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Letter
Markers of non-coeliac wheat sensitivity in patients with myalgic encephalomyelitis/chronic fatigue syndrome
  1. Melanie Uhde1,2,
  2. Alyssa C Indart1,
  3. Xuechen B Yu1,3,
  4. Sophie S Jang1,3,
  5. Roberto De Giorgio4,
  6. Peter H R Green1,2,
  7. Umberto Volta4,
  8. Suzanne D Vernon5,
  9. Armin Alaedini1,2,3
  1. 1 Department of Medicine, Columbia University Medical Center, New York, New York, USA
  2. 2 Celiac Disease Center, Columbia University Medical Center, New York, New York, USA
  3. 3 Institute of Human Nutrition, Columbia University Medical Center, New York, New York, USA
  4. 4 Departments of Medical and Surgical Sciences and Digestive System, Centro di Ricerca Biomedica Applicata (C.R.B.A.), University of Bologna, St. Orsola-Malpighi Hospital, Bologna, Italy
  5. 5 Bateman Horne Center, Salt Lake City, Utah, USA
  1. Correspondence to Dr. Armin Alaedini, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA; aa819{at}columbia.edu

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We recently reported in Gut that non-coeliac wheat sensitivity (NCWS) is associated with a state of systemic immune activation in conjunction with a compromised intestinal epithelium.1 Patients with NCWS experience GI symptoms, most commonly including abdominal pain and bloating, as well as extraintestinal symptoms, among which fatigue, headache and cognitive difficulties feature prominently.1 2 A principal component analysis of the generated data from our study, including markers of antibody reactivity to wheat gluten, intestinal cell damage and systemic innate and adaptive immune responses to microbial components, found clustering of the patients and controls into discernible groups and demonstrated the potential utility of the identified biomarkers for identifying patients with NCWS.1

Extreme fatigue, in particular one that does not improve with rest, is a hallmark of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).3 Immune system abnormalities have been found to be associated with symptoms in a substantial number of patients with ME/CFS.4 5 Furthermore, many patients complain of GI symptoms of unknown aetiology. …

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