Gluten, NCGS
Conditions
Brief summary
The investigators will investigate the effects of acute and sub-acute administration of gluten on mood, intestinal permeability, gastrointestinal symptoms, gut microbiota and cortisol levels in NCGS patients.
Interventions
Tereos
Nestlé Health Science
Sponsors
Study design
Intervention model description
single-blinded, randomised - controlled, crossover
Eligibility
Inclusion criteria
* Non-coeliac gluten sensitivity patients * Previous symptoms of IBS fulfilling Rome III criteria that self reportedly improved with a gluten-free diet * Symptoms currently well controlled on a gluten-free diet * Adherence to the gluten-free diet for at least 6 weeks prior to recruitment * Coeliac disease excluded (either by absence of the HLA-DQ2 and HLA-DQ8 haplotype or by a normal duodenal biopsy (Marsh 0) performed at endoscopy while on a gluten-containing diet in individuals expressing the HLA-DQ2 or HLA-DQ8 haplotype) * IgA anti-tissue-transglutaminase or IgG anti-deaminated gliadin peptide positive * Body Mass Index (BMI) of 20 - 25 kg/m2 * Stable body weight for at least 3 months prior to the start of the study
Exclusion criteria
* Medical * Coeliac disease * Abdominal or thoracic surgery. Exception: appendectomy * Gastrointestinal, endocrine or neurological diseases * Cardiovascular, respiratory, renal or urinary diseases * Hypertension * Food or drug allergies * Psychiatric disorders * Eating disorders * Depressive disorders * Anxiety disorders * Psychotic disorders * Restraint or emotional eating * Medication on a regular basis, exception: oral contraception * History of cannabis use or any other drug of abuse for at least 12 months prior to the study * Alcohol abuse (more than 21 units of alcohol for men, more than 14 units for woman per week) * Pregnant or breastfeeding women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The effect of gluten acutely and sub-acutely on extraintestinal symptoms in NCGS patients measured on the Positive and Negative Affect Schedule | At the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 20), after test visit 3 (at day 35), after test visit 4 (at day 40) | Change from baseline. Scores can be 'very slightly or not at all', 'a little', 'moderately', 'quite a bit', 'extremely' |
| The effect of gluten acutely and sub-acutely on extraintestinal symptoms in NCGS patients measured on the Profile of Mood State | At the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 20), after test visit 3 (at day 35), after test visit 4 (at day 40) | Scores are measured on the Visual Analogue Scale. Change from baseline. The scale is ranged 0 - 10, in which 0 no occurrence of the symptom and 10 a lot occurrence of the symptom. Measured at day 0, day 15, day 21, day 36 and day 41. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Effect of acute and sub-acute gluten administration on high sensitive reactive protein levels in bloodsample | During test visit 0 (day 0), test visit 2 (at day 21), after test visit 4 (at day 41) | Change in high sensitive reactive protein levels measured at day 0, day 21 and day 41 |
| Effect of acute and sub-acute gluten administration on Lipopolysaccharide-Binding Protein levels in bloodsample | During test visit 0 (day 0), test visit 2 (at day 21), after test visit 4 (at day 41) | Change in lipopolysaccharide-binding protein levels measured at day 0, day 21 and day 41 |
| The effect of gluten acutely and sub-acutely on gastrointestinal symptoms in NCGS patients measured on the visual analogue scale for gastrointestinal symptoms | At the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 20), after test visit 3 (at day 35), after test visit 4 (at day 40) | With '0' no complaints and '10' a lot of complaints (change from baseline). Measured on the Visual Analogue Scale. Measured at day 0, day 15, day 21, day 36 and day 41. |
| Effect of acute and sub-acute gluten administration on gut microbiota composition | After test visit 0 (day 0), day 13 and day 14, after test visit 1 (day 15), day 16, 17, 18, 19 and 20, two days before test visit 3 (day 34 and 35), day 36, 37, 38, 39, 40 | Change in gut microbiota composition (compared to day 0) with focus on: Bifidobacterium, Lactobacillus, Enterobacteriaceae, E. coli (stool samples) |
| Effect of acute and sub-acute gluten administration on cortisol awakening response | Day before test visit 1 (day 14), test visit 1 (day 15), test visit 2 (day 21), day before test visit 3 (day 35), test visit 3 (day 36) and test visit 4 (day 41) | Change in cortisol levels between gluten and placebo administration (saliva samples). Measured using an ELISA assay. |
| Effect of acute and sub-acute gluten administration on lipopolysaccharide levels in bloodsample | During test visit 0 (day 0), test visit 2 (at day 21), after test visit 4 (at day 41) | Change in lipopolysaccharide levels measured at day 0, day 21 and day 41 |
| Effect of acute and sub-acute gluten administration on intestinal permeability (lactulose mannitol ratio) | At the beginning of test visit 0 (day 0), visit 1 (at day 15), test visit 2 (at day 21), after test visit 3 (at day 36), after test visit 4 (at day 41) | Change in intestinal permeability after gluten administration. In the urine we can measure the ratio lactulose/mannitol. This can be measured using High Performance Liquid Chromatography at day 0, day 15, day 21, day 36 and day 41. |
Countries
Belgium