ArticleNutrients2020
Beneficial Effects of a Low-Nickel Diet on Relapsing IBS-Like and Extraintestinal Symptoms of Celiac Patients during a Proper Gluten-Free Diet: Nickel Allergic Contact Mucositis in Suspected Non-Responsive Celiac Disease.
Article in Nutrients, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 22 citations in OpenAlex.
- Systemic Nickel Allergy Syndrome: A Critical Appraisal of an Unvalidated Diagnostic Entity.Clinical and translational allergy · 2026Review
- Rome Foundation Working Team Report on overlap in disorders of gut-brain interaction.Nature reviews. Gastroenterology & hepatology · 2025Review
- Gluten-Free Diet for Fashion or Necessity? Review with New Speculations on Irritable Bowel Syndrome-like Disorders.Nutrients · 2024Review
- Development of a Whole-Cell System Based on the Use of Genetically Modified Protoplasts to Detect Nickel Ions in Food Matrices.International journal of molecular sciences · 2024Article
- New Insights and Evidence on "Food Intolerances": Non-Celiac Gluten Sensitivity and Nickel Allergic Contact Mucositis.Nutrients · 2023Article
- Vitamin D and chronotype: is there any relationship in individuals with obesity?Journal of endocrinological investigation · 2023Article
- Metal Allergy: State-of-the-Art Mechanisms, Biomarkers, Hypersensitivity to Implants.Journal of clinical medicine · 2022Review
- Datterino Trial: A Double Blind, Randomized, Controlled, Crossover, Clinical Trial on the Use of Hydroponic Cultivated Tomato Sauce in Systemic Nickel Allergy Syndrome.Journal of clinical medicine · 2022Article
- A comprehensive summary of disease variants implicated in metal allergy.Journal of toxicology and environmental health. Part B, Critical reviews · 2022Review
- Article
- New Perspectives on Gluten-Free Diet.Nutrients · 2020Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimNickel (Ni)-rich foods can induce allergic contact mucositis (ACM) with irritable bowel syndrome (IBS)-like symptoms in predisposed subjects. Ni ACM has a high prevalence (>30%) in the general population and can be diagnosed by a Ni oral mucosa patch test (omPT). Many celiac disease (CD) patients on a gluten-free diet (GFD) often show a recrudescence of gastrointestinal and extraintestinal symptoms, although serological and histological remission has been achieved. Since a GFD often results in higher loads of ingested alimentary Ni (e.g., corn), we hypothesized that it would lead to a consequent intestinal sensitization to Ni in predisposed subjects. We wanted to (1) study Ni ACM prevalence in still symptomatic CD patients on a GFD and (2) study the effects of a low-Ni diet (LNiD) on their recurrent symptoms. MATERIAL AND
methodsWe recruited 102 consecutive CD patients (74 female, 28 male; age range 18-65 years, mean age 42.3 ± 7.4) on a GFD since at least 12 months, in current serological and histological remission (Marsh-Oberhuber type 0-I) who complained of relapsing gastrointestinal and/or extraintestinal symptoms. INCLUSION CRITERIA: presence of at least three gastrointestinal symptoms with a score ≥5 on the modified Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. EXCLUSION CRITERIA: IgE-mediated food allergy; history of past or current cancer; inflammatory bowel diseases; infectious diseases including
resultsTwenty patients (all female, age range 23-65 years, mean age 39.1 ± 2.9) out of 102 (19.6%) were finally included. All 20 patients enrolled (100%) showed positive Ni omPT, confirming an Ni ACM diagnosis. A correct GFD (T0 vs. T1) induced the improvement of 19 out of the total 24 (79.2%) symptoms, and 14 out of 24 (58.3%) were statistically significant (
conclusionsOur data suggest that the recrudescence of gastrointestinal and extraintestinal symptoms observed in CD subjects during GFD may be due to the increase in alimentary Ni intake, once gluten contamination and persisting villous atrophy are excluded. Ni overload can induce Ni ACM, which can be diagnosed by a specific Ni omPT. Improvement of symptoms occurs after a proper LNiD. These encouraging data should be confirmed with larger studies.
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