|This is the talk page for discussing improvements to the Gluten sensitivity article.|
|This article is of interest to the following WikiProjects:|
- 1 Not just too technical, misleading
- 2 Audience
- 3 Gluten sensitivity and Multiple Sclerosis
- 4 Oat sensitivity
- 5 What's the relationship between GS and coeliac disease?
- 6 Additional info needed: symptoms and development
- 7 Incidence and prevalence
- 8 Connection to diabetes
- 9 Out-of-date
- 10 What is going on with the Odds Ratio tables?
- 11 Definition
- 12 Autism as a Symptom of Gluten Sensitivity
- 13 Celiac vs. coeliac
- 14 Ambiguity of 'Gluten sensitivity'
- 15 Speculation in lead
- 16 schizophrenia
- 17 Comparative pathophysiology: Citations?
- 18 The toilet cleaner is here
- 19 Difference between idiopathic gluten sensitivity and celiac disease
- 20 Wheat allergy vs. Gluten sensitivity
- 21 Digestive Enzymes
- 22 Rename article?
Not just too technical, misleading
While I find this page and some of the associated pages on gluten sensitivity interesting in terms of the amount of data amassed and correlated, it is, as others suggested, too technical, and furthermore it's probably misleading for most non-medical audiences that can't easily distinguish between low-quality and high-quality evidence. The former predominates on most of these pages. It looks like someone just did a pubmed search for gluten sensitivity and then summarized everything they could find without regard for whether the findings had been replicated, distinguishing between causation and correlation, etc.
I also agree that this article is too technical, and probably inaccessible to most people who'd want to read it. Should we at least re-phrase the introduction so that it's more easy to understand? Armadillo1985 (talk) 13:12, 13 September 2011 (UTC)
Hey folken. I'm concerned that this page is too dense in its current state. I don't suggest removing any information, but perhaps some jargon could be better explained. I'm a molecular biology graduate student and I'm still having trouble getting through it. I realize that immunology is very complicated, and that it may be impossible to avoid jargon completely; but I'd also recommend that it be reduced. See also: Tone, particularly the parts on jargon and context. --aciel (talk) 00:00, 8 January 2008 (UTC)
I agree the page is dense it took me a few reads (and a bit of background reading) to understand it but please do not make the mistake of oversimplification. This is a complex issue and I have found this page and its associated links enormously helpful in understanding what is really at the core of this affliction I have. Thanks to the Authors. 126.96.36.199 (talk) 23:09, 19 February 2008 (UTC)NBelford
- The jargon tag was removed without an edit comment, and without discussing here. Kindly do not remove this tag until consensus is reached HERE that this issue has been resolved. Thank you. Socrates2008 (Talk) 23:05, 23 February 2008 (UTC)
Wow! Great article. There is a lot of new information coming out in this field and this article does an incredible job of collecting it. This was a lot of work. The other commenters thoughts reflect the technical nature of this article. The article could use an introductory article (certainly more than a paragraph) to ease readers with less of a technical background into the article. Kd4ttc (talk) 04:12, 26 February 2008 (UTC)
Gluten sensitivity and Multiple Sclerosis
This article is so unreadable. It moves from kind of easy to read to lots of technical nomenclature. Also, what's with the blaming gluten on every disease. For example, gluten sensitivity has nothing to do with MS, yet the article makes it read like it's causal. At best, there's some sensitivity for patients with MS, but that's hardly definitive. OrangeMarlin Talk• Contributions 20:02, 2 March 2008 (UTC)
- The inclusion of the article on multiple schlerosis follows a strand within the literature that associates the incidence of anti-gliadin antibodies with other neurological diseases. Personally, I question whether there is significance after the association with GSE has been elucidated, but that is my opinion. The purpose of this page is to _differentiate_ three forms of gluten or wheat sensitivity discussed either in the literature or by third party genetic typing groups. As these groups are frequently assigning risk of disease (GSE, IGS, or allergy) based on genetic typing and AGA. It is not to validate these claims, simply to parse the claims into groupings so that people do not confuse MS w/AGA as being celiac disease.
- Note: One of the factors that is associated with MS, particularly stress to the nervous system. Gluten sensitivity in any of its forms can cause the types of stress that can cause crisis for MS patients. As for the readability issues, I have been quite busy for the last few months. I am getting back to editing the article to create an encyclopedic format where-ever possible. Currently working on the immunochemistry section. Wikilinks will be provided whereever possible, so that the reader can read on the technical words used to describe each type of sensitivity. Pdeitiker (talk) 16:27, 7 June 2008 (UTC)
"OBJECTIVE: We wanted to measure immunoglobulin A (IgA) antibodies to some common food antigens in MS and also IgG against gliadin and gluten. METHODS: The IgA antibodies were measured in serum against gluten, gliadin, lactoglobulin, lactalbumin, casein and ovalbumin in patients with MS and controls using ELISA technique. IgG was likewise measured for gluten and gliadin. RESULTS: Highly significant increases compared with controls were found for IgA and IgG antibodies against gliadin and gluten. IgA antibodies against casein were significantly increased. Anti-endomycium and anti-transglutaminase antibodies were negative."
"Two atypical patients with a multiple sclerosis (MS)-like illness and evidence of occult celiac disease (CD) were managed by the authors. This prompted screening of a further 49 unselected MS cases for serologic evidence of CD. IgA anti-endomysial antibody was found in one case (2%). IgG anti-gliadin antibody was found in 12% of patients and 13% of blood donors. Anti-gliadin antibody (especially IgG isotype) can be a nonspecific finding."
- I interpret this finding like many others that recently appear in the literature. There are factors in the western diet that allow the penetration of food peptides into systemic circulation. Omega-gliadin is one which is involved in anaphlaxis and urticaria. It can also be induced by Aspirin or NSAIDS, or other factors such as MSG, benzoate, or tartazine. The wiki page on idiopathic disease identifies that these findings could be due to GSE or Allergy, but there is also the possibility that gliadin directly interfers with neurologcal function. There is simply not enough data.Pdeitiker (talk) 03:08, 9 June 2008 (UTC)
"Recent investigations have documented that aspirin consumption, in place of exercise, also induces allergic symptoms. CASE SUMMARY: A 63-year-old man began low dose aspirin therapy on September 2005. Since January 2006, he had repeated episodes of generalized urticaria and lost consciousness while he was exercising after eating wheat. He was strongly positive for omega-5 gliadin in a cap-system fluorescent enzyme immunoassay. Therefore, a diagnosis of wheat-dependent exercise-induced anaphylaxis was made. DISCUSSION: Patients with aspirin-provoked FDEIA have been reported previously as taking ordinary doses of aspirin for reducing pain, inflammation and fever. However, in our patient, low dose aspirin therapy for reducing cardiovascular risk possibility induced FDEIA.",
- There are other case findings for these effects of aspirin are published, aspirin appears to be a gluten sensitizer.
- Agardh D (November 2007). "Antibodies against synthetic deamidated gliadin peptides and tissue transglutaminase for the identification of childhood celiac disease". Clin. Gastroenterol. Hepatol. 5 (11): 1276–81. doi:10.1016/j.cgh.2007.05.024. PMID 17683995.
- Pengiran Tengah CD, Lock RJ, Unsworth DJ, Wills AJ (June 2004). "Multiple sclerosis and occult gluten sensitivity". Neurology 62 (12): 2326–7. PMID 15210909.
- Fujii H, Kambe N, Fujisawa A, Kohno K, Morita E, Miyachi Y (March 2008). "Food-dependent exercise-induced anaphylaxis induced by low dose aspirin therapy". Allergol Int 57 (1): 97–8. doi:10.2332/allergolint.C-07-53. PMID 18089939.
I am currently adding much information concerning oats to this page. However a split page on oat sensitivity is already in the formative stages, after which information dealing with oat allergy and avenin sensitive enteropathy will be split off. A link to that page will be provided within the gluten sensitivity template.
What's the relationship between GS and coeliac disease?
This article is not very clear on what gluten sensitivity is outside of coeliac disease. Besides dermatitis herp., what other diseases are there, really? Does idiopathic GS present itself with histological abnormalities? ImpIn | (t - c) 05:54, 23 June 2008 (UTC)
- Aside from these idiopathic diseases, there are an increasing number of studies that show gluten can cause damage to the GI without an adaptive response similar studies are showing the gliadin allergens can bypass the <500 Dalton cut off for tight junction permeability and enter into the region of the lamina proxima. There are lingering question about one person gets allergies and another gets CD. Typically the response on gets CD when one has the gene, and factors unknown.
- The reason gluten sensitivity is unclear outside of celiac disease is that the studies that have claimed GS exists outside of CD are also not clear, or not well done, or lack statistical significance.
- Specifically Gluten sensitivity is encompasses gluten sensitive enteropathy, it encompasses idiopathic disease, and it encompasses symptomology to gluten when GSE or allergic reactions cannot be, or have not been shown.Pdeitiker (talk) 22:27, 23 June 2008 (UTC)
As I've pointed out under "Definition" below, I think this is an inherent problem with using this definition of gluten sensitivity. Much more accurate now would be to talk about coeliac disease as part of the spectrum of gluten related disorders. I disagree about the strength of research into gluten sensitivity as a separate pathology outside coeliac disease, but either way, the confusion does appear to lend weight to the growing recognition that a better umbrella term would be gluten related disorders. Chrismarritt (talk) 08:59, 5 October 2011 (UTC)
- Gluten Sensitivity is more like an allergy. Celiac disease is an autoimmune response to gluten (or a component of gluten). They have nothing to do with each other. Celiac disease is a clearly defined and well understood condition. GS or Gluten Intolerance, not so much. These conditions or diseases are not on the same spectrum. There is no plausible path for CS to become DC. This should be clarified. CarbShark (talk) 20:15, 27 July 2013 (UTC)
Additional info needed: symptoms and development
Please add to this article:
(1) A clear section on symptoms of gluten sensitivity. (Or a statement of why it is inappropriate or impossible to provide such a section.)
(2) Clear information on development of the problem (etiology?). E.g., is gluten sensitivity always congenital/present from infancy, or can it develop later in life?
Totally agree: I came to this page wondering what the symptoms of this were and how common the various symptoms are. I didn't find an answer to either question. Jacob (talk) 17:29, 17 February 2009 (UTC)
Incidence and prevalence
Connection to diabetes
- This is a press release. The connection between Type 1 diabetes and Coeliac disease is not new:
- Type 1 diabetes is genetically linked DR4-DQ8 and DR3-DQ2.5, Coeliac disease is linked to DQ2.5 and DQ8
- A study of dutch early onset case males revealed a sizable fraction of males with Coeliac disease also had type 1 diabetes.
- A study of type 1 diabetes found that a relatively large percent of early onset cases have anti-transglutaminase antibodies even though celiac disease was not evident in many cases.
- A study of reactivity found that the GLb-1 protein of wheat, which shares some sequence similarity with the major antigen of peanuts elicited antibodies that were implicated in the destruction of the islet of langerhans cells, however glb-1 is not a prolamin, and is therefore not a gluten.
What is going on with the Odds Ratio tables?
I have never seen odds ratios formatted like this. In fact, I'm not even sure that I'm properly interpreting them. Why not use an fraction or a simple decimal? This is even how the wiki on odds ratios does it Odds Ratio. 188.8.131.52 (talk) 14:37, 25 August 2011 (UTC) Josh
Apologies if I put this in the wrong place previously. I think this piece no longer reflects what people mean when they talk about "gluten sensitivity". It has in the past been used as an umbrella term for the full spectrum of conditions linked to gluten, but in the past few years has been used to refer to a specific pathology, distinct from coeliac disease and wheat allergy. 'Gluten-related disorders' is a better and now more accepted term for the wider spectrum of conditions. For clarity, this article should explain the emerging condition of gluten sensitivity, then perhaps move towards including much of the content here under a different article on gluten-related disorders? Chrismarritt (talk) 12:14, 3 October 2011 (UTC)
Autism as a Symptom of Gluten Sensitivity
This article repeatedly cites a paper called "The Gluten-Free, Casein-Free Diet In Autism: Results of A Preliminary Double Blind Clinical Trial", suggesting that autism is a symptom of gluten sensitivity. The paper in question states clearly: "Data on autistic symptoms and urinary peptide levels were collected in the subjects’ homes over the 12 weeks that they were on the diet. Group data indicated no statistically significant findings"
It sound as though inferring that autism is caused by gluten sensitivity is a gross misrepresentation.
Here's the paper: http://www.springerlink.com/content/8575wx07436024k5/ — Preceding unsigned comment added by 184.108.40.206 (talk) 19:58, 6 March 2012 (UTC)
Agree completely. I looked at the claim in the article with skepticism, checked the reference...the paper refers only to treatment of gluten-sensitive autistic patients who *otherwise* have some indicator of gluten sensitivity by adhering to a gluten-free diet. In no way does this paper seem to claim that gluten sensitivity could claim autism as a "symptom". I am going to remove the autism reference in the article as the linked reference clearly does not support that claim. TonyHagale (talk) 05:57, 8 March 2012 (UTC)
Celiac vs. coeliac
Just to explain my edit a little further, the article used mixed variants of the word "c(o)eliac" and since it doesn't mention anything about using UK spelling, I've standardized the spelling of "coeliac" to "celiac", even though the Coeliac disease article uses the UK spelling. I tried to only do the "appropriate" ones, in other words, not those that are titles of books, quotations, etc., but if I goofed anywhere, or if we want to standardize on UK/international spelling, please feel free to correct them. I'm not picky on which one we use, just as long as it's standard throughout the article. – RobinHood70 talk 05:32, 7 March 2012 (UTC)
Ambiguity of 'Gluten sensitivity'
It appears that the term 'gluten sensitivity' is used in at least two different senses throughout this article. In one sense, it is an inclusive umbrella term that includes celiac disease, wheat allergy, and other conditions. In another sense, it refers only to the 'other conditions'; that is, a syndrome of abnormal signs or symptoms after ingesting gluten in persons in whom celiac disease and wheat allergy have been ruled out. For example, under the section titled 'Separating forms of gluten sensitivity,' the first two sentences state--
"Only rarely should gluten sensitivity be without cause. Generally the sensitivity can be split between celiac disease, gluten sensitivity and wheat allergy."
It seems the first 'gluten sensitivity' and 'the sensitivity' are used in the inclusive sense and the second 'gluten sensitivity' is used in the exclusive sense.
Can we find a different term for one of these senses? Since it seems that celiac disease and wheat allergy ARE forms of sensitivity to gluten, I would favor using 'gluten sensitivity' in the broader inclusive sense and perhaps using something like 'non-celiac, non-allergic gluten sensitivity' for the exclusive sense. (Yes, that is awkward. Someone else might have a more elegant alternative.) Steveorwig (talk) 16:01, 19 May 2012 (UTC)
Actually, I now see that 'idiopathic gluten sensitivity' seems to be used in the narrower, exclusive sense as described above, though I am not sure if that exhausts the 'other conditions' category. Are there generally accepted syndromes of gluten sensitivity that have known causes, other than celiac disease and wheat allergy? If not, then I think 'idiopathic gluten sensitivity' would work for the exclusive sense (and it is much less clumsy than 'non-celiac etc.'), but it needs to be used more consistently throughout the article. (Part of the problem is that this whole area is dynamic and evolving, so some of the boundaries are inherently fuzzy and in flux at present.) — Preceding unsigned comment added by Steveorwig (talk • contribs) 16:40, 19 May 2012 (UTC)
The term is idiopathic gluten sensitivity meaning gluten sensitivity without a defined cause. once the cause is defined it becomes [whatever cause] gluten sensitivity.PB666 yap 14:24, 11 September 2012 (UTC)
Speculation in lead
"Sapone speculates that some form gluten sensitivity affects roughly 10% of the general population." I don't see why this speculation is worthy of support without review. Who is Sapone and why is his speculation lead-worthy? Why is a primary source highlighted in the lead? Ultra Venia (talk) 00:39, 3 June 2012 (UTC)
I agree. This whole article reads a little strangely. That weirdo side-bar, the rhetorical question at the opening of one of the sections. In general, it reads like it was written with an, if not an agenda, at least by someone(s) who know a lot about a single point of view on the issue. — Preceding unsigned comment added by 220.127.116.11 (talk) 01:45, 14 July 2012 (UTC)
Although I wrote most of the article some sections were markedly changed. I have not agenda with regard to idiopathic gluten sensitivity, an argument developed as a consequence of 1 english research group, so I created this page. I have not attended this page in quite some time, and I noticed alot of it is confusing and contradictory stuff (ihave not looked at the history so it might be mine?), I have tried to correct these. I do not know who Sapone is. Over the next few months I will go about adding stuff to the article, more research has been done including in the realm of immunochemisty.PB666 yap 14:24, 11 September 2012 (UTC)
I should point out the reason for the questions. The primary reason is that the debate in the gluten-sensitive community, clearly substantial enough for a wiki article, but much of the debate lacks the standard criteria for broad scientific acceptance. There are several camps in the debate. First, gluten sensitivity = celiac disease, nothing more. Second gluten sensitivity has a broader scope, but is difficult to define (mainly because it has not been investigated). Third gluten sensitivity is expansive, almost as abundant as celiac disease, and includes all kinds of neuropathies, and other conditions. I suspect the last idea is 'overly ambitious', most GS should have a defined cause and not be idiopathic, therefore likely a diagnostic issue.PB666 yap 14:24, 11 September 2012 (UTC)
The lead to this article claims that schizophrenia is a symptom of gluten sensitivity and cites this paper; http://www.ncbi.nlm.nih.gov/pubmed/20471632 (in a list of papers - non of the others mention schizophrenia). However that paper was investigating whether schizophrenia leads to gluten sensitivity, rather than whether gluten leads to schizophrenia. I also note that none of the references provided to that sentence actually provide evidence for the other "non-intestinal" symptoms, and only one even mentions some of those (but didn't actually study whether those are legitimate symptoms or not). --Owheelj (talk) 00:58, 8 October 2012 (UTC)
Comparative pathophysiology: Citations?
The toilet cleaner is here
Thee are some major problems with this article. I will be taking out anything not referenced to a proper source in one week from now. If that leaves it looking like a stub, I would find that preferable to its current state. One week from now is 5 February. --John (talk) 22:07, 29 January 2013 (UTC)
- I started this off today. I am sure it still needs more trimming. It would be great if others could help out. --John (talk) 11:48, 16 February 2013 (UTC)
- No idea if it's due to edits, but abbreviations are used rather copiously without prior explanation - GSE ("gluten-sensitive enteropathy" I guess, a phrase that occurs nowhere in the text), GFD ("gluten free diet", I guess?) Donnx (talk) 18:42, 5 March 2013 (UTC)
Difference between idiopathic gluten sensitivity and celiac disease
Anyone care to explain this section, Gluten sensitivity#Difference between idiopathic gluten sensitivity and celiac disease? That section needs to be interpreted and written in much simpler language. GB fan 23:02, 20 February 2013 (UTC)
- Or if not simpler, at least more coherent. The title proposes that the text will be in large part about idiopathic GS, but the text itself seems to drift back and forth on whether it's about idiopathic, or that's just a rare corner case of gluten related enteropathy. Likely a product of extensive editing from different points of view, the result is it's incomprehensible to someone who doesn't already know this stuff. Donnx (talk) 14:18, 20 March 2013 (UTC)
Wheat allergy vs. Gluten sensitivity
The wheat allergy article currently covers all forms of gluten allergy as a subset of wheat allergy; this article covers all forms of wheat allergy as gluten sensitivity. I believe that both articles are incorrect: the gluten allergen also exists (in varying degrees) in all the members of the Triticeae tribe - i.e. in rye and barley as well as in wheat - and wheat has non-gluten allergens such as pollen. Further, while the wheat, rye, and barley glutens are all seed storage proteins, people are only sensitive (vs. allergic) to two of the four types; and there are are other seed storage proteins in other grains (such as avenin in oats) to which some people are sensitive. (Per the Mayo Clinic article on food allergy, a food intolerance (e.g. celiac disease) is a food sensitivity but not a food allergy - though an individual may be both sensitive and allergic to a food. For example, a person may have celiac disease and also be allergic to wheat.)Penelope Gordon (talk) 09:18, 14 March 2013 (UTC)
Anyone who has experties in Digestive Enzymes, please do contribute this article or related sister articles so they will be more useful as a way of preventative medicine other than rediculous glutin free diet. Also other known preventional measure should be added as well. General public will surely appreciate it. — Preceding unsigned comment added by 18.104.22.168 (talk) 02:41, 12 September 2013 (UTC)
I'm wondering if we should rename the article to 'Nonceliac gluten sensitivity' and rewrite it to talk specifically about this proposed condition. Currently the article is confusing and ambiguous - is it talking about gluten inolerance as an umbrella term covering celiac, or is it just talking about non-celiac intolerance? I think renaming it to only cover nonceliac sensitivity would make sense. --sciencewatcher (talk) 02:30, 5 June 2014 (UTC)
- Agreed. II | (t - c) 05:23, 5 June 2014 (UTC)
- Partly agree, but move rather than rename - I agree their should be an article discussing "non-coeliac gluten sensitivity", which is much of the contents of this article, but there also needs be an overview of gluten-related conditions which is this article's title and is shown in top table and bottom template listing the related articles. David Ruben Talk 22:44, 27 July 2014 (UTC)