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Intestinal Barrier Function in Gluten-Related Disorders

1
Department of Gastroenterology, Rheumatology and Infectious diseases, Campus Benjamin Franklin, Charité—University Medicine, 12203 Berlin, Germany
2
Department of Genetics, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2019, 11(10), 2325; https://doi.org/10.3390/nu11102325
Received: 1 September 2019 / Revised: 25 September 2019 / Accepted: 27 September 2019 / Published: 1 October 2019
(This article belongs to the Special Issue Dietary Intake and Gluten-Associated Disease)
Gluten-related disorders include distinct disease entities, namely celiac disease, wheat-associated allergy and non-celiac gluten/wheat sensitivity. Despite having in common the contact of the gastrointestinal mucosa with components of wheat and other cereals as a causative factor, these clinical entities have distinct pathophysiological pathways. In celiac disease, a T-cell mediate immune reaction triggered by gluten ingestion is central in the pathogenesis of the enteropathy, while wheat allergy develops as a rapid immunoglobulin E- or non-immunoglobulin E-mediated immune response. In non-celiac wheat sensitivity, classical adaptive immune responses are not involved. Instead, recent research has revealed that an innate immune response to a yet-to-be-defined antigen, as well as the gut microbiota, are pivotal in the development in this disorder. Although impairment of the epithelial barrier has been described in all three clinical conditions, its role as a potential pathogenetic co-factor, specifically in celiac disease and non-celiac wheat sensitivity, is still a matter of investigation. This article gives a short overview of the mucosal barrier of the small intestine, summarizes the aspects of barrier dysfunction observed in all three gluten-related disorders and reviews literature data in favor of a primary involvement of the epithelial barrier in the development of celiac disease and non-celiac wheat sensitivity. View Full-Text
Keywords: epithelial barrier; permeability; celiac disease; non-celiac gluten sensitivity; non-celiac wheat sensitivity; wheat allergy epithelial barrier; permeability; celiac disease; non-celiac gluten sensitivity; non-celiac wheat sensitivity; wheat allergy
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MDPI and ACS Style

Cardoso-Silva, D.; Delbue, D.; Itzlinger, A.; Moerkens, R.; Withoff, S.; Branchi, F.; Schumann, M. Intestinal Barrier Function in Gluten-Related Disorders. Nutrients 2019, 11, 2325.

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