For years we’ve been talking about the existence of a gluten intolerance that is not celiac disease. For years we’ve also been claiming that many biopsies with type 1 or 2 Marsh diagnosis, defined on slides as being compatible with celiac disease, are not really indicators of celiac disease but of an entity that can be modulated and cured.
Scientific reports refer to a 10% prevalence among the average population, that is a presence that is 10 times greater than that of celiac disease sufferers (around 1% of the population): very widespread and frequent…
It is my personal experience that in many cases these people are able to recover food tolerance and return to a more unrestricted diet, in the same manner as for food intolerances, without transforming a laboratory diagnosis into a life drama.
At least two recent scientific works, which we’ll discuss in greater detail during the coming weeks, have studied and defined this difference in a precise manner.
The first study, published by an Italian research group (Sapone A et al, BMC Med. 2011; 9: 23. Published online 2011 March 9. doi: 10.1186/1741-7015-9-23) describes the differences among the two conditions. It also emphasizes the fact that while celiac disease is linked to the development of autoimmunity connected with adaptive immunity, in gluten sensitivity there is the activation of innate immunity in particular with the activation of type 2 Toll Like Receptors (those responsible for creating an immediate inflammatory response and which justify a low grade inflammation that is ever-present in these conditions).
The second work, published in the American Journal of Gastroenterology several days ago, confirms the existence of this double entity (Biesiekierski JR et al, Am J Gastroenterol. 2011 Mar;106(3):508-14; quiz 515. Epub 2011 Jan 11). The Australian group showed that irritable colon can be gluten-induced without being an expression of celiac disease even when there is a partial presence of DQ2 or DQ8.
So there’s good news for those celiac sufferers who received an excessive diagnosis, and excellent news for the scientific world that deals with food intolerance. The Australian authors wrote an interesting closing phrase: “Non-celiac gluten intolerance may exist”. Gluten intolerance exists, but it isn’t celiac disease.