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
Wheat allergy high molecular weight glutenin subunit, and similar proteins in other "Triticeae" genera, enter the blood stream during exercise where they cause acute asthmatic or allergic reaction. One recent study of ω-gliadins demonstrated these gliadins are more similar to the bulk of oat avenins than α/β or γ gliadins but, so far, oat avenins have not been linked to WDEIA. Wheat may specifically induce WDEIA and certain chronic urticaria because the anti-gliadin IgE detects ω-gliadins expressed by most of the Gli-B1 alleles, but prolamins extracted from rye or wheat/rye translocates invoke almost no responses. The Gli-B1 gene in wheat, "Triticum aestivum",