Distinguishing IgE-mediated wheat allergy, celiac disease, and non-celiac wheat sensitivity: a mechanism-informed diagnostic review
Gastroenterology and Hepatology from Bed to Bench,
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2 March 2026
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Page 1-14 (e19)
https://doi.org/10.22037/ghfbb.v19i01.3324
Abstract
Wheat consumption can trigger adverse reactions through distinct pathological mechanisms that share similar clinical presentations but require entirely different diagnostic and therapeutic approaches. IgE-mediated wheat allergy is an immediate hypersensitivity reaction driven by allergen-specific IgE and Th2-mediated responses. Celiac disease is a chronic autoimmune enteropathy characterized by an HLA-restricted adaptive T-cell response and tissue transglutaminase 2 autoantibody production. Non-celiac wheat sensitivity represents a heterogeneous, non-autoimmune, non-allergic syndrome where the causal wheat component and underlying pathophysiology remain poorly defined. This narrative review provides a comprehensive synthesis of the biological pathways, clinical phenotypes, diagnostic accuracies of established and emerging biomarkers, and a clinical reasoning framework to differentiate these three conditions.
- pathogenesis
- diagnostic
- Wheat Allergy
- Non-Celiac Gluten Sensitivity
- Celiac Disease
How to Cite
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