Gluten related diseases are activated by the ingestion of gluten containing cereals (wheat, barley and rye) by people with a genetic and/or immunologic predisposition.
The two well defined clinical entities in relation with gluten ingestion are: wheat allergy and celiac disease. Both are mediated by the adaptive immune system
- In wheat allergy the mechanism involves IgE as in all other allergies.
- Celiac disease, has characteristics of an autoimmune disorder
In addition to celiac disease and wheat allergy, there have been cases of reactions to gluten-containing grains that involved neither allergic nor autoimmune mechanisms. These generally are termed non celiac gluten sensitivity (NCGS) or simply gluten sensitivity. The current evidence points that in NCGS the innate immune system is also involved.