“I know from personal experience that histamine intolerance can be very confusing and frustrating because the symptoms seem to come out of nowhere. I used to get terrible migraine headaches out of the blue and couldn’t pinpoint what was causing them. However, once you determine that a histamine intolerance is behind your mysterious symptoms, you can make smart dietary choices to minimize your symptoms while you work at addressing the underlying cause of the imbalance.” Amy Myers, MD.
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
Circadian profiling reveals higher histamine plasma levels and lower diamine oxidase serum activities in 24% of patients with suspected histamine intolerance compared to food allergy and controls
Allergy. 2018 Apr;73(4):949-957. doi: 10.1111/all.13361. Epub 2017 Dec 15.
- Department of Medicine 1, Hector Center for Nutrition, Exercise and Sports, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Histamine intolerance is thought to trigger manifold clinical symptoms after ingesting histamine-rich food due to reduced activity of diamine oxidase (DAO). No study has hitherto systematically assessed daily fluctuations of histamine levels and DAO activities in symptomatic patients. The aim of the study was to investigate the presence of histamine intolerance, to therefore establish day profiles of histamine levels and DAO activities, and to compare the results between patients with suspected histamine intolerance, food allergy and healthy controls.
We determined day profiles of histamine plasma levels and DAO serum activities in 33 patients with suspected histamine intolerance, in 21 patients with proven food allergy and in 10 healthy control patients. Clinical symptoms, food intolerances and further clinical and laboratory chemical parameters were evaluated.
Twenty-four percent (8 of 33) suspected histamine-intolerant patients showed elevated histamine levels during the day. That might be caused by constantly and significantly reduced DAO activities in these patients compared to food-allergic and control patients. The remaining 25 patients presented normal histamine levels and DAO activities, but an increased prevalence of multiple food intolerances compared to the other subgroup of suspected histamine-intolerants. There was no correlation between subjective complaints and serological histamine parameters in patients with suspected histamine intolerance.
We determined by daily profiling that decreased DAO activities correlated with elevated histamine levels in a subgroup of suspected histamine-intolerants. This finding discriminates these patients from food intolerant individuals with similar clinical symptoms and strongly suggests the presence of histamine intolerance.
© 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
day profile; diamine oxidase activities; food allergy; histamine intolerance; histamine levels
Pregnancy-associated diamine oxidase originates from extravillous trophoblasts and is decreased in early-onset preeclampsia
Human extravillous trophoblast (EVT) invasion of the pregnant uterus constitutes a pivotal event for the establishment of the maternal-fetal interface. Compromised EVT function manifesting in inadequate arterial remodeling is associated with the severe pregnancy disorder early-onset preeclampsia (eoPE).
Published 5 apr. 2018 – AmyMyersMD – Language: English
Empirical Valence Bond Simulations Suggest a Direct Hydride Transfer Mechanism for Human Diamine Oxidase
Empirical Valence Bond Simulations Suggest a Direct Hydride Transfer Mechanism for Human Diamine Oxidase.
ACS Omega, 2018, 3 (4), pp 3665–3674
Mapping of the binding sites of human diamine oxidase (DAO) monoclonal antibodies.
Inflamm Res. 2018 Mar;67(3):245-253. doi: 10.1007/s00011-017-1118-3. Epub 2017 Nov 21.
- Department of Visceral, Transplant and Thoracic Surgery, Molecular Biology Laboratory, Medical University Innsbruck, Schöpfstraße 41, 6020, Innsbruck, Austria. firstname.lastname@example.org.
- Department of Visceral, Transplant and Thoracic Surgery, Molecular Biology Laboratory, Medical University Innsbruck, Schöpfstraße 41, 6020, Innsbruck, Austria.
- Department of Autoimmunology and Biomarkers, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen, Denmark.
Recently we characterized five mouse monoclonal antibodies that allow the specific and sensitive detection of human diamine oxidase (DAO). To understand differences in binding characteristics and recognition of enzyme variants, we mapped the antibody binding sites.
Fragments of human DAO were expressed as glutathione-S-transferase fusion proteins that were used for testing antibody binding on immunoblots. Combined information from species cross-reactivity, sequence comparison and binding site-prediction software were used to localize the epitope recognized by each antibody.
All five monoclonal DAO antibodies bound to linear epitopes between the N3 and enzymatic domains of the 732 amino acid protein. The binding sites could be mapped onto amino acid regions V262-E278 and P279-R288, respectively, which exhibit considerable sequence variation in mammals explaining the fact that the human DAO antibodies do not cross-react with DAO from other species. The antibodies efficiently bind only denatured human DAO but not the native protein.
Characterization of the binding sites of the DAO antibodies revealed that the antibodies bind two adjacent epitopes and exhibit similar binding characteristics and species cross-reactivity. As the epitopes do not overlap any of the amino acid substitutions described for clinically significant DAO gene polymorphisms, our antibodies will also be useful for analyses of the mutant DAO proteins.
Diamine oxidase; Epitope mapping; Histamine metabolism; Monoclonal antibodies; Protein expression
Published 30 mar. 2018 – INFARMA 2018 – Adriana Duelo – Language: Spanish.
Here we share the talk that Adriana Duelo, nutritionist and dietician, and the Dr. Ismael San Mauro gave on 14 March in the International Pharma Congress INFARMA 2018 (Madrid), in which addressed the dietary treatment of the histaminosis caused by DAO deficiency. They talked about the importance of properly treat the excess of histamine, both exogenous (from food) as the endogenous (from body).
DAO deficiency plays a fundamental role in this accumulation, but there are also other factors that facilitate the increase of histamine as stress, the growth of some microorganisms and the consumption of certain drugs, among others.
Speakers: Gda. Adriana Duelo (AD director Dieticians – Barcelona) Dr. Ismael San Mauro (Cinusa Clinic Director – Madrid)