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Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema.
J Allergy Clin Immunol. 2006 May; 117(5):1106-12.JA

Abstract

BACKGROUND

A diminished histamine degradation based on a reduced diaminoxidase activity is suspected as a reason for non-IgE-mediated food intolerance caused by histamine. Atopic eczema (AE) is often complicated by relapses triggered by IgE-mediated allergy to different kinds of food. However, in a subgroup of patients with AE, allergy testing proves negative, although these patients report a coherence of food intake and worsening of AE and describe symptoms that are very similar to histamine intolerance (HIT).

OBJECTIVES

It was the aim of our study to evaluate symptoms of HIT in combination with diaminoxidase levels in a total of 360 individuals consisting of patients with AE (n = 162) in comparison with patients with HIT (n = 124) without AE and healthy control volunteers (n = 85).

METHODS

Histamine plasma level was determined with an ELISA and diaminoxidase serum activity with the help of radio extraction assays using [3H]-labeled putrescine-dihydrochloride as a substrate. Detailed clinical evaluations of characteristic features of AE and HIT were performed.

RESULTS

Reduced diaminoxidase serum levels leading to occurrence of HIT symptoms like chronic headache, dysmenorrhea, flushing, gastrointestinal symptoms, and intolerance of histamine-rich food and alcohol were significantly more common in patients with AE than in controls. Reduction of both symptoms of HIT and Severity Scoring of Atopic Dermatitis could be achieved by a histamine-free diet in the subgroup of patients with AE and low diaminoxidase serum levels.

CONCLUSION

Higher histamine plasma levels combined with a reduced histamine degradation capacity might influence the clinical course of a subgroup of patients with AE.

CLINICAL IMPLICATIONS

As HIT emerges in a subgroup of patients with AE, a detailed anamnestic evaluation of food intolerance and HIT symptoms complemented by an allergological screening for food allergy, a diet diary, and, in confirmed suspicion of HIT, measurement of diaminoxidase activity and a histamine-free diet should be undertaken.

Authors+Show Affiliations

Department of Dermatology, University of Bonn, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16675339

Citation

Maintz, Laura, et al. "Evidence for a Reduced Histamine Degradation Capacity in a Subgroup of Patients With Atopic Eczema." The Journal of Allergy and Clinical Immunology, vol. 117, no. 5, 2006, pp. 1106-12.
Maintz L, Benfadal S, Allam JP, et al. Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema. J Allergy Clin Immunol. 2006;117(5):1106-12.
Maintz, L., Benfadal, S., Allam, J. P., Hagemann, T., Fimmers, R., & Novak, N. (2006). Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema. The Journal of Allergy and Clinical Immunology, 117(5), 1106-12.
Maintz L, et al. Evidence for a Reduced Histamine Degradation Capacity in a Subgroup of Patients With Atopic Eczema. J Allergy Clin Immunol. 2006;117(5):1106-12. PubMed PMID: 16675339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema. AU - Maintz,Laura, AU - Benfadal,Said, AU - Allam,Jean-Pierre, AU - Hagemann,Tobias, AU - Fimmers,Rolf, AU - Novak,Natalija, Y1 - 2006/02/08/ PY - 2005/07/30/received PY - 2005/11/15/revised PY - 2005/11/29/accepted PY - 2006/5/6/pubmed PY - 2006/6/8/medline PY - 2006/5/6/entrez SP - 1106 EP - 12 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 117 IS - 5 N2 - BACKGROUND: A diminished histamine degradation based on a reduced diaminoxidase activity is suspected as a reason for non-IgE-mediated food intolerance caused by histamine. Atopic eczema (AE) is often complicated by relapses triggered by IgE-mediated allergy to different kinds of food. However, in a subgroup of patients with AE, allergy testing proves negative, although these patients report a coherence of food intake and worsening of AE and describe symptoms that are very similar to histamine intolerance (HIT). OBJECTIVES: It was the aim of our study to evaluate symptoms of HIT in combination with diaminoxidase levels in a total of 360 individuals consisting of patients with AE (n = 162) in comparison with patients with HIT (n = 124) without AE and healthy control volunteers (n = 85). METHODS: Histamine plasma level was determined with an ELISA and diaminoxidase serum activity with the help of radio extraction assays using [3H]-labeled putrescine-dihydrochloride as a substrate. Detailed clinical evaluations of characteristic features of AE and HIT were performed. RESULTS: Reduced diaminoxidase serum levels leading to occurrence of HIT symptoms like chronic headache, dysmenorrhea, flushing, gastrointestinal symptoms, and intolerance of histamine-rich food and alcohol were significantly more common in patients with AE than in controls. Reduction of both symptoms of HIT and Severity Scoring of Atopic Dermatitis could be achieved by a histamine-free diet in the subgroup of patients with AE and low diaminoxidase serum levels. CONCLUSION: Higher histamine plasma levels combined with a reduced histamine degradation capacity might influence the clinical course of a subgroup of patients with AE. CLINICAL IMPLICATIONS: As HIT emerges in a subgroup of patients with AE, a detailed anamnestic evaluation of food intolerance and HIT symptoms complemented by an allergological screening for food allergy, a diet diary, and, in confirmed suspicion of HIT, measurement of diaminoxidase activity and a histamine-free diet should be undertaken. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/16675339/Evidence_for_a_reduced_histamine_degradation_capacity_in_a_subgroup_of_patients_with_atopic_eczema_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(05)02600-X DB - PRIME DP - Unbound Medicine ER -