Food-induced histaminosis as an epidemiological problem: Plasma histamine elevation and haemodynamic alterations after oral histamine administration and blockade of diamine oxidase (DAO)

Abstract

In a randomized controlled trial, 30 pigs were orally treated with histamine (60 mg). In addition, half of the animals underwent a specific blockade of the enzyme diamine oxidase (DAO), which is the main histamine catabolising enzyme in the intestinal tract. Only these DAO-blocked animals exhibited severe clinical symptoms (e.g. hypotension, flush, vomiting) and, in parallel, showed tremendous elevations of plasma histamine levels of up to 160 ng/ml. 3 out of 15 animals in this group died within the experimental period. In contrast, the control animals neither exhibited plasma histamine levels above 5 ng/ml nor had any clinical reactions. These results contradict the current opinion that oral histamine intake in food is not clinically relevant, especially since many commonly used drugs are DAO-inhibitors and approximately 20% of our population take these drugs. Apart from drugs, some other factors (alcohol, spoilt food etc.) can also function via a blockade of DAO as an additional risk. DAO-blockade is therefore a real epidemiological problem. Evidence is presented here for the new disease concept: Food-Induced Histaminosis.

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

“…For the first time, we were able to demonstrate that there are patients who can be classified as histamine‐intolerants according to the definition 9, 10, 11, 12. In 24% (8 of 33) suspected histamine‐intolerants, constantly and significantly reduced DAO activities triggered elevated histamine levels throughout the day.…”

“…The frequency of histamine intolerance is not fully understood yet, but indirect evidence suggests that about 1%‐3% of the population is affected 8. Reduced activity of diamine oxidase (DAO), the key enzyme in histamine metabolism, has been hypothesized as the main factor in the development of histamine intolerance leading to the accumulation of histamine above the individual critical value 9, 10, 11, 12. Consequently, this is provoking disorders within a short time lag from hours up to days.…”

“…To some extent, low DAO activities and high histamine levels in the blood are indicators of the disease 10, 11, 12, 18. But do the complaints of the patients indeed correlate with the measured histamine parameters?…”

Identification of novel heparin-releasable proteins, as well as the cytokines midkine and pleiotrophin, in human postheparin plasma.

“…One possibility is that the heparin-releasable proteins are specif-ically targeted to the endothelial surface by attachment to glycosaminoglycans and that the heparin-releasable proteins have functions specific to the endotheliumblood interface. There is evidence that the known heparin-releasable proteins contribute to vascular homeostasis: the lipases, by providing fatty acids for metabolic and structural needs 9 ; tissue factor pathway inhibitor, by regulating coagulation and protecting vessel patency 14 ; extracellular superoxide dismutase, by protecting the endothelium from oxidative stress"; diamine oxidase (histaminase), by degrading the biologically active and potentially dangerous amines, histamine and putrescine 15 ; platelet factor 4, by regulating inflammatory responses and angiogenesis and opposing the actions of heparin 16 ; and tumor necrosis factor-binding protein-1, by regulating the actions of tumor necrosis factor. 7 A useful technique for isolating heparin-releasable proteins is heparin-affinity chromatography of postheparin plasma (PHP).…”

227 Effect of different cooking methods on histamine levels in selected foods

“…Histidine decarboxylase is the enzyme that converts the histidine in food into histamine. The formation of histamine in food requires the presence of histidine decarboxylase-positive microorganisms, in conjunction with conditions allowing the growth and enzyme activity of these bacteria 42 . It is known that there are several factors (e.g., pH, temperature, and NaCl concentration) that affect histidine decarboxylase activity 14,43,44 .…”