Serum Diamine Oxidase Values, Indicating Histamine Intolerance, Influence Lactose Tolerance

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Abstract: Lactose intolerance (LIT) is one of the major causes of irritable bowel syndrome (IBS) spectrum complaints. Differences in inadequate lactose digestion are described as various LIT phenotypes with basically unknown pathophysiology. In LIT patients, we retrospectively assessed the effect of histamine intolerance (HIT) on expiratory hydrogen (H2) during H2 lactose breath tests. In a retrospective evaluation of charts from 402 LIT patients, 200 patients were identified as having only LIT. The other 202 LIT patients were found to additionally have diamine oxidase (DAO) values of <10 U/mL, which indicates histamine intolerance (HIT). To identify HIT, standardized questionnaires, low serum DAO values and responses to a histamine-reduced diet were used. Patients were separated into three diagnostic groups according to the result of H2 breath tests: (1) LIT, with an H2 increase of >20 parts per million (ppm), but a blood glucose (BG) increase of >20 mg/dL, (2) LIT with an H2 increase of 20 ppm in combination with a BG increase of <20 mg/dL, and (3) LIT with an exhaled H2 increase of <20 ppm and BG increase of <20 mg/dL. Pairwise comparison with the KruskalWallis test was used to compare the areas under the curve (AUC) of LIT and LIT with HIT patients. Exhaled H2 values were significantly higher in H2 > 20 ppm and BG < 20 mg/dL patients with LIT and HIT (p = 0.007). This diagnostic group also showed a significant higher number of patients (p = 0.012) and a significant higher number of patients with gastrointestinal (GI) symptoms during H2 breath tests (p < 0.001). Therefore, low serum DAO values, indicating HIT, influence results of lactose tolerance breath tests.

Citation: Schnedl,W.J.; Meier-Allard, N.; Michaelis, S.; Lackner, S.; Enko, D.; Mangge, H.; Holasek, S.J. Serum Diamine Oxidase Values, Indicating Histamine Intolerance, Influence Lactose Tolerance Breath Test Results. Nutrients 2022, 14, 2026. https://doi.org/10.3390/nu14102026

Wolfgang J. Schnedl 1,* , Nathalie Meier-Allard 2, Simon Michaelis 3 , Sonja Lackner 2 , Dietmar Enko 3,4 , Harald Mangge 4 and Sandra J. Holasek 2
1 Practice for General Internal Medicine, Dr. Theodor Körnerstrasse 19b, 8600 Bruck an der Mur, Austria
2 Division of Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, 8010 Graz, Austria; nathalie.allard@medunigraz.at (N.M.-A.); sonja.lackner@medunigraz.at (S.L.); sandra.holasek@medunigraz.at (S.J.H.)
3 Institute of Clinical Chemistry, Laboratory Medicine, Hospital Hochsteiermark, Vordernberger Straße 42, 8700 Leoben, Austria; simon.michaelis@kages.at (S.M.); enko.dietmar@gmx.at (D.E.)
4 Clinical Institute of Medical, Chemical Laboratory Diagnosis, Medical University of Graz, Auenbruggerplatz 30, 8036 Graz, Austria; harald.mangge@klinikum-graz.at

• Correspondence: w.schnedl@dr-schnedl.at; Tel.: +43-3612-55833; Fax: +43-3612-55833-22

International Congress of DAO Deficiency 2021

You are invited to map a new future in managing DAO Deficiency attending the International Congress on DAO Deficiency.

Sign up here

SAVE THE DATE: November 4th 2021

At DR HEALTHCARE, we are pioneers in DAO Deficiency. Since our beginnings, scientific evidence and research have driven each one of our steps. The time has come to share this knowledge with the scientific and medical community, nutrition specialists, and patients who suffer from this metabolic deficiency’s different recurring symptoms.

Together, we can go farther.

Which is why we are delighted to invite you to the International Congress of DAO Deficiency, to be held 4 November 2021, in virtual format.

Our end goal:

is to reinforce knowledge of DAO Deficiency through a complete programme of scientific sessions, with experts of worldwide renown. With a forward-looking approach, we will address both diagnosis and treatment, as well as how knowledge of DAO Deficiency has led to a paradigm shift in the field of medical nutrition.

The event will be held entirely online:

as required by this exceptional situation caused by the pandemic. However, this way we will also be able to make our shared knowledge and experiences available to professionals all around the world, saving on costs and travel, and reducing our ecological footprint.

Technology will make it possible:

for guests to attend all conferences through an immersive, comprehensive experience. In addition to the extensive medical and scientific programme, the exhibition with 3D stands, and online interaction with guests, congress participants and speakers will provide a one-of-a-kind stage with services just like at a face-to-face event. All in real time.

We eagerly await you.

Warm regards,

Gerald Dard                                             Juanjo Duelo

    Managing Director ABBiotek                   Global Business Development Director Enzymes

AB Mauri set to lead first-ever virtual congress into DAO enzyme deficiency

Article published in bakeryandsnacks.com the 29-oct-2021, by Gill Hyslop. Publication link

The business unit of AB Biotek – which is part of the global yeast and bakery ingredients specialist – is hosting the first International Congress of DAO Deficiency online on 4 November.

HTTPS://WWW.BAKERYANDSNACKS.COM/ARTICLE/2021/10/29/AB-MAURI-SET-TO-LEAD-FIRST-EVER-VIRTUAL-CONGRESS-INTO-DAO-ENZYME-DEFICIENCY 

AB Biotek Acquires Spanish Biomedical DR Healthcare

Respective leaders in fermentation science and DAO-based medical nutrition join together to focus on innovative enzyme-based solutions for the human nutrition & health market.

Migraine and DAO deficiency – el farmacéutico.es

Puedes decargar el suplemento en pdf clicando sobre la imagen de abajo o a través de aquí.

el farmacéutico.es publica su suplemento nº 585 titulado “Migraña y déficit de DAO (Diamino Oxidasa)”.

En esta publicación se exponen las bases científicas y clínicas de la migraña causada por déficit de DAO y se muestran los métodos diagnósticos y las formas de manejo de la migraña causada por esta alteración metabólica. También se muestran los productos que se pueden encontrar en farmacias para el manejo y diagnóstico de la migraña causada por déficit de DAO.

El suplemento ha sido elaborado por los PhD. Medical Writer Antoni X. Torres-Collado y Eva Morán-Salvador, editado por ediciones MAYO y publicado el 2 de marzo – 2020.

Contenidos del suplemento nº585 “Migraña y déficit de DAO (Diamino Oxidasa)”:

1. ¿Qué es la migraña?
   1. Clasificación
   2. Sintomatología y diagnóstico
   3. Manejo y tratamiento de la migraña
2. ¿Qué sucede en la migraña?
   1. Fases de la crisis de migraña
   2. Mecanismos fisopatológicos
   3. What is histamine?
3. ¿Qué es la Diamino Oxidasa?
4. Déficit de DAO y migraña
   1. embarazo y migraña
   2. síntomas asociados (comorbilidad de la migraña)
   3. Diagnóstico
   4. Tratamiento de la migraña por déficit de DAO
5. ¿Cómo manejar la migraña por déficit de DAO desde la farmacia?
   1. Suplementación con DAO en el paciente con migraña: alimentos para usos médicos especiales
6. Bibliografía

The biomedical company DR Healthcare installs a research center and production plant on the Campus of Rovira i Virgili University – Indicador d’Economia

The center will dedicate 75% of the activity in research and a 25% in the production of the enzyme DiAmine Oxidase (DAO) as an ingredient in functional foods

DR Healthcare has invested 500,000 euros in this new center for research and in the production plant, both located in the Sescelades Campus of the URV (Tarragona, Spain). This biomedical company manufactured in Tarragona the enzyme that is the essential ingredient of its innovative product indicated for the dietary treatment of migraine.“The URV is a dynamic university and in Tarragona we hope to generate many synergies with different research groups located in the same campus” explains Juanjo Duelo, founder and CEO of DR Healthcare.

DR Healthcare was founded 12 years ago as a emergent company (start up) of the Universitat de Barcelona to investigate the relationship between diet and migraine. In 2010 published one of the first studies, which demonstrated the relationship between the DAO deficiency and the triggering of migraine. In these years the company, with headquarters in Barcelona, has focused the activity to generate scientific and clinical evidence about the deficit of diaminooxidase, the key enzyme in the metabolism of histamine. This deficiency leads to a series of associated disorders that, in addition to migraine, include fibromyalgia, dermatological problems, rhinitis, irritable bowel syndrome or Attention Deficiency- Hyperactivity Disorder (ADHD).

The dietary product of DR Healthcare for the treatment of migraine obtained last year the official certificate of the European Union that categorizes it as “new food with therapeutic objective.” This new recognition should definitely boost the marketing of the DAO enzyme as “food for special medical purposes,” according to Duelo, beyond the 500 pharmacies in within the Spanish state that they have participated in a pilot test.

The goal of the new plant of DR Healthcare

The company has generated more than 80 patents and the aim of the Tarragona plant is to continue with the production of DAO of animal origin for marketing, in addition to do research to lead to other modalities of this enzyme, such as that of plant and biotechnology origin. “We are the only company specialized in DAO deficiency and in the treatment of its associated symptoms, and we want that the plant of Tarragona to become a center of reference from where we will promote various research projects in collaboration with other departments of the University,” explains Juanjo Duelo, founder and director of the company.The plant has been installed in the building N5 of the Sescelades Campus and will be managed by Jaume Bori, holds a bachelor’s degree in Biochemistry and Biotechnology by the URV and PHD in Environmental Engineering. His figure will depend on the scientific department of the company, and will be devoted to seek synergies in the environment of the URV and launch projects with different areas of the University.The incorporation of this new company in the campus is in the line of the University, who wants to promote the relationship with the company and to promote the transfer of knowledge for the benefit of society.

Other arguments in favor of this location, according to Duelo is that “we are looking for partners to be able to expand all over the world. If we have to use the airport of Tarragona or the Prat, we will obtain the same as if we are in Barcelona.”

Objective of the URV: The attraction of companies of high technological value

The attraction of companies of high technological value is a strategic objective for the URV, who currently maintains advanced negotiations with another company in the health sector. “This type of companies are very interesting because with their level of specialization cause interaction, mutual learning and generate new opportunities and projects. Contribute to raise the bar of the research that we do in the university,” explains Lourdes Jane, director of the Center for Transfer of Technology of the Foundation URV.

Data of interest

The Technology Transfer Center of the Foundation URV managed 318 collaboration contracts with companies and institutions the year 2018. Transfer contracts allow to create applicable solutions, and from the research results that are generated in the university. Of the 190 clients with whom collaborated the URV last year, 85 are private companies. The rest are public entities, associations, foundations and cooperatives. The sum of the value of contracts was supposed to the university 5.6 million euros of income.

Access the original new through here.

This new also has been published in the digital diary of University Rovira i Virgili the 1-4-2019, access the publication here, and in the publication Economic Indicator of URV, access the pdf.

What is Histamine Intolerance? – 30ytantos, OndaCero

30ytantos, ONDACERO – WITH PEPA GEA – Language: Spanish.

@Pepagea |@30ytantosondac1 | medicepepa.es

In this interview from the ONDACERO radio station in its program 30ytantos, Roser Sala, responsible for marketing of SYNLAB (european leader in management and services of clinical and pathological anatomy laboratories),  explains what is histamine intolerance, which are their most common symptoms and how it is diagnosed.

Here is the link to the podcast of the interview.

Causes of intolerance to histamine

The histamine intolerance is a disorder whose causes can be genetic, pharmacological or pathological and which produces diverse symptoms throughout the body.

• The genetic causes are due to mutations in the gene of the diamine oxidase (DAO), an enzyme that metabolizes histamine in the intestine, as a part of which is exogenous: from food, thus preventing to be absorbed by the bloodstream. These mutations discovered on the gene of the DAO reduce or prevent its activity, generating an accumulation of histamine.
• The pharmacological factors are related with the use of certain drugs that cause a deficit in the activity of the enzyme diamine oxidase, such as analgesics (aspirin) and tranquilizers (Diazepam).
• Certain inflammatory bowel diseases such as Crohn’s disease, Ulcerative Colitis and colon cancer make decrease the activity of the diamine oxidase to affect parts of the intestinal mucosa that produce it.

All of these can be causes related to the different symptoms involving the histamine intolerance by DAO Deficiency, let`s now to know its symptoms.

Symptoms of DAO deficiency

Migraines and vascular headaches are one of the most notable symptoms, since they are highly disabling diseases and in which is involved the deficit of DAO. According to clinical studies the deficit of DAO is involved in up to 87% of cases of migraine patients.

This intolerance also causes effects on the rest of the systems, triggering a rash, urticaria, dry skin, or atopic dermatitis; hot flashes, dizziness, muscle fatigue, fibromyalgia; indigestion, heartburn, bloating, diarrhea, vomiting… and all the latest studies show that is also involved in the development of the Attention Deficit Hyperactivity Disorder (ADHD), due to the neuronal functions of histamine in the brain.

The histamine

The histamine is a molecule that we can be found in different food, but which we also manufacture within our cells and it is involved in various regulatory processes in our body. In fact the histamine is involved in the process of inflammation, in the regulation of the immune system, in the neuronal connections (acts as a neurotransmitter in the brain) and one of its most visible negative effects are allergies.

With regard to its origin, as we have already commented the source of histamine is not only internally, but also externally, because it comes from the foods we eat and our digestive process. Rich histamine foods like chocolate, ripe cheeses, monosodium glutamate , the skin of fish, some fruits and nuts, fermented products or pickles, yeast and cured meats or processed contain it in large quantities. On the other hand, alcoholic beverages block the activity of DAO, preventing that it metabolice histamine in the intestine.

In this way, there are people that in order to different causes (genetic, pharmacological or pathological) accumulate histamine in their body, triggering a series of symptoms such as migraine headaches, fibromyalgia, different gastrointestinal and skin disorders, and attention deficit and hyperactivity disorder.

Diagnosis of intolerance to histamine by DAO deficiency

There are no tests to detect the allergy to histamine. What is done in hospitals is a measurement of the diamine oxidase activity in the body by the test MigraTest, Designed to know what level of enzyme activity the patient has and if it is within normal or pathological ranges.

Measures to prevent and treat DAO Deficiency

Patients should be placed in the hands of a doctor and nutritionist. This is the way to control the medication and diet of the patient, to receive recommendations and guidelines to avoid, to the extent possible, certain drugs and foods that are triggering or exacerbating symptoms caused by the DAO deficiency. This joint action allows a correct custom design of treatments that the patient requires for its particular pathological condition to the time that is deployed a diet that will try to feed properly and complete nutrition.

To ensure the benefits of good management of feeding and nutrition for patients, there are dietary supplements of the DAO enzyme , which are functional foods that help to the metabolization of histamine in a natural way, without any side effect, and preventing it from to trigger all symptoms resulting from intolerance to the histamine by DAO deficiency.

Some of these nutraceuticals have been designed and formulated for the specific treatment of certain diseases, such as migraine, fibromyalgia,  intestinal dysbiosis, gastrointestinal and skin disorders or attention deficit and hyperactivity disorder.

Other causes of intolerance to the histamine by DAO deficiency

On the other hand, other causes of the DAO deficiency are related with the processes of the  intestinal dysbiosis. The intestinal dysbiosis is the alteration of the microbiota of our intestines, the set of microorganisms that live and carry out their functions in our intestines naturally, and that in certain conditions are affected in the tasks involved. Among them we can highlight: the proper absorption of nutrientsa and its function as a barrier of defense against external pathogens such as parasites and viruses. The deterioration of the intestinal micriobita loses the integrity of the intestinal mucosa and can cause malnutrition, and in some cases malnutrition must be controlled from the beginning to avoid illness and highly negative effects.

The  intestinal dysbiosis can be caused by overconsumption of antacids, since these unbalance the intestinal pH (increasing it, making alkaline) causing an overgrowth of species that are not inherent in our intestine. The stress and overuse of antibiotics can also cause these processes of deterioration and alteration of our intestinal microbiota.

In this way, due to the complexity of the variety of factors acting in these diseases, from the first moment patients should be in the hands of specialized doctors and nutritionists, make a diagnosis of DAO deficiency and perform a continuous control of both the medication, diet and living habits of the patients, since all of them are involved in the origin and worsening of these pathologies and their symptoms.

Finally, if is diagnosed a intolerance to histamine by DAO deficiency should be to supplement the diet with nutraceuticals that include diamine oxidase.

This is a council of the International Society of DAO Deficiency.