Bulletin of Medical and Biological Research

Gluten-sensitive disorders, including coeliac disease and non-coeliac gluten sensitivity, are common gastroenterological conditions characterised by impaired gastrointestinal function, systemic immune responses, and disruption of epithelial barrier integrity. This review aimed to provide a comprehensive analysis of the effects of gluten on the gut microbiota and to determine the role of the microbiome in the pathogenesis of these conditions. The analysis draws on findings from recent clinical studies, systematic reviews, and meta-analyses, as well as high-precision " next-generation sequencing techniques used to assess changes in bacterial and fungal communities of the gut microbiota at various stages of disease progression. It has been established that a gluten-free diet contributes to the partial restoration of microbial balance, in particular by reducing the number of pathogenic and opportunistic microorganisms associated with the development and persistence of chronic intestinal inflammation. At the same time, an increase in beneficial commensal microbiota – such as Lactobacillus and Bifidobacterium – has been observed. Special attention is given to the antimicrobial peptide cathelin-related antimicrobial peptide, which plays a key regulatory role in the immune response, controls the inflammatory process, and helps to maintain the homeostasis of the intestinal mucosa. The significance of the gutbrain axis has also been evaluated in the context of gluten-sensitive conditions, given that dysbiosis may influence patients’ neuropsychological status, including the development of anxiety disorders, depression, and cognitive impairment. Potential therapeutic strategies are discussed, including the use of probiotics, prebiotics, postbiotics, and a diet low in fermentable oligo-, di-, monosaccharides and polyols (FODMAPs). It has been shown that diet exerts both direct and long-term effects on the composition and functional activity of the gut microbiota, which in turn modifies the clinical presentation of disease, symptom severity, and treatment outcomes. The practical value of this review lies in substantiating modern approaches to the diagnosis and treatment of glutensensitive disorders through targeted modulation of the intestinal microbiota. This opens new perspectives for personalised therapy, improvement of quality of life, prevention of complications, and restoration of patient health at a deeper – microbiome – level

gluten intolerance; gluten-free diet; healthy nutrition; clinical nutrition; dysbiosis