Spectrum of gluten-related disorders: celiac disease, wheat allergy, baker’s asthma and non-celiac gluten sensitivity

Gluten, which is a protein found in wheat, can trigger some gastrointestinal diseases in people with genetic predisposition. Gluten related disorders include celiac disease (CD), wheat allergy, baker’s asthma and non-celiac gluten sensivity (NCGS). Approximately 1% of population suffers from celiac disease. It is believed, that the occurrence of the disease is determined by the interaction of genetic, immunological and environmental factors. The consequence of the inflammatory process is the atrophy of the intestinal villi. That results in impaired bowel motility, improper digestion and impaired absorption of substances contained in the diet. Wheat allergy occurs among people with a genetic predisposition to allergies. People with this disorder are sensitized to products containing gluten and every contact with this antigen leads to mast cell activation and the release of mediators of the allergic reaction - mainly histamine. They mainly affect the skin (urticaria, atopic eczema, angioedema), digestive system (nausea, vomiting, spasmic abdominal pain) and respiratory tract (asthma, allergic rhinitis). Baker’s asthma is an interesting and common allergic, occupational disorder related to inhalation of flour containing gluten. The main symptoms include: conjunctivitis, rhinitis, dermatitis, as well as work-related cough and dyspnea. First reports on non-celiac gluten sensitivity (NCGS) appeared in 1980. The diagnosis of non-celiac gluten sensitivity is based on the exclusion of celiac disease and food allergy in a patient who has symptoms induced by ingestion of gluten. The exact pathomechanism of this disease is still unknown. Interestingly, some researches doubt that this disorder is caused by gluten intake. All of the above-mentioned diseases have a similar spectrum of clinical symptoms, and as part of the treatment require an elimination diet with the exclusion of gluten. The aim of this study is to provide information on gluten-related diseases, taking into account their pathomechanism and clinical picture.