Gluten immunochemistry to react with gamma gliadin to a degree comparable to DQ2.5. T-cell responses to the high molecular weight glutenin may be more important with DQ8 mediated than DQ2.5 mediated celiac disease. Antibody recognition of gluten is complex. Direct binding to gluten such as anti-gliadin antibodies has an ambiguous pathogenesis in coeliac disease. The crosslinking of gliadin with tissue transglutaminase leads to the production of anti-transglutaminase antibodies, but this is mediated through T-cell recognition of gliadin. The allergic recognition of gliadin by mast cells, eosinophiles in the presence of IgE has notable direct consequences, such as exercise-induced anaphylaxis. Anti-gliadin antibodies, like
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