Intestinal microbiome biomarkers for non-celiac gluten sensitivity: new diagnostic and therapeutic targets.

Non-celiac gluten sensitivity (NCGS) is a recently characterized gastrointestinal and extra-intestinal syndrome within the spectrum of gluten-related disorders. Due to the absence of biomarkers, NCGS can only be clinically established based on symptom generation upon gluten ingestion in patients for which celiac disease and wheat allergy have been excluded. The gut microbiome is now emerging as a crucial factor in multifactorial intestinal diseases, and our hypothesis, supported by preliminary findings in mice and the lack of known pathogenetic mechanisms, is that microbial dysbiosis is implied in NCGS and can provide reproducible diagnostic biomarkers for this condition. Based on our expertise in both NCGS and metagenomics, our aim is to identify biomarkers of NCGS and NCGS-related symptoms in a large longitudinal NCGS cohort with the most advanced cultivation-free approaches. This will have a major impact in designing new diagnostic tools and understanding the pathogenesis of NCGS.