Non‐celiac gluten sensitivity (NCGS) is a clinical entity triggered by the ingestion of gluten‐containing grains leading to intestinal and/or extraintestinal symptoms that resolve once the gluten‐containing foodstuff is eliminated from the diet, and it is diagnosed when celiac disease (CD) and wheat allergy (WA) have been ruled out. The limited knowledge about the pathophysiology of NCGS and the lack of validated biomarkers are still major limitations for clinical studies, making it difficult to differentiate NCGS from other gluten‐related disorders (GRD). In the absence of clear‐cut diagnostic criteria, NCGS is still mainly a diagnosis of exclusion. Several studies suggest that NCGS is an immune‐mediated disease that likely activates an innate immune response. Moreover, it has recently been hypothesized that in addition to gluten, other components of wheat may be responsible for the symptoms observed in individuals without CD. This review aims at discussing available evidence related to the histological and immunological features in the gut mucosa of patients with NCGS and at outlining new dietary opportunities for these patients.

中文翻译：

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非乳糜泻的麸质敏感性：其肠道免疫激活和潜在的饮食管理与乳糜泻有何不同

非芹菜麸质敏感性（NCGS）是由于摄入含有谷蛋白的谷物而引起的肠和/或肠外症状而触发的临床实体，一旦从饮食中去除了含有谷蛋白的食物，该症状便会缓解，并在乳糜泻时进行诊断（CD）和小麦过敏（WA）已被排除。对NCGS病理生理学的了解有限，以及缺乏经过验证的生物标记物，仍然是临床研究的主要局限性，因此很难将NCGS与其他与麸质相关的疾病（GRD）区别开来。在缺乏明确的诊断标准的情况下，NCGS仍主要是排除诊断。多项研究表明，NCGS是一种免疫介导的疾病，可能会激活先天性免疫应答。而且，最近有假说，除了面筋，小麦的其他成分可能是导致没有CD的个体中观察到的症状的原因。这篇综述旨在讨论与NCGS患者肠道粘膜的组织学和免疫学特征有关的可用证据，并概述这些患者的新饮食机会。