Histamine intolerance (HIT)
DOI:
https://doi.org/10.20883/medical.e727Keywords:
histamine intolerance, diamine oxidase (DAO), pseudoallergy, low-histamine dietAbstract
Histamine intolerance (HIT) is food intolerance of non-immunological origin, and it results from an imbalance between the consumption of histamine with food and the organism ability to metabolize it. The patients with HIT were found to have a significantly reduced concentration of histamine-degrading enzymes, diamine oxidase (DAO) and histamine N-methyltransferase (HNMT). Factors which have been identified that are conducive to histamine intolerance are: genetic factors, dysbacteriosis, chronic diseases – especially allergic and intestinal diseases, chronic infections, mastocytosis and some drug use. Clinical symptoms of histamine excess may affect various organs and systems - the most common are skin symptoms (pruritis, erythema) nausea, vomiting, abdominal pain, diarrhea, headaches and sometimes severe reactions with shortness of breath, arrhythmias, blood pressure drop, and even cardiac arrest.
Diagnostic methods in HIT utilize determination of serum DAO, determination of histamine metabolites in urine, measurement of the histamine wheal in the 50th minute of the skin prick test (SPT), gastroscopy with intestinal biopsy, diagnostic and therapeutic test, oral histamine-challenge test and genetic tests.
The mainstay of histamine intolerance treatment if a low-histamine diet. Patients should avoid products belonging to the three groups of food: containing large amounts of histamine, histamine liberators, and products inhibiting the activity of DAO. Additionally, supplements containing DAO and antihistamines can be used.
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Tuck CJ, Biesiekierski JR, Schmid-Grendelmeier P, Pohl D. Food Intolerances. Nutrients 2019, Vol 11, Page 1684 [Internet]. 2019 [cited 2022 Aug 24];11:1684. doi: 10.3390/NU11071684. PMID: 31336652. DOI: https://doi.org/10.3390/nu11071684
Hrubisko M, Danis R, Huorka M, Wawruch M. Histamine Intolerance—The More We Know the Less We Know. A Review. Nutrients 2021, Vol 13, Page 2228 [Internet]. 2021 [cited 2022 Aug 24];13:2228. doi: 10.3390/NU13072228. PMID: 34209583. DOI: https://doi.org/10.3390/nu13072228
Reese I, Ballmer-Weber B, Beyer K, Dölle-Bierke S, Kleine-Tebbe J, Klimek L, Lämmel S, Lepp U, Saloga J, Schäfer C, et al. Guideline on management of suspected adverse reactions to ingested histamine: Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergology and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA) as well as the Swiss Society for Allergology and Immunology (SGAI) and the Austrian Society for Allergology and Immunology (ÖGAI). Allergol Select [Internet]. 2021 [cited 2022 Aug 24];5:305–314. doi: 10.5414/ALX02269E. PMID: 34651098. DOI: https://doi.org/10.5414/ALX02269E
Comas-Basté O, Sánchez-Pérez S, Veciana-Nogués MT, Latorre-Moratalla M, Vidal-Carou MDC. Histamine Intolerance: The Current State of the Art. Biomolecules 2020, Vol 10, Page 1181 [Internet]. 2020 [cited 2022 Aug 24];10:1181. doi: 10.3390/BIOM10081181. PMID: 32824107. DOI: https://doi.org/10.3390/biom10081181
Schink M, Konturek PC, Tietz E, Dieterich W, Pinzer TC, Wirtz S, Neurath MF, Zopf Y. Microbial patterns in patients with histamine intolerance. J Physiol Pharmacol [Internet]. 2018 [cited 2022 Aug 24];69:579–593. doi: 10.26402/JPP.2018.4.09. PMID: 30552302.
Doeun D, Davaatseren M, Chung MS. Biogenic amines in foods. Food Sci Biotechnol [Internet]. 2017 [cited 2022 Aug 24];26:1463–1474. doi: 10.1007/S10068-017-0239-3. PMID: 30263683. DOI: https://doi.org/10.1007/s10068-017-0239-3
Espã S, Meza-Velázquez R, López-Márquez F, Espinosa-Padilla S, Rivera-Guillen M, Gutíerrez-Díaz N, Pérez-Armendáriz L, Rosales-González M. Allergologia et immunopathologia Association between two polymorphisms of histamine-metabolising enzymes and the severity of allergic rhinitis in a group of Mexican children Background. Allergol Immunopathol (Madr) [Internet]. 2016 [cited 2022 Aug 24];44:433–438. doi: 10.1016/j.aller.2016.01.002. DOI: https://doi.org/10.1016/j.aller.2016.01.002
Szczepankiewicz A, Breborowicz A, Sobkowiak P, Popiel A. Polymorphisms of two histamine-metabolizing enzymes genes and childhood allergic asthma: a case control study. Clin Mol Allergy [Internet]. 2010 [cited 2022 Aug 24];8. doi: 10.1186/1476-7961-8-14. PMID: 21040557. DOI: https://doi.org/10.1186/1476-7961-8-14
Schnedl WJ, Mangge H, Schenk M, Enko D. Non-responsive celiac disease may coincide with additional food intolerance/malabsorption, including histamine intolerance. Med Hypotheses [Internet]. 2021 [cited 2022 Aug 24];146. doi: 10.1016/J.MEHY.2020.110404. PMID: 33268003. DOI: https://doi.org/10.1016/j.mehy.2020.110404
Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr [Internet]. 2007 [cited 2022 Aug 24];85:1185–1196. doi: 10.1093/AJCN/85.5.1185. PMID: 17490952. DOI: https://doi.org/10.1093/ajcn/85.5.1185
Akdis CA, Simons FER. Histamine receptors are hot in immunopharmacology. Eur J Pharmacol [Internet]. 2006 [cited 2022 Aug 24];533:69–76. doi: 10.1016/J.EJPHAR.2005.12.044. PMID: 16448645. DOI: https://doi.org/10.1016/j.ejphar.2005.12.044
Schnedl WJ, Lackner S, Enko D, Schenk M, Holasek SJ, Mangge H. Evaluation of symptoms and symptom combinations in histamine intolerance. Intest Res [Internet]. 2019 [cited 2022 Aug 24];17:427–733. doi: 10.5217/IR.2018.00152. PMID: 30836736. DOI: https://doi.org/10.5217/ir.2018.00152
Shulpekova YO, Nechaev VM, Popova IR, Deeva TA, Kopylov AT, Malsagova KA, Kaysheva AL, Ivashkin VT. Food Intolerance: The Role of Histamine. Nutrients 2021, Vol 13, Page 3207 [Internet]. 2021 [cited 2022 Aug 24];13:3207. doi: 10.3390/NU13093207. PMID: 34579083. DOI: https://doi.org/10.3390/nu13093207
Muñoz-Esparza NC, Latorre-Moratalla ML, Comas-Basté O, Toro-Funes N, Veciana-Nogués MT, Vidal-Carou MC. Polyamines in food. Front Nutr. 2019;6:108. doi: 10.3389/FNUT.2019.00108/BIBTEX. DOI: https://doi.org/10.3389/fnut.2019.00108
Muñoz‐esparza NC, Costa‐catala J, Comas‐basté O, Toro‐funes N, Latorre‐moratalla ML, Veciana‐nogués MT, Vidal‐carou MC. Occurrence of Polyamines in Foods and the Influence of Cooking Processes. Foods 2021, Vol 10, Page 1752 [Internet]. 2021 [cited 2022 Aug 24];10:1752. doi: 10.3390/FOODS10081752. DOI: https://doi.org/10.3390/foods10081752
Cucca V, Ramirez GA, Pignatti P, Asperti C, Russo M, Della-Torre E, Breda D, Burastero SE, Dagna L, Yacoub MR. Basal Serum Diamine Oxidase Levels as a Biomarker of Histamine Intolerance: A Retrospective Cohort Study. Nutrients 2022, Vol 14, Page 1513 [Internet]. 2022 [cited 2022 Aug 24];14:1513. doi: 10.3390/NU14071513. PMID: 35406126. DOI: https://doi.org/10.3390/nu14071513
Kofler L, Ulmer H, Kofler H. Histamine 50-Skin-Prick Test: A Tool to Diagnose Histamine Intolerance. ISRN Allergy. 2011;2011:1–5. doi: 10.5402/2011/353045. DOI: https://doi.org/10.5402/2011/353045
Bai T, Wang WF, Zhang L, Wang H, Qian W, Song J, Hou XH. Positive endoscopic and ultrasonographic findings in patients with symptom-diagnosed functional gastrointestinal disorder: Data from a Chinese cross-sectional study. J Dig Dis [Internet]. 2018 [cited 2022 Aug 24];19:759–765. doi: 10.1111/1751-2980.12693. PMID: 30520233. DOI: https://doi.org/10.1111/1751-2980.12693
Comas-Basté O, Latorre-Moratalla ML, Bernacchia R, Veciana-Nogués MT, Vidal-Carou MC. New approach for the diagnosis of histamine intolerance based on the determination of histamine and methylhistamine in urine. J Pharm Biomed Anal [Internet]. 2017 [cited 2022 Aug 24];145:379–385. doi: 10.1016/J.JPBA.2017.06.029. PMID: 28715791. DOI: https://doi.org/10.1016/j.jpba.2017.06.029
Schnedl WJ, Schenk M, Lackner S, Enko D, Mangge H, Forster F. Diamine oxidase supplementation improves symptoms in patients with histamine intolerance. Food Sci Biotechnol [Internet]. 2019 [cited 2022 Aug 24];28:1779–1784. doi: 10.1007/S10068-019-00627-3. PMID: 31807350. DOI: https://doi.org/10.1007/s10068-019-00627-3
Komericki P, Klein G, Reider N, Hawranek T, Strimitzer T, Lang R, Kranzelbinder B, Aberer W. Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: a randomised, double-blind, placebo-controlled cross-over study. Wien Klin Wochenschr [Internet]. 2011 [cited 2022 Aug 24];123:15–20. doi: 10.1007/S00508-010-1506-Y. PMID: 21165702. DOI: https://doi.org/10.1007/s00508-010-1506-y
Pereira AR, Araújo AN, Montenegro MCBSM, Amorim CMPG. A simpler potentiometric method for histamine assessment in blood sera. Anal Bioanal Chem [Internet]. 2020 [cited 2022 Aug 24];412:3629–3637. doi: 10.1007/S00216-020-02597-6. PMID: 32239258. DOI: https://doi.org/10.1007/s00216-020-02597-6
Sánchez-Pérez S, Comas-Basté O, Veciana-Nogués MT, Latorre-Moratalla ML, Vidal-Carou MC. Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content? Nutrients 2021, Vol 13, Page 1395 [Internet]. 2021 [cited 2022 Aug 24];13:1395. doi: 10.3390/NU13051395. PMID: 33919293. DOI: https://doi.org/10.3390/nu13051395
San Mauro Martin I, Brachero S, Garicano Vilar E. Histamine intolerance and dietary management: A complete review. Allergol Immunopathol (Madr) [Internet]. 2016 [cited 2022 Aug 24];44:475–483. doi: 10.1016/J.ALLER.2016.04.015. PMID: 27590961. DOI: https://doi.org/10.1016/j.aller.2016.04.015
Izquierdo-Casas J, Comas-Basté O, Latorre-Moratalla ML, Lorente-Gascón M, Duelo A, Soler-Singla L, Vidal-Carou MC. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial. Clin Nutr [Internet]. 2019 [cited 2022 Aug 24];38:152–158. doi: 10.1016/J.CLNU.2018.01.013. PMID: 29475774. DOI: https://doi.org/10.1016/j.clnu.2018.01.013
Yacoub MR, Ramirez GA, Berti A, Mercurio G, Breda D, Saporiti N, Burastero S, Dagna L, Colombo G. Diamine Oxidase Supplementation in Chronic Spontaneous Urticaria: A Randomized, Double-Blind Placebo-Controlled Study. Int Arch Allergy Immunol [Internet]. 2018 [cited 2022 Aug 24];176:268–271. doi: 10.1159/000488142. PMID: 29698966. DOI: https://doi.org/10.1159/000488142
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Accepted 2022-09-14
Published 2022-09-16
