Nonceliac gluten sensitivity (NCGS) is an emergent condition, the framework of which is yet unclear. The diagnosis suggested by gluten-dependent symptoms after excluding wheat allergy and celiac disease (CD) is today based only on double blind placebo controlled trial. Recently a promising tool consisting in a gluten oral mucosa patch test has been used to diagnose this illness. Besides, exposure through intestinal mucosa of foods containing nickel (Ni) may cause an hypersensitivity reaction too, defined as allergic contact mucositis (ACM). This condition is reproducible and usable as a specific diagnostic tool by the oral mucosa patch test (omPT), a qualitative and subjective diagnostic tool which it requires a clinical expertise. For this reason, laser doppler perfusion imaging tecnique has been used in oral mucosa patch test in both gluten and Ni ACM diagnosis. Our goal will be investigate on possible inflammatory markers and morphological alterations in biopsies obtained from NCGS and Ni sensitive patients to identify possible new diagnostic tools.
Despite NCGS has an estimated prevalence of 6%, its pathogenesis is still unknown and no specific or sensitive diagnostic methods have been yet identified, so that the only certainty is a prompt clinical response to GFD. The ingestion of Ni-rich foods may result in ACM, a not yet well defined condition identifiable by omPT. A specific and validated diagnostic method doesn¿t yet exist for these two different conditions. From the literature, it is know that an increased permeability appears to precede different diseases and causes an abnormality in antigen delivery that triggers the multiorgan process leading for example to the autoimmune response. On this basis, our aim will be investigate on the presence of potentially markers on biopsies of NCGS and Ni sensitive patients, highlighting an alterated permeability and/or intestinal mucosa damage. The identification of new and potentially markers can increase the knowledge of the pathogenic picture of NCGS and ACM, and can guarantee a saving time and resources in identifying NCGS and Ni sensitive patients.