Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema - 17/08/11
Reprint requests: Natalija Novak, MD, Department of Dermatology, University of Bonn, Sigmund-Freud-Str 25, 53105 Bonn, Germany.Bonn, Germany
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.
Le texte complet de cet article est disponible en PDF.Key words : Atopic eczema, histamine, diaminoxidase, food intolerance, allergy
Abbreviations used : AE, FA, HIT, HNMT, SCORAD
Plan
| Supported by grants from the Deutsche Forschungsgemeinschaft (DFG NO454/1-4 and DFG NO454/2-3) and a BONFOR grant of the University of Bonn. Dr Novak is supported by a Heisenberg-Fellowship, DFG NO454/3-1. Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest. |
Vol 117 - N° 5
P. 1106-1112 - mai 2006 Retour au numéro
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