Gluten-free diet participants, which could have masked the true effect of gluten reintroduction. In a review of May 2015 published in Gastroenterology, Fasano "et al." conclude that besides gluten, ATIs and FODMAPs present in gluten, wheat, barley, rye, and their derivatives play a role in the development of NCGS symptoms. ATIs, which resist proteolytic digestion, may be the inducers of innate immunity in people with coeliac disease or NCGS. FODMAPs cause mild wheat intolerance at most, which is mainly limited to gastrointestinal symptoms. After exclusion of coeliac disease and wheat allergy, the subsequent step for diagnosis and treatment of NCGS is to
Anti-gliadin antibodies in food products. Some of these antibodies can recognize only wheat prolamins or very closely related grass seeds; others can detect antigens over broad taxa. The G12 antibody is the newest example which detects the most immunotoxic fragment, a 33-mer peptide from �-2 gliadin; available from Romer Laboratories and the Spanish company Biomedal. It recognizes the toxic fraction of wheat, barley, rye and also of oat. The R5 sandwich assay is another such assay. This assay can recognize wheat, barley and rye, which makes it ideal for evaluating the presence of contaminants in gluten-free foods that do not contain oat.