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 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.
Serum levels of histamine and diamine oxidase in multiple sclerosis
Am J Clin Exp Immunol 2018;7(6):100-105 www.ajcei.us /ISSN:2164-7712/AJCEI0086352
Aryan Rafiee Zadeh1, Masih Falahatian1, Fereshteh Alsahebfosoul2
1School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; 2Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system, mostly affecting young adults. Diamine oxidase is an enzyme essential for histamine production. Histamine which is produced mostly by mast cells can have effects on different aspects of immune system via its different histamine receptors (H1R, H2R, H3R and H4R). The crucial role of diamine oxidase and histamine in immune balance has been documented in different studies and experiments both on MS patients and on experimental allergic encephalomyelitis (EAE). In this regard, we aimed to measure the level of histamine and diamine oxidase in the serum of MS patients.
A total number of 50 relapsing-remitting MS (RRMS) patients and 41 age and sex matched controls were enrolled in this study. Assessments of serum levels of histamine and diamine oxidase enzyme were performed using enzyme-linked immune sorbent assay (ELISA). Results: The serum levels of histamine and diamine oxidase in RRMS patients were lower than healthy controls (P-value = 0.00, for both).
Our research team found significant low levels of histamine and diamine oxidase in RRMS patients; however the pathogenesis of this issue was unclear.
Biogenic Amines in Plant-Origin Foods: Are they Frequently Underestimated in Low-Histamine Diets?
Foods 2018, 7(12), 205.
Low-histamine diets are currently used to reduce symptoms of histamine intolerance, a disorder in histamine homeostasis that increases plasma levels, mainly due to reduced diamine-oxidase (DAO) activity. These diets exclude foods, many of them of plant origin, which patients associate with the onset of the symptomatology. This study aimed to review the existing data on histamine and other biogenic amine contents in nonfermented plant-origin foods, as well as on their origin and evolution during the storage or culinary process. The only plant-origin products with significant levels of histamine were eggplant, spinach, tomato, and avocado, each showing a great variability in content. Putrescine has been found in practically all plant-origin foods, probably due to its physiological origin. The high contents of putrescine in certain products could also be related to the triggering of the symptomatology by enzymatic competition with histamine. Additionally, high spermidine contents found in some foods should also be taken into account in these diets, because it can also be metabolized by DAO, albeit with a lower affinity. It is recommended to consume plant-origin foods that are boiled or are of maximum freshness to reduce biogenic amine intake.
Cite this article:
Sánchez-Pérez, S.; Comas-Basté, O.; Rabell-González, J.; Veciana-Nogués, M.T.; Latorre-Moratalla, M.L.; Vidal-Carou, M.C. Biogenic Amines in Plant-Origin Foods: Are they Frequently Underestimated in Low-Histamine Diets? Foods 2018, 7, 205.
Microbial patterns in patients with histamine intolerance.
J Physiol Pharmacol. 2018 Aug;69(4). doi: 10.26402/jpp.2018.4.09. Epub 2018 Dec 9.
- First Department of Medicine, Hector Center for Nutrition, Exercise and Sports, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Erlangen, Germany.
- Second Department of Medicine, Thuringia-Clinic Saalfeld, Saalfeld/Saale, Germany.
- First Department of Medicine, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Erlangen, Germany.
- First Department of Medicine, Hector Center for Nutrition, Exercise and Sports, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Erlangen, Germany. email@example.com.
Histamine intolerance represents a controversially discussed disorder. Besides an impaired degradation of orally supplied histamine due to diamine oxidase (DAO) deficiency, a deranged gut flora may also contribute to elevated histamine levels. Our aim was to determine the intestinal bacterial composition in patients with proven histamine intolerance in comparison to other food intolerances and healthy controls. A total of 64 participants were included in the study, encompassing 8 patients with histamine intolerance (HIT), 25 with food hypersensitivity (FH), 21 with food allergy and 10 healthy controls (HC). All participants underwent blood testing for total and food-specific immunoglobulin E, plasma histamine and DAO serum activity. Stool samples were used to analyze stool histamine and zonulin levels and bacterial composition by 16s rRNA sequencing. No significant differences in stool histamine levels were observed, but HIT patients showed elevated levels of stool zonulin. Microbiota analysis revealed increased levels of Proteobacteria (5.4%) and a significantly reduced alpha-diversity in the HIT group (P = 0.019). On family level, HC showed a significantly higher abundance of Bifidobacteriaceae compared to other study groups (P = 0.005), with lowest levels in the HIT group (P = 0.036). Also significantly reduced abundances of the genera Butyricimonas (P = 0.026) and Hespellia (P = 0.025) were observed in the HIT patients, whereas Roseburia were significantly elevated (P = 0.021). We concluded that the altered occurrence of Proteobacteria and Bifidobacteriaceae, reduced alpha-diversity as well as elevated stool zonulin levels suggest a dysbiosis and intestinal barrier dysfunction in histamine intolerant patients, which in turn may play an important role in driving disease pathogenesis.
Conformational Design and Characterisation of a Truncated Diamine Oxidase from Arthrobacter globiformis
Conformational Design and Characterisation of a Truncated Diamine Oxidase from Arthrobacter globiformis
A functional mini protein can be developed by miniaturising its size. The minimisation technique provides an excellent model system for studying native enzymes, especially in creating an alternative novel biocatalyst. Miniaturised proteins may have enhanced stability, a crucial characteristic for large-scale production and industrial applications. In this study, a huge enzyme molecule, known as diamine oxidase (DAO, comprising 700 amino acids), was selected to undergo the process.
Histamine-reduced diet and increase of serum diamine oxidase correlating to diet compliance in histamine intolerance
Diagnosis of histamine intolerance (HIT) has been based on low serum diamine oxidase (DAO) values, functional gastrointestinal disorders and improvement of symptoms with a histamine-reduced diet (HRD). In a retrospective analysis of outpatients’ charts we identified 101 patients with HIT. After a median of 13 months, a questionnaire was distributed to the patients so that they could be classified into four diet-compliance groups.
Low-histamine diet supplemented with exogenous diamine oxidase enzyme is useful for treating migraine in patients with DAO Deficiency
Low-histamine diets and/or exogenous diamine oxidase (DAO) supplementation are currently used to treat symptoms of histamine intolerance (IH), a disorder in histamine homeostasis that increases its plasma levels, mainly dou to DAO deficiency. Headache is the most recognized symptoms.
The use of exogenous diamine oxidase (DAO) enzyme has been recently postulated as a potential strategy for the treatment of histamine intolerance, a disorder in the homeostasis of histamine caused by a reduction of its intestinal degradation. Dietary supplements based on gastro-resistant encapsulated porcine kidney protein extract ara available on the market to reduce the symptoms of this intolerance. Although with scarce scientific research, there are some references about the potential of pea seedlings as a source of DAO.
Plasma concentration of diamine oxidase (DAO) predicts 1-month mortality of acute-on-chronic hepatitis B liver failure
The plasma DAO level of survivals [14.0 (7.1; 26.5) ng/mL] was significantly lower than the nonsurvivals [58.6 (32.5; 121.3) ng/mL, P < .001]. The plasma DAO level, hepatic encephalopathy, spontaneous bacterial peritonitis and model for end-stage liver disease (MELD) score were independent factors associated with the 1-month mortality for ACHBLF.
Diamine Oxidase Supplementation in Chronic Spontaneous Urticaria: A Randomized, Double-Blind Placebo-Controlled Study
Diamine Oxidase Supplementation in Chronic Spontaneous Urticaria: A Randomized, Double-Blind Placebo-Controlled Study.
Int Arch Allergy Immunol. 2018;176(3-4):268-271. doi: 10.1159/000488142. Epub 2018 Apr 26.
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, Milan, Italy.
- Università Vita-Salute San Raffaele, Milan, Italy.
- Unit of Cellular and Molecular Allergology, IRCCS Ospedale San Raffaele, Milan, Italy.
Diamine oxidase (DAO) catabolizes and inactivates histamine, a key player in a wide range of invalidating conditions, such as migraine and chronic spontaneous urticaria (CSU). The highest expression of DAO occurs in the gastrointestinal tract, possibly to control the burden of histamine intake from food.
Here, we tested the hypothesis that a 30-day oral supplementation with DAO (1 capsule b.i.d., 15 min before a meal) could reduce the severity of CSU as estimated by the 7-Day Urticaria Activity Score (UAS-7). The study was designed as a double-blind, placebo-controlled, crossover investigation of 22 patients with CSU incompletely controlled by first-line antihistamine therapy.
Twenty patients completed the study. Supplemental therapy with DAO caused a 3.8 ± 1.2 point mean ± SEM UAS-7 score reduction in patients with low serum DAO levels at time 0 (p = 0.041 compared to placebo). The degree of UAS-7 improvement was inversely correlated with the levels of basal DAO (p = 0.019). Patients receiving DAO supplementation were able to slightly reduce their daily antihistamine dose (p = 0.049).
These data suggest that DAO may be involved in the pathogenic cascade of CSU and that DAO supplementation could be effective for symptom relief in patients with low DAO levels in serum.
© 2018 S. Karger AG, Basel.
Chronic spontaneous urticaria; Diamine oxidase; Histamine; Histamine intolerance