Genetic modifications of gluten-containing grains, carried out in the last 10,000 years to improve their quantitative and qualitative features, were an “evolutionary mistake” which created the background to the onset of human diseases dependent on exposure to this substance. These types of intolerances to gluten that, all together, affect about 10% of the general population, are among the most common pathologies, especially if we consider that coeliac disease (CD) alone, which is the most characterized form of intolerance to gluten, affects about 1% of the European population, both children and adults.
Reactivity to gluten can be based on allergic or autoimmune mechanisms. If in the UK the estimated prevalence of CD is 1 in every 100 people but only 10-15% of cases are thought to be clinically diagnosed (approximately 125,000) this means there are still approximately 600,000 coeliac patients who are unaware they have this condition or it has not been recognised by the medical community.. It is important to remember that we are only speaking of cases of CD that, together with gluten allergy, is a recognisable disease.

Things are different when we speak of another kind of reactivity to gluten, in which neither allergic nor autoimmune mechanisms are involved: the emerging condition gluten sensitivity. It is not easy to precisely identify how many subjects are gluten sensitive, even if this condition seems to be much more frequent than CD. At the same time, it is not easy to diagnose gluten sensitivity because of the lack of typical markers identifying it. At present, it is possible to define it, only by a diagnosis of exclusion, as a “condition of reaction to gluten ingestion in which CD and gluten allergy have been excluded and only innate immunity is possibly involved (assuming that the spectrum of gluten reactions includes three main categories – allergy, CD, sensitivity.)

Because of the broad diffusion of this problem, there arose the need to inform healthcare professionals via this website. We will try to better identify the symptoms (overlapping with those of CD) and the present possibilities of diagnosis and treatment, besides trying to understand why some individuals become sensitive to gluten and then, suddenly, with a temporary gluten-free diet, the problem resolves. In order to understand what factors trigger the problems related to gluten ingestion, we think it is useful to clarify, even shortly, how genetic modifications of wheat itself could have contributed – in some predisposed individuals – to the onset of the three big categories in which gluten reaction is preponderant. Finally, healthcare professionals will be able to get a full overview on all scientific news on this subject, to share opinions with a panel of national and international experts, and to be up-to-date and use resources which will certainly be useful for their patients as well.