Nonceliac Wheat Sensitivity: An Immune-Mediated Condition with Systemic Manifestations

Gastroenterol Clin North Am. 2019 Mar;48(1):165-182. doi: 10.1016/j.gtc.2018.09.012. Epub 2018 Dec 13.


Non-celiac wheat sensitivity (NCWS) is characterized by gastrointestinal and extra-intestinal symptoms following the ingestion of gluten-containing cereals in subjects without celiac disease or wheat allergy. The identity of the molecular triggers in these cereals responsible for the symptoms of NCWS remains to be delineated. Recent research has identified a biological basis for the condition, with the observation of systemic immune activation in response to microbial translocation that appears to be linked to intestinal barrier defects. Ongoing research efforts are aimed at further characterizing the etiology, mechanism, and biomarkers of the condition.

Keywords: Amylase/protease inhibitor; Antibody to native gliadin; Biomarkers; Fructan; Gluten; Intestinal barrier function; Systemic immune activation; Wheat.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adaptive Immunity
  • Adult
  • Celiac Disease
  • Diet, Gluten-Free
  • Female
  • Gastrointestinal Microbiome
  • Humans
  • Immunity, Innate
  • Intestinal Mucosa / immunology
  • Male
  • Middle Aged
  • Wheat Hypersensitivity / diagnosis*
  • Wheat Hypersensitivity / immunology*
  • Wheat Hypersensitivity / physiopathology