adults № 50 years of age. Scand. J. Gastroenterol. 2013 May; 48 (5): 523-529.

13. Breckan, R.K.; Asfeldt, A.M.; Straume, B.; et al. Prevalence, comorbidity, and risk factors for functional bowel symptoms: A population-based survey in Northern Norway. Scand. J. Gastroenterol. 2012, 47: 1274-1282.

14. 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. 2011; 106: 508-514.

15. 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. 2012; 107: 1898-1906.

16. Brottveit M., Beitnes A. R., Tollefsen S., et al. Mucosal cytokine response after short-term gluten challenge in celiac disease and non-celiac gluten sensitivity. Am. J. Gastroenterol. 2013; 108: 842-850.

17. Bucci C.; Zingone F.; Russo I.; et al. Gliadin does not induce mucosal inflammation or basophil activation in patients with non-celiac gluten sensitivity. Clin. Gastroenterol. Hepatol. 2013; 11: 1294-1299.

18. Junker Y., Zeissig S., Kim S., et al. Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. J. Exp. Med. 2012; 209: 2395-2408.

19. Trankone R., Jabri B. Coeliac disease and gluten sensitivity. J. Intern. Med. 2011; 269: 582-590.

20. De Magistris L.; Familiari V.; Pascotto A.; et al. Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. J. Pediatr. Gastroenterol. Nutr. 2010; 51: 418-424.

21. ForsytheP.; Bienenstock J.; Kunze W. A. Vagal pathways for microbiome-brain-gut axis communication. Adv. Exp. Med. Biol. 2014; 817: 115-133.

22. Armstrong D., Don-Wauchope A.C., Elena F., Verdu E. F. Testing for gluten-related disorders in clinical practice: the role of serology in managing the spectrum of gluten sensitivity. Can. J. Gastroenterol. 2011; 25: 193-197.

23. Massari S., Liso M., De Santis L., et al. Occurrence of nonceliac gluten sensitivity in patients with allergic disease. Int. Arch. Allergy. Immunol. 2011; 155: 389-394.

24. Volta U., Tovoli F., Cicola R., et al. Serological tests in gluten sensitivity (Nonceliac gluten intolerance). J. Clin. Gastroenterol. 2012; 46: 680-685.

25. 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. 2011; Mar (9): 9:23.

26. Husby S., Koletzko S., Korponay-Szabo I.R., et al. European Society for pediatric Gastroenterology, Hepatology, and Nutrition Guidelines for the diagnosis of coeliac disease. J. Pediatr. Gastroenterol. Nutr. 2012; 54: 136-160.

27. Volta U., Tovoli F., Cicola R., et al. Serological tests in gluten sensitivity (Nonceliac gluten intolerance). J. Clin. Gastroenterol. 2012; 46: 680-685.

28. 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. 2011; 106: 508-514.

29. Kabbani T. A., Vanga R. R., Leffler D. A., et al. Celiac disease or non-celiac gluten sensitivity? An approach to clinical differential diagnosis. Am. J. Gastroenterol. 2014; 109: 741-746.

30. Elli L., Branchi F., Tomba C. et al. Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World. J. Gastroenterol. 2015; June 21; 21(23): 7110-7119.

31. Catassi С., Elli L., Bonaz B. et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015; 7: 4966-4977.

32. Catassi С., Bai J.C, Bonaz B. et al. Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Nutrients. 2013; 5: 3839-3853.

33. Caio G, Riegler G, Patturelli M, et al. Pathophysiology of non-celiac gluten sensitivity: where are we now? Minerva Gastroenterol Dietol. 2017 Mar; 63(1):16-21.