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Celiac.com 12/05/2024 - Over the past five decades, the prevalence of celiac disease and gluten sensitivity has increased dramatically, leading researchers to investigate the underlying causes. While no single theory can explain the rise in gluten-related disorders, several supported by scientific research offer insights into why these conditions are becoming more common. Here are the most popular theories. 1. The Hygiene Hypothesis The hygiene hypothesis posits that modern improvements in hygiene have led to reduced exposure to pathogens, which in turn weakens the immune system’s ability to distinguish between harmful and harmless substances. This theory suggests that reduced contact with bacteria, viruses, and other microorganisms early in life leaves the immune system more prone to overreaction, including triggering autoimmune diseases like celiac disease. Several studies support this hypothesis, showing a correlation between increased hygiene practices in developed nations and the rise in autoimmune disorders. For example, a 2016 study found that children raised in environments with higher exposure to microbes, such as on farms or in large families, have lower rates of autoimmune conditions, including celiac disease . The theory suggests that early immune system training helps prevent overreaction to proteins like gluten later in life. 2. Changes in Wheat Cultivation Modern agricultural practices have altered wheat's genetic composition over the last century. Through selective breeding, wheat varieties have been developed that are more resilient, produce higher yields, and contain higher levels of gluten. Some researchers propose that these genetic changes have made modern wheat more likely to trigger gluten sensitivity or celiac disease. Although no genetically modified (GMO) wheat is commercially available, modern wheat varieties do contain higher levels of gluten, especially the types of gluten proteins most harmful to those with celiac disease. A study published in the American Journal of Clinical Nutrition in 2013 compared ancient wheat varieties like einkorn with modern wheat and found that older varieties contained less of the gluten peptides that trigger immune responses in celiac disease . 3. Increased Gluten Consumption in Modern Diets Another popular theory is that people today are consuming more gluten than previous generations. The proliferation of processed and convenience foods has led to gluten being added to a wide range of products beyond bread and pasta. As gluten is often used as a thickener, stabilizer, or flavor enhancer in processed foods, people may be unknowingly consuming more gluten, which could contribute to the rise in gluten-related disorders. A 2020 review in the journal Nutrients highlighted how the increased use of gluten in processed foods has raised overall gluten consumption. The study found that the modern diet includes gluten in unexpected places, such as sauces, soups, and even supplements. This increased exposure, combined with genetic predisposition, might lead to higher rates of gluten sensitivity and celiac disease. 4. Microbiome Alterations and Gut Health The human gut microbiome, which consists of trillions of bacteria and other microorganisms, plays a key role in regulating immune function and digestion. Changes in diet, widespread use of antibiotics, and other environmental factors have disrupted the balance of the gut microbiome in many individuals. Some researchers believe this disruption contributes to the increase in autoimmune diseases like celiac disease by weakening the immune system's ability to tolerate gluten. A growing body of research connects gut health and celiac disease. A 2021 study in Frontiers in Microbiology found that individuals with celiac disease often have distinct microbiomes compared to healthy individuals, with fewer beneficial bacteria and higher levels of pathogenic strains . This altered microbiome may influence the body's immune response to gluten, increasing the risk of developing celiac disease. 5. Early Introduction of Gluten to Infants There is ongoing debate about whether the timing of gluten introduction in infancy affects the development of celiac disease. Some researchers believe that introducing gluten too early or too late during a child’s development could increase the likelihood of triggering an autoimmune response. The "window of tolerance" hypothesis suggests that introducing gluten during a specific developmental window might help the immune system develop tolerance to it. A large study known as the PreventCD project, conducted in Europe, examined how the timing of gluten introduction affected celiac disease risk in genetically predisposed children. The results, published in The New England Journal of Medicine in 2014, indicated that neither early nor delayed gluten introduction significantly affected the risk of developing celiac disease, but other studies still explore whether a small window may exist. 6. Environmental Factors and Chemical Exposure Some researchers believe that increased exposure to environmental chemicals, pesticides, and additives may contribute to the rise in autoimmune conditions, including celiac disease. Glyphosate, a common herbicide used in modern agriculture, has been speculated to contribute to intestinal permeability (also known as leaky gut), which could increase the risk of developing autoimmune diseases like celiac disease. Although this theory is more controversial, some research suggests that environmental chemicals may play a role in the development of autoimmune diseases. A 2013 paper in Interdisciplinary Toxicology argued that glyphosate's effects on gut bacteria could impair digestion and immune regulation, potentially increasing the risk of gluten sensitivity . However, further research is needed to confirm the link between glyphosate and celiac disease. Conclusion The increased prevalence of celiac disease and gluten sensitivity is a complex issue with multiple contributing factors. Theories ranging from changes in wheat cultivation and higher gluten consumption to microbiome disruption and the hygiene hypothesis offer plausible explanations for why more people are developing gluten-related disorders today. While no single theory has been definitively proven, ongoing research continues to shed light on the factors driving this rise, helping scientists and healthcare providers better understand, diagnose, and treat these conditions. As awareness grows and research advances, a deeper understanding of the relationship between gluten and autoimmune disease will help individuals manage and prevent the development of celiac disease and gluten sensitivity in future generations. Watch the video version of this article:

Celiac.com 06/12/2024 - A recent study presented at the Digestive Disease Week (DDW) Annual Meeting 2024 has sparked a significant conversation around the relationship between celiac disease and obesity. Traditionally, celiac disease was understood primarily as a condition affecting malnourished children with chronic diarrhea. However, recent findings suggest that the clinical presentation of celiac disease has evolved, with obesity now emerging as a noteworthy symptom among affected adults. Study Objectives and Methodology The primary goal of the study was to evaluate how prevalent obesity is among patients with celiac disease. To achieve this, researchers utilized data from the All of Us Research Program, a comprehensive national database. They examined a large sample size, consisting of 407,333 patients with celiac disease and an equal number of control individuals without the disease. These groups were matched by age and analyzed using health survey data. The main focus was to compare the prevalence of obesity between these two groups. Key Findings: Obesity Rates in Celiac Disease The results were striking: nearly one-third (32.6%) of patients with celiac disease were found to be obese, compared to only 18.4% of the control group. This substantial difference indicates that individuals with celiac disease are significantly more likely to be obese. The study reported an odds ratio of 2.111, underscoring the strong association between celiac disease and obesity. Demographic Insights When the data was broken down by sex, it was observed that women with celiac disease had the highest rates of obesity. However, men with celiac disease also exhibited a higher prevalence of obesity compared to their counterparts in the control group. Additionally, age stratification revealed that obesity was more common among individuals over the age of 65 with celiac disease. These demographic insights highlight that the relationship between celiac disease and obesity is consistent across different segments of the population. The Role of the Gut Microbiome One of the most intriguing aspects of this study is the suggested role of the gut microbiome in linking celiac disease and obesity. The researchers speculated that changes in the gut microbiota might contribute to the increased obesity rates observed in patients with celiac disease. This idea is supported by the notion that maintaining a strict gluten-free diet, which is essential for managing celiac disease, can be challenging for some patients. The resulting gut dysbiosis, or microbial imbalance, might therefore play a role in both celiac disease and obesity. Implications for Treatment and Future Research The study authors emphasized that their findings highlight the need for further investigation into how microbial changes and dietary exposures influence the development and progression of both celiac disease and obesity. Understanding these connections could pave the way for new therapeutic approaches that target gut dysbiosis. This could be particularly beneficial for patients struggling to adhere to a gluten-free diet or those experiencing obesity as a direct symptom of celiac disease. Conclusion This study's findings are particularly meaningful for individuals with celiac disease as they challenge the traditional understanding of the disease and expand its clinical spectrum to include obesity. For patients and healthcare providers alike, recognizing obesity as a potential symptom of celiac disease can lead to more comprehensive management strategies that address both dietary and microbiome-related aspects of the condition. By acknowledging and investigating the link between celiac disease and obesity, there is potential to improve patient outcomes and develop more effective, targeted treatments in the future. Read more: infectiousdiseaseadvisor.com

Celiac.com 06/08/2024 - Gastrointestinal disorders, such as gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), gastritis, peptic ulcer disease (PUD), and celiac disease, significantly affect individuals globally, influencing both health and economic stability. This comprehensive summary explores these conditions, focusing on their impact, underlying mechanisms, and current management strategies, with a particular emphasis on celiac disease. Understanding Gastrointestinal Disorders GERD involves the frequent backflow of stomach acids into the esophagus due to a malfunctioning lower esophageal sphincter (LES). This results in symptoms like heartburn and regurgitation, and can lead to complications such as erosive esophagitis and Barrett’s esophagus. Diagnosis often includes endoscopy and pH monitoring, while treatment involves lifestyle modifications and medications like proton pump inhibitors (PPIs). IBD encompasses Crohn’s disease and ulcerative colitis, both characterized by chronic inflammation of the GI tract. Crohn’s can affect any part of the GI tract, while ulcerative colitis is confined to the colon. Symptoms include abdominal pain, diarrhea, and weight loss. Diagnosis relies on endoscopy and biopsy, with treatment options ranging from anti-inflammatory medications to surgery. Gastritis involves inflammation of the stomach lining, often caused by Helicobacter pylori infection or NSAID use. PUD involves open sores in the stomach or upper small intestine. Symptoms include stomach pain and nausea. Treatment focuses on addressing the underlying cause, such as eradicating H. pylori with antibiotics or discontinuing NSAIDs. Celiac Disease: Beyond Gluten Intolerance Pathophysiology and Symptoms: Celiac disease is an autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals. The immune response damages the small intestine's lining, leading to malabsorption of nutrients. Symptoms vary widely and can include diarrhea, weight loss, anemia, and fatigue. Diagnosis: Diagnosing celiac disease can be challenging due to its diverse symptoms. Blood tests for specific antibodies, such as anti-tissue transglutaminase (tTG), and intestinal biopsies are commonly used diagnostic tools. Confirming the diagnosis typically involves both positive antibody tests and evidence of intestinal damage. Management: The cornerstone of celiac disease management is a strict, lifelong gluten-free diet. This diet involves avoiding all foods containing wheat, barley, and rye. Despite the challenges of adhering to this diet, it is essential for managing symptoms and preventing complications. Emerging therapies, including enzyme supplements and immune modulators, are being researched to complement dietary management. The Role of the Gut Microbiome The gut microbiome, a complex community of microorganisms in the digestive tract, plays a critical role in overall health. It aids in nutrient absorption, immune regulation, and protection against pathogens. Dysbiosis, or an imbalance in the microbiome, is linked to various GI disorders. Modulating the microbiome through probiotics, prebiotics, and diet is a promising therapeutic approach. For instance, a diet rich in fiber can promote a healthy microbiome, while processed foods can disrupt it. Advances in GI Disorder Management Recent advancements in the treatment of GI disorders include personalized medicine approaches, such as using biologics that target specific inflammatory pathways in IBD. Technological innovations like high-resolution manometry and capsule endoscopy improve diagnostic accuracy. Additionally, fecal microbiota transplantation is emerging as an effective treatment for conditions like recurrent Clostridium difficile infection. Importance of a Multidisciplinary Approach Managing GI disorders requires a comprehensive, multidisciplinary approach. This includes collaboration between gastroenterologists, dietitians, mental health professionals, and primary care providers. Addressing psychological factors, such as anxiety and depression, which often accompany chronic GI conditions, is crucial. Patient education and lifestyle modifications, including dietary changes and stress management, play significant roles in treatment. Conclusion: Implications for Celiac Disease Patients This review highlights the complex nature of GI disorders and the importance of a holistic, patient-centered approach to management. For those with celiac disease, understanding the disease's immunological basis and adhering to a gluten-free diet are essential for symptom management and preventing complications. Continued research into the gut microbiome and emerging therapies offers hope for improved treatments. A multidisciplinary approach, integrating medical, dietary, and psychological care, is vital for enhancing the quality of life and health outcomes for individuals with celiac disease. Read more: cureus.com

Celiac.com 03/06/2023 - We get a lot of questions about celiac disease and gluten-free-related issues. One question we've seen lately is: Is there a connection between the human gut microbiome and celiac disease? The short answer is yes. The longer answer is that research has show a number of connections between the two conditions, but we still have far more questions than answers. Here's a rundown of what we do know. Celiac disease is an autoimmune disorder that affects the small intestine. When individuals with celiac disease consume gluten, a protein found in wheat, barley, and rye, it triggers an immune response that damages the lining of the small intestine and interferes with the absorption of nutrients. One of the key components of the gut environment is the microbiome, a complex community of microorganisms that live in the gut. Recent research has shown that the gut microbiome plays a crucial role in the development and progression of celiac disease. Studies have shown that celiac disease is associated with changes in the composition and diversity of the gut microbiome. In individuals with celiac disease, there is a decrease in beneficial bacteria, such as Lactobacillus and Bifidobacterium, and an increase in pathogenic bacteria, such as Clostridium. This disruption of the gut microbiome, also known as dysbiosis, can lead to an imbalance in the gut environment, which can trigger an immune response and further damage to the small intestine. Celiac Disease Disrupts the Gut Microbiome Recent studies have shown that celiac disease not only affects the gut lining but also disrupts the balance of the gut microbiome. The gut microbiome is made up of trillions of microorganisms that reside in the gut and play a crucial role in maintaining overall health. In healthy individuals, the gut microbiome is diverse and balanced, but in celiac patients, the gut microbiome is often imbalanced, known as dysbiosis. Gluten-Free Diet Affects Gut Microbiome Dysbiosis in celiac patients can lead to a reduction in beneficial bacteria and an increase in harmful bacteria. This can cause a number of issues such as inflammation, changes in gut motility and nutrient malabsorption. Additionally, research has shown that the gut microbiome in celiac patients also changes after starting a gluten-free diet. For instance, the levels of certain beneficial bacteria such as Lactobacillus and Bifidobacterium increase, which can help to restore balance in the gut microbiome. Gut-Brain Axis It is not entirely clear yet how the gut microbiome is affected in celiac disease, but researchers believe that the gut-brain axis, which connects the gut and the brain, plays a key role. Studies have shown that the gut microbiome can influence the brain-gut axis and may impact nociceptive behavior and brain function. There's also a connection between gut-brain axis and migraines in people with celiac disease. Connections Between Microbiome and Celiac Research We also know that Genetic Risk for Autoimmune Disease Tied to Gut Microbiome We know that Celiac Disease Onset Changes Gut Microbiota in Children Recent research shows that Gluten Does Not Change Gut Microbiome in Patients with Celiac Disease and Non-Celiac Gluten Sensitivity We just recently learned that Altered Gut Bacteria Linked With Long COVID-19 Symptoms We also know that, in some cases, Fecal Microbiota Transplant Restores Gut Microbiome New research tells us that interaction between the gut microbiome and micronutrients are a key to the availability of minerals and vitamins. Gut Microbiome Affects Bioavailability of Micronutrients The gut microbiome can variously influence the bioavailability of micronutrients, as well as be influenced by micronutrient supplementation, with potential implications for health, even in the long term. Although several mechanisms have been advanced, a thorough characterization of the microbiome–micronutrient bidirectional axis is of utmost importance, as it can guide the design of microbiome‐based precision intervention strategies, aimed at improving micronutrient status and overall health. Studies have shown that celiac disease is associated with changes in the composition and diversity of the gut microbiome, which can lead to an imbalance in the gut environment, known as dysbiosis. Gut microbiome imbalance can lead to a number of issues such as inflammation, changes in gut motility and nutrient malabsorption. Research has shown that the gut microbiome in celiac patients also changes in some worrisome ways after starting a gluten-free diet. Much Unknown About "Healthy" Gut Microbiome Additionally, we need a clear understanding of what constitutes a "healthy" gut microbiome in people with or without celiac disease to fully understand the implications of gut health on celiac disease. When it comes to the connection between the human gut microbiome and celiac disease, we're learning that the two conditions are connected. Some evidence suggests that the health of the gut microbiome can influence certain symptoms of celiac disease, especially headaches. However, much more research is needed before we can make any hard conclusions about the exact nature of the connections, and the implications for people with celiac disease and other auto-immune conditions.

Celiac.com 02/14/2022 - Prior studies have found links between the gut microbiome and COVID-19, along with other diseases. However, a new study by investigators at the Chinese University of Hong Kong offers the first published data specifically linking gut health to COVID's long-term effects. The research team assessed 106 patients with COVID-19 from February to August 2020, at three different hospitals, and compared their results against a group of patients recruited in 2019, who did not have COVID. Patients had mostly mild to moderate Covid severity. At 3 months, nearly ninety of the COVID patients had post–acute COVID-19 syndrome (PACS), which researchers defined as at least one persistent, otherwise unexplained symptom 4 weeks after testing negative for Covid. After six months, more than eighty patients still had PACS, with the main complaints being anxiety, fatigue, poor memory, hair loss, and difficulty sleeping. Stool sample analysis of PACS patients showed sharply lower bacteria diversity and abundance at six months, compared with with control subjects, and those without PACS. In patients with PACS, at both baseline and follow-up, nearly thirty bacteria species were reduced, while nearly fifteen were increased. Patients with COVID but not PACS showed just 25 changes to bacteria species at hospital intake, and all of those patients normalized by 6 months. The team linked patient respiratory symptoms at 6 months to higher levels of opportunistic pathogens such as Streptococcus anginosus and S. vestibularis. They also tied neuropsychiatric symptoms and fatigue to nosocomial pathogens, which are linked to opportunistic infections, such as Clostridium innocuum and Actinomyces naeslundii (P < .05). Bacteria that produce the beneficial fatty acid butyrate were substantially reduced in patients with hair loss. They also found that specific bacteria, including Bifidobacterium pseudocatenulatum and Faecalibacterium prausnitzii, showed the greatest inverse correlations with PACS at 6 months.. "Particular gut microbial profiles may indicate heightened susceptibility," said Dr Siew Ng, MBBS, PhD, associate director at the university's Center for Gut Microbiota Research. "Although the findings were drawn from patients with earlier strains of the COVID-19 virus, the findings still apply to new variants, including Omicron, since these pose the same problem of persistent disruption of the immune system," Ng adds. Dr Ng's group is currently carrying out trials to assess how long COVID might be prevented, and antibodies boosted, by modulating the microbiome after vaccination in high-risk people. "To our knowledge, this is the first study to show that altered gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus," said Dr Ng. Meanwhile, Eugene Chang, MD, professor of medicine at the University of Chicago, who has studied the gut microbiome and gastrointestinal disease, cautions that the study is "too preliminary" to lead to any clinical changes. Dr. Chang notes that the observations merely identify the microbes present, not their actual effects. Stay tuned for more on this and related stories about celiac disease and Covid. Read more in Medscape Medical News

Celiac.com 07/26/2021 - Cases of chronic inflammatory autoimmune conditions, such as celiac disease are rising at a rate that concerns many researchers. To better understand the etiology and pathogenesis of celiac disease, especially the role of environmental stimuli, and gut microbiota in connection with the immune system, a team of researchers recently conducted a study, in which they did both cross-sectional and longitudinal analysis of gut microbiota, functional pathways, and metabolites, starting from 18 months before celiac disease onset in 10 infants who developed celiac, compared with 10 infants who did not. The research team included Maureen M. Leonard, Francesco Valitutti, Hiren Karathia, Meritxell Pujolassos, Victoria Kenyon, Brian Fanelli, Jacopo Troisi, Poorani Subramanian, Stephanie Camhi, Angelo Colucci, Gloria Serena, Salvatore Cucchiara, Chiara Maria Trovato, Basilio Malamisura, Ruggiero Francavilla, Luca Elli, Nur A. Hasan, Ali R. Zomorrodi, Rita Colwell, Alessio Fasano, and The celiac disease-GEMM Team. Cross-sectional analysis at celiac onset showed altered levels of six microbial strains and several metabolites between cases and control subjects, but no change in microbial species or pathway levels. Meanwhile, longitudinal analysis showed increased levels of several microbial species/strains/pathways/metabolites before celiac onset. These had previously been linked to autoimmune and inflammatory conditions, such as Dialister invisus, Parabacteroides sp., Lachnospiraceae, tryptophan metabolism, and metabolites serine and threonine. Others, found in reduced levels before celiac onset, are known to have anti-inflammatory effects, such as Streptococcus thermophilus, Faecalibacterium prausnitzii, and Clostridium clostridioforme. They also found previously unreported microbes/pathways/metabolites, including Porphyromonas sp., high mannose–type N-glycan biosynthesis, and serine, that point to celiac-specific biomarkers. The team found clear changes in the gut microbiota, functional pathways, and molecular biochemistry before the start of celiac disease. This finding indicates that this information could be used to improve celiac disease prediction. The researchers hope that by identifying the early warning signs of celiac disease, they may be able to eventually provide preventive interventions to reestablish tolerance and prevent autoimmune disfunction. Read more in PNAS July 20, 2021 118 (29) e2020322118 The researchers are variously affiliated with the Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA; the Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA; the Celiac Research Program, Harvard Medical School, Boston, MA; the European Biomedical Research Institute of Salerno, Salerno, Italy; the Pediatric Unit, Maternal and Child Health Department, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, 84125 Salerno, Italy; the Cosmos ID Inc., Rockville, MD; the Theoreo srl, University of Salerno, Salerno, Italy; the Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy; the Pediatric Gastroenterology, Sapienza University of Rome, Rome, Italy; the Pediatric Unit, Maternal and Child Health Department, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy; the Pediatric Gastroenterology, University of Bari, Bari, Italy; lCenter for Prevention and Diagnosis of Celiac Disease, Fondazione Department and University Hospital (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; and the Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD.

Celiac.com 02/15/2019 - Aiming for a wheat that is safe for people with coeliac disease and other gluten-sensitive individuals to consume, Professor Francisco Barro and colleagues of the CSIC Institute for Sustainable Agriculture in Cordoba, Spain have developed transgenic wheat lines in which the gliadin proteins (the gluten elements responsible for the damaging immune response of people with coeliac disease) have been strongly, and specifically, supressed.(1) Now, a study published in December 2018 in the journal Nutrients(2) has shown that fresh bread, made from the new wheat line, causes no negative response in non-coeliac gluten sensitive (NCGS) individuals when consumed regularly over several days. The bread was considered highly palatable by the trial participants. Moreover, in addition to the success in not triggering any acute gut symptoms, analysis of gut microbial populations demonstrated that the low-gliadin bread caused clear changes in the microbial profile consistent with a more beneficial population of natural bacteria, when compared to the profile present whilst consuming a gluten-free diet. The new wheat lines are being developed as an alternative option for people with gluten sensitivity by commercial partners of Plant Bioscience Limited, a UK-based technology transfer company, who have also patented the new wheat lines on behalf of CSIC. Prof. Barro said "This wheat opens up exciting new perspectives for NCGS patients; it's like following a gluten-free diet but with the aroma and taste of traditional wheat bread and favouring a much healthier microbiome." Professor Alastair Forbes, Clinical Professor in Medicine at the University of East Anglia, a leader in gastroenterology clinical research said; "This work is really encouraging news for the gluten sensitivity research community and the patients it serves. With no apparent drawbacks we now have a promising new wheat line in development that is non-toxic and promotes a healthier gut microbiome than the often-unpalatable gluten-free options hitherto available." Sarah Sleet, Coeliac UK chief executive said: "This is an exciting development showing real potential to develop a new bread from wheat, that may be suitable for people with coeliac disease. We’re not quite there yet, as this paper shows that bread from LGW is acceptable to people with gluten sensitivity but it has not completed testing in individuals with coeliac disease. We look forward to seeing the results of the ongoing tests in coeliac patients, who currently must follow a lifelong strict gluten-free diet to manage this serious autoimmune condition." For enquiries regarding the low-gliadin wheat, please contact Plant Bioscience Limited on telephone +44 (0)1603 45600, or via email info@pbltechnology.com. The full article can be read for free here: https://www.mdpi.com/2072-6643/10/12/1964 References: Effective shutdown in the expression of celiac disease-related wheat gliadin T-cell epitopes by RNA interference. Gil-Humanes J, Pistón F, Tollefsen S, Sollid LM, Barro F (2010). PNAS; 107(39): 17023-17028. The Dietary Intervention of Transgenic Low-Gliadin Wheat Bread in Patients with Non-Celiac Gluten Sensitivity (NCGS) Showed No Differences with Gluten Free Diet (GFD) but Provides Better Gut Microbiota Profile. Carmen Haro, Myriam Villatoro, Luis Vaquero, Jorge Pastor , María J. Giménez, Carmen V. Ozuna, Susana Sánchez-León, María D. García-Molina, Verónica Segura, Isabel Comino, Carolina Sousa, Santiago Vivas, Blanca B. Landa and Francisco Barro (2018). Nutrients; 10(12), 1964.