The Use of DAO as a Marker for Histamine Intolerance: Measurements and Determinants in a Large Random Population-Based Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Considerations
2.2. Questionnaire
2.3. Analysis of DAO
2.4. Analysis of IgE Antibodies
2.5. Statistical Analyses
3. Results
3.1. Demographic Data
3.2. Distribution of DAO Activity
3.3. Factors Associated with DAO Levels
3.4. Symptoms Association with Foods Rich in Histamine
4. Discussion
4.1. The Natural History of DAO and Histamine Intolerance
4.2. DAO in Relation to Allergy, Diet and Other Factors
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Johansson, S.G.; Bieber, T.; Dahl, R.; Friedmann, P.S.; Lanier, B.Q.; Lockey, R.F.; Motala, C.; Ortega Martell, J.A.; Platts-Mills, T.A.; Ring, J.; et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J. Allergy Clin. Immunol. 2004, 113, 832–836. [Google Scholar] [CrossRef]
- Tuck, C.J.; Biesiekierski, J.R.; Schmid-Grendelmeier, P.; Pohl, D. Food Intolerances. Nutrients 2019, 11, 1684. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Comas-Basté, O.; Latorre-Moratalla, M.L.; Bernacchia, R.; Veciana-Nogués, M.T.; Vidal-Carou, M.C. New approach for the diagnosis of histamine intolerance based on the determination of histamine and methylhistamine in urine. J. Pharm. Biomed. Anal. 2017, 145, 379–385. [Google Scholar] [CrossRef] [PubMed]
- Comas-Basté, O.; Sánchez-Pérez, S.; Veciana-Nogués, M.T.; Latorre-Moratalla, M.; Vidal-Carou, M.D.C. Histamine Intolerance: The Current State of the Art. Biomolecules 2020, 10, 1181. [Google Scholar] [CrossRef]
- Maintz, L.; Novak, N. Histamine and histamine intolerance. Am. J. Clin. Nutr. 2007, 85, 1185–1196. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Reese, I.; Ballmer-Weber, B.; Beyer, K.; Fuchs, T.; Kleine-Tebbe, J.; Klimek, L.; Lepp, U.; Niggemann, B.; Saloga, J.; Schäfer, C.; et al. German guideline for the management of adverse reactions to ingested histamine: Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Association of Allergologists (AeDA), and the Swiss Society for Allergology and Immunology (SGAI). Allergo J. Int. 2017, 26, 72–79. [Google Scholar] [CrossRef] [Green Version]
- Schnedl, W.J.; Schenk, M.; Lackner, S.; Enko, D.; Mangge, H.; Forster, F. Diamine oxidase supplementation improves symptoms in patients with histamine intolerance. Food Sci. Biotechnol. 2019, 28, 1779–1784. [Google Scholar] [CrossRef] [Green Version]
- EFSA. Scientific Opinion on Risk Based Control of Biogenic Amine Formation in Fermented Foods; Wiley: Hoboken, NJ, USA, 2011; pp. 2393–2485. [Google Scholar]
- Doeun, D.; Davaatseren, M.; Chung, M. Biogenic amines in foods. Food Sci. Biotechnol 2017, 26, 1463–1474. [Google Scholar] [CrossRef]
- Cucca, V.; Ramirez, G.A.; Pignatti, P.; Asperti, C.; Russo, M.; Della-Torre, E.; Breda, D.; Burastero, S.E.; Dagna, L.; Yacoub, M.R. Basal Serum Diamine Oxidase Levels as a Biomarker of Histamine Intolerance: A Retrospective Cohort Study. Nutrients 2022, 14, 1513. [Google Scholar] [CrossRef]
- Mayer, I.; Pittner, F.; Hermann, M.; Missbichler, A. Highly sensitive determination of DAO activity by oxidation of a luminescence reagent. Appl. Biochem. Biotechnol. 2007, 143, 164–175. [Google Scholar] [CrossRef]
- Mušič, E.; Korošec, P.; Šilar, M.; Adamič, K.; Košnik, M.; Rijavec, M. Serum diamine oxidase activity as a diagnostic test for histamine intolerance. Wien. Klin. Wochenschr. 2013, 125, 239–243. [Google Scholar] [CrossRef] [PubMed]
- Kofler, H.; Aberer, W.; Deibi, M.; Hawranek, T.H.; Klein, G.; Reider, N.; Fellner, N. Diamine oxidase (DAO) serum activity: Not a useful marker for diagnosis of histamine intolerance. Allergologie 2009, 32, 105. [Google Scholar] [CrossRef]
- Nwaru, B.I.; Ekerljung, L.; Rådinger, M.; Bjerg, A.; Mincheva, R.; Malmhäll, C.; Axelsson, M.; Wennergren, G.; Lotvall, J.; Lundbäck, B. Cohort profile: The West Sweden Asthma Study (WSAS): A multidisciplinary population-based longitudinal study of asthma, allergy and respiratory conditions in adults. BMJ Open 2019, 9, e027808. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rentzos, G.; Johanson, L.; Goksör, E.; Telemo, E.; Lundbäck, B.; Ekerljung, L. Prevalence of food hypersensitivity in relation to IgE sensitisation to common food allergens among the general adult population in West Sweden. Clin. Transl. Allergy 2019, 9, 22. [Google Scholar] [CrossRef] [PubMed]
- Petersen, J.; Raithel, M.; Schwelberger, H.G. Characterisation of functional polymorphisms of the human diamine oxidase gene. Inflamm. Res. Off. J. Eur. Histamine Res. Soc. 2005, 54 (Suppl. S1), S58–S59. [Google Scholar] [CrossRef] [PubMed]
- Maintz, L.; Yu, C.F.; Rodríguez, E.; Baurecht, H.; Bieber, T.; Illig, T.; Weidinger, S.; Novak, N. Association of single nucleotide polymorphisms in the diamine oxidase gene with diamine oxidase serum activities. Allergy 2011, 66, 893–902. [Google Scholar] [CrossRef] [PubMed]
- Rönmark, E.P.; Ekerljung, L.; Lötvall, J.; Torén, K.; Rönmark, E.; Lundbäck, B. Large scale questionnaire survey on respiratory health in Sweden: Effects of late- and non-response. Respir. Med. 2009, 103, 1807–1815. [Google Scholar] [CrossRef] [Green Version]
- Nwaru, B.I.; Hickstein, L.; Panesar, S.S.; Roberts, G.; Muraro, A.; Sheikh, A. Prevalence of common food allergies in Europe: A systematic review and meta-analysis. Allergy 2014, 69, 992–1007. [Google Scholar] [CrossRef]
- Burney, P.G.; Potts, J.; Kummeling, I.; Mills, E.N.; Clausen, M.; Dubakiene, R.; Barreales, L.; Fernandez-Perez, C.; Fernandez-Rivas, M.; Le, T.M.; et al. The prevalence and distribution of food sensitization in European adults. Allergy 2014, 69, 365–371. [Google Scholar] [CrossRef] [Green Version]
- Wantke, F.; Proud, D.; Siekierski, E.; Kagey-Sobotka, A. Daily variations of serum diamine oxidase and the influence of H1 and H2 blockers: A critical approach to routine diamine oxidase assessment. Inflamm. Res. Off. J. Eur. Histamine Res. Soc. 1998, 47, 396–400. [Google Scholar] [CrossRef]
- Maintz, L.; Schwarzer, V.; Bieber, T.; van der Ven, K.; Novak, N. Effects of histamine and diamine oxidase activities on pregnancy: A critical review. Hum. Reprod. Update 2008, 14, 485–495. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bonds, R.S.; Midoro-Horiuti, T. Estrogen effects in allergy and asthma. Curr. Opin. Allergy Clin. Immunol. 2013, 13, 92–99. [Google Scholar] [CrossRef] [PubMed]
- Jarisch, R. Histamine Intolerance; Jarsich, R., Ed.; Springer: Vienna, Austria, 2012. [Google Scholar]
- Raithel, M.; Küfner, M.; Ulrich, P.; Hahn, E.G. The involvement of the histamine degradation pathway by diamine oxidase in manifest gastrointestinal allergies. Inflamm. Res. Off. J. Eur. Histamine Res. Soc. 1999, 48 (Suppl. S1), S75–S76. [Google Scholar] [CrossRef]
- Vassilopoulou, E.; Konstantinou, G.N.; Dimitriou, A.; Manios, Y.; Koumbi, L.; Papadopoulos, N.G. The Impact of Food Histamine Intake on Asthma Activity: A Pilot Study. Nutrients 2020, 12, 3402. [Google Scholar] [CrossRef]
- Maintz, L.; Benfadal, S.; Allam, J.P.; Hagemann, T.; Fimmers, R.; Novak, N. Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema. J. Allergy Clin. Immunol. 2006, 117, 1106–1112. [Google Scholar] [CrossRef] [PubMed]
- van Odijk, J.; Rentzos, G. Is DAO in serum affected by food challenge with histamine rich meal? J. Allergy Clin. Immunol. Glob. 2023, 2, 100097. [Google Scholar] [CrossRef]
Demographic Factors | DAO Analyzed N 1051 | DAO Not Analyzed N 121 | p-Value | |
---|---|---|---|---|
Sex (%) | Females | 52.9 | 61.2 | 0.101 ^ |
Age (mean ± SD) | 50.7 ± 15.3 | 48.2 ± 15.6 | 0.100 ^ | |
Age group (%) | 17–30 | 14.7 | 18.2 | 0.099 # |
31–45 | 24.5 | 29.8 | ||
46–60 | 30.1 | 25.6 | ||
61–78 | 30.7 | 26.4 | ||
BMI (%) | <20 | 4.5 | 4.1 | 0.103 # |
20–24 | 37.0 | 46.3 | ||
25–29 | 43.2 | 33.9 | ||
≥30 | 15.3 | 15.7 | ||
Education level (%) | Primary school | 14.9 | 9.9 | 0.132 # |
Secondary school | 4.6 | 3.3 | ||
High school | 34.2 | 40.5 | ||
University | 46.1 | 45.5 | ||
Comorbid diseases | ||||
Asthma (%) | 12.3 | 7.4 | 0.136 | |
Sensitized to airborne allergens (%) | 27.3 | 28.2 | 0.823 | |
Sensitized to common foods (%) $ | 5.4 | 5.7 | 0.823 | |
Used medication for hay fever (%) | 27.8 | 31.4 | 0.395 | |
Heart medication (%) | 9.2 | 5.8 | 0.158 | |
Hyperlipidemia (%) | 10.0 | 8.3 | 0.630 | |
Gastric reflux (%) | 44.1 | 49.6 | 0.464 |
DAO (U/mL) | |||||
---|---|---|---|---|---|
≥10 | 3–10 | <3 | p-Value | ||
Total of included subjects (%) | 55.7 | 39.8 | 4.6 | ||
Sex (%) | Females | 53.1 | 41.7 | 5.2 | 0.056 * |
Males | 58.6 | 37.6 | 3.8 | ||
Age group (%) | 17–30 | 50.0 | 43.5 | 6.5 | 0.001 # |
31–45 | 52.7 | 41.9 | 5.4 | ||
46–60 | 53.5 | 40.5 | 6.0 | ||
61–78 | 62.8 | 35.6 | 1.5 | ||
Age (mean ±SD) | 51.8 ± 15.3 | 49.6 ± 15.3 | 45.3 ± 14.7 | 0.003 ^ | |
BMI (%) | <20 | 46.8 | 40.4 | 12.8 | 0.027 # |
20–24 | 54.0 | 40.6 | 5.4 | ||
25–29 | 55.3 | 41.4 | 3.3 | ||
≥30 | 63.4 | 32.9 | 3.7 | ||
Asthma (%) | Yes | 54.3 | 38.8 | 7.0 | 0.430 * |
No | 55.9 | 39.9 | 4.2 | ||
Sensitized to airborne allergens (%) | Yes | 54.8 | 38.5 | 6.7 | 0.296 * |
No | 56.2 | 40.0 | 3.8 | ||
Sensitized to common foods (%) $ | Yes | 60.8 | 31.4 | 7.8 | 0.833 * |
No | 55.2 | 40.7 | 4.0 | ||
Used medication for hay fever (%) | Yes | 51.5 | 42.3 | 6.2 | 0.041 * |
No | 57.4 | 38.8 | 3.8 | ||
Heart medication (%) | Yes | 56.4 | 40.6 | 3.0 | 0.696 * |
No | 55.7 | 39.5 | 4.8 | ||
Medication for hyperlipidemia (%) | Yes | 60.0 | 35.2 | 4.8 | 0.449 * |
No | 55.2 | 40.2 | 4.6 | ||
Gastric reflux (%) | Yes | 56.6 | 39.7 | 3.7 | 0.448 * |
No | 54.9 | 39.8 | 5.3 |
DAO | |||
---|---|---|---|
<3 | 3–10 | ||
Sex (%) | Females | 1.16 (0.62–2.17) | 1.20 (0.92–1.55) |
Age group (%) | 31–45 | 3.84 (1.22–12.12) | 1.49 (0.98–2.27) |
46–60 | 3.49 (1.21–10.08) | 1.37 (0.97–1.95) | |
61–76 | 4.30 (1.57–11.82) | 1.30 (0.94–1.80) | |
BMI (%) | <20 | 2.30 (0.81–6.52) | 1.01 (0.52–1.95) |
25–29 | 0.70 (0.34–1.42) | 1.09 (0.82–1.46) | |
≥30 | 0.69 (0.26–1.78) | 0.74 (0.50–1.11) |
Symptoms from Histamine Rich Foods | Median DAO U/mL (IQR) | p-Value * |
---|---|---|
Gastrointestinal | 11..4 (13.0) | 0.6 |
Dermatological | 14.3 (14.0) | 0.197 |
Airway | 9.6 (8.0) | 0.215 |
Neurological | 14.0 (7.5) | 0.423 |
Any of above | 11.9 (12.3) | 0.215 |
None | 11.2 (11.5) | n/a |
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van Odijk, J.; Weisheit, A.; Arvidsson, M.; Miron, N.; Nwaru, B.; Ekerljung, L. The Use of DAO as a Marker for Histamine Intolerance: Measurements and Determinants in a Large Random Population-Based Survey. Nutrients 2023, 15, 2887. https://doi.org/10.3390/nu15132887
van Odijk J, Weisheit A, Arvidsson M, Miron N, Nwaru B, Ekerljung L. The Use of DAO as a Marker for Histamine Intolerance: Measurements and Determinants in a Large Random Population-Based Survey. Nutrients. 2023; 15(13):2887. https://doi.org/10.3390/nu15132887
Chicago/Turabian Stylevan Odijk, Jenny, Adina Weisheit, Monica Arvidsson, Nicolae Miron, Bright Nwaru, and Linda Ekerljung. 2023. "The Use of DAO as a Marker for Histamine Intolerance: Measurements and Determinants in a Large Random Population-Based Survey" Nutrients 15, no. 13: 2887. https://doi.org/10.3390/nu15132887
APA Stylevan Odijk, J., Weisheit, A., Arvidsson, M., Miron, N., Nwaru, B., & Ekerljung, L. (2023). The Use of DAO as a Marker for Histamine Intolerance: Measurements and Determinants in a Large Random Population-Based Survey. Nutrients, 15(13), 2887. https://doi.org/10.3390/nu15132887