{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:31:22Z","timestamp":1788280282776,"version":"build-2803163510"},"reference-count":27,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T00:00:00Z","timestamp":1485993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Fundation for Celiac Disease","award":["Grant for Project 013 \/ 2014"],"award-info":[{"award-number":["Grant for Project 013 \/ 2014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Non\u2010celiac wheat sensitivity (NCWS) is a new clinical entity in the world of  gluten\u2010related diseases. Nickel, the most frequent cause of contact allergy, can be found in wheat  and results in systemic nickel allergy syndrome and mimics irritable bowel syndrome (IBS).  Objective: To evaluate the frequency of contact dermatitis due to nickel allergy in NCWS patients  diagnosed by a double\u2010blind placebo\u2010controlled(DBPC)challenge,and to identify  the  characteristics  of  NCWS  patients  with  nickel  allergy.  Methods: We performed  a prospective study  of 60 patients (54 females, 6 males; mean age 34.1 \u00b1 8.1 years) diagnosed with NCWS from  December  2014 to November 2016; 80 age\u2010 and sex\u2010matched subjects with functional gastrointestina l symptoms served as controls. Patients reporting contact dermatitis related to nickel\u2010containing objects  underwent  nickel  patch  test  (Clinicaltrials.gov  registration number: NCT02750735).Results:  Six  out  of  sixty  patients  (10%)  with  NCWS  suffered  from contact dermatitis and  nickel allergy  and  this  frequency  was  statistically  higher (p = 0.04)than observed in the control group(5%. The main clinical characteristic of  NCWS  patients with nickel allergy was a  higher frequency  of  cutaneous  symptoms  after  wheat ingestion compared to NCWS patients who did not suffer  from  nickel  allergy  (p &lt; 0.0001. Conclusions: Contact dermatitis and nickel allergy  are more  frequent  in  NCWS  patients than  in  subjects  with  functional gastrointestinal disorders;furthermore, these patients had a very high frequency of cutaneous manifestations after wheat  ingestion.  Nickel  allergy  should  be  evaluated  in  NCWS  patients  who  have  cutaneous  manifestations after wheat ingestion.<\/jats:p>","DOI":"10.3390\/nu9020103","type":"journal-article","created":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T11:24:06Z","timestamp":1486034646000},"page":"103","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Contact Dermatitis Due to Nickel Allergy in Patients Suffering from Non\u2010Celiac Wheat Sensitivity"],"prefix":"10.3390","volume":"9","author":[{"given":"Alberto","family":"D\u2019Alcamo","sequence":"first","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Mansueto","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Soresi","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Iacobucci","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Blasca","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8239-9830","authenticated-orcid":false,"given":"Girolamo","family":"Geraci","sequence":"additional","affiliation":[{"name":"Surgery Department, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cavataio","sequence":"additional","affiliation":[{"name":"Pediatric Unit, \u201cGiovanni Paolo II\u201d Hospital, Sciacca (ASP Agrigento) 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Fayer","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Arini","sequence":"additional","affiliation":[{"name":"DiBiMIS, Gastroenterology Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Di Stefano","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Iacono","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, \u201cARNAS Di Cristina\u201d Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana","family":"Bosco","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze e Tecnologie Biologiche Chimiche e Farmaceutiche (Ste.Bi.CeF), University of Palermo, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Carroccio","sequence":"additional","affiliation":[{"name":"Dipartimento di Biologia e Medicina Interna e Specialistica (DiBiMIS), Internal Medicine Unit, University Hospital, Palermo 90100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,2,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sapone, A., Bai, J.C., Ciacci, C., Dolinsek, J., Green, P.H., Hadjivassiliou, M., Kaukinen, K., Rostami, K., Sanders, D.S., and Schumann, M. (2012). Spectrum of gluten related disorders: Consensus on new nomenclature and classification. BMC Med., 10.","DOI":"10.1186\/1741-7015-10-13"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3839","DOI":"10.3390\/nu5103839","article-title":"Non-celiac gluten sensitivity: The new frontier of gluten related disorders","volume":"5","author":"Catassi","year":"2013","journal-title":"Nutrients"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4966","DOI":"10.3390\/nu7064966","article-title":"Diagnosis of Non-Celiac gluten sensitivity (NCGS): The Salerno Experts\u2019 Criteria","volume":"7","author":"Catassi","year":"2015","journal-title":"Nutrients"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1053\/j.gastro.2013.08.061","article-title":"Non-celiac wheat sensitivity is a more appropriate label than non-celiac gluten sensitivity","volume":"146","author":"Carroccio","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000260087","article-title":"Differential mucosal IL-17 expression in two gliadin-induced disorders: Gluten sensitivity and the autoimmune enteropathy celiac disease","volume":"152","author":"Sapone","year":"2010","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Sapone, A., Lammers, K.M., Casolaro, V., Cammarota, M., Giuliano, M.T., De Rosa, M., Stefanile, R., Mazzarella, G., Tolone, C., and Russo, M.I. (2011). Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: Celiac disease and gluten sensitivity. BMC Med., 9.","DOI":"10.1186\/1741-7015-9-23"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1038\/ajg.2013.91","article-title":"Mucosal cytokine response after short-term gluten challenge in celiac disease and non-celiac gluten sensitivity","volume":"108","author":"Brottveit","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1053\/j.gastro.2013.01.049","article-title":"A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: Effects on bowel frequency and intestinal function","volume":"144","author":"Camilleri","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.1038\/ctg.2016.35","article-title":"Predominance of type 1 innate lymphoid cells in the rectal mucosa of patients with non-celiac wheat sensitivity: Reversal after a wheat-free diet","volume":"7","author":"Mansueto","year":"2016","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1053\/j.gastro.2013.04.051","article-title":"No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates","volume":"145","author":"Biesiekierski","year":"2013","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1136\/gutjnl-2015-309757","article-title":"Sensitivity to wheat, gluten and FODMAPs in IBS: Facts or fiction?","volume":"65","author":"Volta","year":"2016","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1053\/j.gastro.2015.05.040","article-title":"High proportions of people with Non-Celiac Wheat Sensitivity have autoimmune disease or anti-nuclear antibodies","volume":"149","author":"Carroccio","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Volta, U., Bardella, M.T., Calabr\u00f2, A., Troncone, R., and Corazza, G.R. (2014). An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med., 12.","DOI":"10.1186\/1741-7015-12-85"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1038\/ajg.2012.236","article-title":"Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: Exploring a new clinical entity","volume":"107","author":"Carroccio","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1038\/ajg.2013.353","article-title":"Non-celiac wheat sensitivity as an allergic condition: Personal experience and narrative review","volume":"108","author":"Carroccio","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s11882-014-0463-3","article-title":"Systemic contact dermatitis to foods: Nickel, BOP, and more","volume":"14","author":"Fabbro","year":"2014","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_17","unstructured":"Rome Foundation Rome III Diagnostic Criteria. Available online: http:\/\/www.romecriteria.org\/criteria."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1136\/jcp.2004.023978","article-title":"Celiac disease","volume":"58","author":"Corazza","year":"2005","journal-title":"J. Clin. Pathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1053\/j.gastro.2014.12.049","article-title":"Non celiac gluten-sensitivity","volume":"148","author":"Fasano","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1038\/nrgastro.2015.107","article-title":"The spectrum of nonceliac gluten-sensitivity","volume":"12","author":"Aziz","year":"2015","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1038\/cmi.2013.28","article-title":"Non-celiac gluten sensitivity: Questions still to be answered despite increasing awareness","volume":"10","author":"Volta","year":"2013","journal-title":"Cell. Mol. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.3390\/nu7031565","article-title":"Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity","volume":"7","author":"Hollon","year":"2015","journal-title":"Nutrients"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1471-230X-14-26","article-title":"Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity","volume":"14","author":"Caio","year":"2014","journal-title":"BMC Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1177\/039463201402700118","article-title":"Systemic nickel allergy syndrome: Epidemiological data from four Italian allergy units","volume":"27","author":"Ricciardi","year":"2014","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.imbio.2014.03.010","article-title":"Immunological characterization of the allergic contact mucositis related to the ingestion of nickel-rich foods","volume":"219","author":"Marino","year":"2014","journal-title":"Immunobiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/cod.12043","article-title":"CD4(+) T cells producing interleukin (IL)-17, IL-22 and interferon-\u03b3 are major effector T cells in nickel allergy","volume":"68","author":"Skov","year":"2013","journal-title":"Contact Dermat."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1084\/jem.20102660","article-title":"Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4","volume":"209","author":"Junker","year":"2012","journal-title":"J. Exp. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/2\/103\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:27:22Z","timestamp":1760207242000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/2\/103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,2]]},"references-count":27,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,2]]}},"alternative-id":["nu9020103"],"URL":"https:\/\/doi.org\/10.3390\/nu9020103","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,2]]}}}