Patologías relacionadas con el gluten: un auténtico desafío para la seguridad alimentaria.

Gluten is the protein fraction obtained from ethanolic extracts of cereal grains such as wheat, barley, rye, spelt, and kamut. It is widely used in the food industry; however, this component can cause adverse reactions in prone individuals. Gluten-related pathologies are divided into three groups based on their etiopathology. The first group corresponds to allergies. The second includes autoimmune diseases, with celiac disease being the most prominent, having a global prevalence of 1 %. This pathology results from the generation of antibodies directed against deamidated gliadin (gluten peptides chemically modified by intestinal enzymes) and against endogenous transglutaminase enzymes. This immune response contributes to creating a pro-inflammatory environment that ultimately destroys intestinal tissue. There is a third group of pathologies called non-celiac gluten sensitivity, whose exact molecular mechanism is still unknown, but the components of innate immunity play a fundamental role. Various alternatives have been attempted to treat these pathologies, but none has proven to be more cost-effective than adhering to a strict gluten-free diet. This diet not only inhibits the symptoms of these pathologies but also stimulates the regeneration of intestinal tissue, especially in children. To ensure that sensitive individuals can follow a gluten-free diet, specific legislation has been developed in various countries worldwide. A comprehensive review has been conducted on gluten-related pathologies, their treatment, the international legislative framework regarding gluten content in foods, and the measures applied in the food industry to protect patients non-tolerant to this compound.