Non-celiac gluten sensitivity yet well understood. It was hypothesized that gluten, as occurs in celiac disease, is the cause of NCGS. Besides gluten, other components in wheat, rye, barley, and their derivatives, including amylasetrypsin inhibitors (ATIs) and FODMAPs, may cause symptoms. Some people may have a reaction to other proteins present in gluten-containing cereals that are able to inhibit amylase and trypsin (-α-amylase/trypsin inhibitors [ATIs]). ATIs are part of the plant's natural defense against insects and may cause toll-like receptor 4 (TLR4)-mediated intestinal inflammation in humans. These TLR4-stimulating activities of ATIs are limited to gluten-containing cereals (wheat, rye, barley, and derivatives) and may
Non-celiac gluten sensitivity in gluten and gluten-containing cereals (wheat, rye, barley, and their derivatives) may have a role in the development of symptoms. FODMAPs are present in gluten-containing grains and have recently been identified as a possible cause of gastrointestinal symptoms in NCGS patients, but do not justify extra-digestive symptoms. For these reasons, NCGS is a controversial clinical condition and some authors still question it. It has been suggested that "non-celiac wheat sensitivity" is a more appropriate term, without forgetting that other gluten-containing cereals are implicated in the development of symptoms. NCGS is the most common syndrome of gluten-related disorders with prevalence rates