A Carroccio et al. Clin Gastroenterol Hepatol 2019; 17: 682-90. This prospective study examined 78 patients with a diagnosis of non-celiac gluten sensitivity (NCGS) based on double-blind wheat challenge. The authors identified markers of inflammation including eosinophils in the duodenum and rectum of patients with NCGS: –the mean eosinophil infiltration was more than 2.5-fold the upper limit of normal in rectum and almost 2-fold in duodenum.
Rectal eosinophilia (>9 eos in the rectal lamina propria) had a sensitivity of 94%, specificity of 70%, positive predictive value of 81% and negative predictive value of 89% for NCGS.
My take: (from the editorial,pg 613-4) “In many cases, NCGS is likely a mislabeled functional GI disorder (IBS or FD) induced by wheat proteins or FODMAPs…tissue eosinophilia [is a] potential biomarker..although this observation needs further confirmation.”