PD313 - NON-CELIAC WHEAT SENSITIVITY (NCWS) IS ASSOCIATED WITH INTESTINAL BARRIER DYSFUNCTION, MUCOSAL IMMUNE ACTIVATION, AND CHANGES IN FECAL SHORT-CHAIN FATTY ACIDS (SCFA)
PD313
NON-CELIAC WHEAT SENSITIVITY (NCWS) IS ASSOCIATED WITH INTESTINAL BARRIER DYSFUNCTION, MUCOSAL IMMUNE ACTIVATION, AND CHANGES IN FECAL SHORT-CHAIN FATTY ACIDS (SCFA)
L. Filipe Rosa1,*, P. P. Petersen1, A. Rings1, S. C. Bischoff1
1Institute of Nutritional Medicine (180a), University of Hohenheim, Stuttgart, Germany
Rationale: NCWS is characterized by a history of wheat sensitivity, exclusion of celiac disease (CD), and wheat allergy (WA), and is ideally confirmed by a double-blind, placebo-controlled food challenge (DBPCFC). In contrast to CD and WA, the pathophysiology of NCWS remains largely unknown, and reliable diagnostic biomarkers are still lacking. NCWS has been associated with intestinal immune activation and intestinal barrier dysfunction. In this study, we aimed to identify potential biomarkers with diagnostic relevance for NCWS.
Methods: Initially, 285 patients with different food sensitivities were recruited. After exclusion, 37 patients with suspected NCWS were included and underwent DBPCFC with wheat flour. NCWS was confirmed in 19 patients, while 18 were classified as having unspecific food reactivity. Intestinal barrier and inflammatory markers were analyzed in duodenal biopsies and SCFAs were quantified in stool samples.
Results: Histological analysis revealed a reduction in duodenal goblet cell size in patients with NCWS (p<0.0001), indicating impaired mucus production. In addition, immunohistochemistry showed increased α-defensin 5 levels (p<0.0001), suggesting increased local innate immune activation. Complementary analysis of fecal metabolites revealed decreased concentrations of several SCFAs, including propionic acid (p<0.05), hexanoic acid (p=0.085), and heptanoic acid (p<0.01).
Conclusion: These findings collectively point to a disruption of mucosal homeostasis and altered microbial metabolic activity in patients with NCWS, offering new mechanistic insights and potential biomarkers for improved diagnostics.
Disclosure of Interest: None declared