Is Autoimmunity More Predominant in Nonceliac Wheat Sensitivity Than Celiac Disease?

The recent paper published by Carroccio et al reported on the prevalence of autoimmunity (as identified by positivity of antinuclear antibodies [ANA] and associated autoimmune disorders) in nonceliac wheat sensitivity (NCWS) versus celiac disease (CD) and irritable bowel syndrome (IBS). More in detail, the results of the study, based on a retrospective and prospective arm, showed that the prevalence of ANA in NCWS was significantly higher than in CD and IBS (46% in NCWS vs 24% in CD and 2% in IBS, retrospectively; and 28% in NCWS vs 7.5% in CD and 6% in IBS, prospectively). Moreover, in both retrospective and prospective analysis, autoimmune disorders (mainly autoimmune thyroiditis) were found in a slightly higher proportion in NCWS (29% vs 24%) than CD (21% vs 20%). Both NCWS and CD showed a significantly higher prevalence of autoimmune disorders than IBS. ANA were significantly related to HLA-DQ2 and -DQ8 in NCWS (both retrospectively and prospectively), whereas these autoantibodies were associated significantly with autoimmune disorders only in the prospective arm.