Special Issue "Unfolding New Evidence on Histamine Intolerance"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: 31 January 2022.

Special Issue Editors

Dr. Mariluz Latorre-Moratalla
E-Mail Website
Guest Editor
Department of Nutrition, Food Sciences and Gastronomy, Food and Nutrition Torribera Campus, University of Barcelona, Spain.
Interests: dry-fermented sausages, biogenic amines, histamine, histamine intolerance, DAO
Dr. Oriol Comas-Basté
E-Mail
Guest Editor
Department of Nutrition, Food Sciences and Gastronomy, Food and Nutrition Torribera Campus, University of Barcelona, Spain.
Prof. Dr. M. Carmen Vidal-Carou
E-Mail Website
Guest Editor
Department of Nutrition, Food Sciences and Gastronomy, Food and Nutrition Torribera Campus, University of Barcelona, Barcelona, Spain
Interests: functional foods; bioactive compounds; food safety; food intolerances; biogenic amines; histamine; histamine intoxication; histamine intolerance; diamine oxidase (DAO) enzyme; tyramine; putrescine; cadaverine; polyamines; amino acid decarboxylase; fermentation; food-drug interactions

Special Issue Information

Dear Colleagues, 

Histamine intolerance, also referred to as enteral histaminosis or sensitivity to dietary histamine, is a non-immune-mediated adverse reaction to food that arises from a reduced histamine degradation capacity in the intestine. Although the first scientific references to histamine intolerance date from the end of the 20th century, it is significant that almost 80% are from the last decade, reflecting the growing interest of researchers in this disorder. 

A deficit of diamine oxidase (DAO), the primary enzyme responsible for scavenging histamine from food at the intestinal level, is recognized as the main etiologic factor that leads to histamine intolerance. This enzymatic deficit may have a genetic, pathological, or pharmacological origin, which causes the accumulation of histamine in plasma and the subsequent appearance of non-specific gastrointestinal and extraintestinal symptoms. 

Currently, there is no consensual diagnostic algorithm for histamine intolerance and the treatment management is limited to the strict avoidance of dietary histamine and DAO enzyme supplementation. Recent and ongoing trials are focused on the study of the efficacy of low-histamine diets and/or DAO supplementation in the preventive treatment of symptoms, as well as on the potential link of this intolerance with other functional gastrointestinal disorders. Moreover, the potential role of microbiota in the pathophysiology of histamine intolerance needs to be elucidated.  

The aim of this Special Issue is to review and unfold new evidence on the etiology, clinical presentation, diagnosis, and treatment of histamine intolerance. Articles dealing with strategies to control the occurrence of histamine and other biogenic amines in foods, as well as analytical methods to detect the presence of these compounds, are also within the scope of this Special Issue.

Dr. Mariluz Latorre-Moratalla
Dr. Oriol Comas-Basté
Prof. Dr. M. Carmen Vidal-Carou
Guest Editors

Manuscript Submission Information

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Keywords

  • histamine
  • histamine intolerance
  • food intolerance
  • histaminosis
  • diamine oxidase (DAO)
  • DAO deficit
  • low-histamine diet
  • DAO supplementation
  • clinical manifestations
  • diagnosis
  • biogenic amines

Published Papers (4 papers)

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Research

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Article
Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content?
Nutrients 2021, 13(5), 1395; https://doi.org/10.3390/nu13051395 - 21 Apr 2021
Cited by 2 | Viewed by 2059
Abstract
A low-histamine diet is currently the most advised strategy to prevent the symptomatology of histamine intolerance. Conceptually, these diets should be founded on the exclusion of histamine-containing foods, although a certain disparity is found within the list of excluded foods in accordance with [...] Read more.
A low-histamine diet is currently the most advised strategy to prevent the symptomatology of histamine intolerance. Conceptually, these diets should be founded on the exclusion of histamine-containing foods, although a certain disparity is found within the list of excluded foods in accordance with the different low-histamine diets available in the literature. This study aimed to critically review low-histamine diets reported in the scientific literature, according to the histamine and other biogenic amine contents of the excluded foods. A total of ten scientific studies that provided specific recommendations on the foods that must be avoided within the framework of a low-histamine diet were found. Overall, the comparative review brought out the great heterogenicity in the type of foods that are advised against for histamine intolerant individuals. Excluded foods were, in most cases, different depending on the considered diet. Only fermented foods were unanimously excluded. The exclusion of 32% of foods could be explained by the occurrence of high contents of histamine. The presence of putrescine, which may interfere with histamine degradation by the DAO enzyme at the intestinal level, could partly explain the reason why certain foods (i.e., citrus fruits and bananas) were also frequently reported in low-histamine diets. Finally, there was a range of excluded foods with an absence or very low levels of biogenic amines. In this case, certain foods have been tagged as histamine-liberators, although the mechanism responsible has not yet been elucidated. Full article
(This article belongs to the Special Issue Unfolding New Evidence on Histamine Intolerance)
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Article
Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption
Nutrients 2020, 12(12), 3690; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12123690 - 30 Nov 2020
Cited by 3 | Viewed by 1357
Abstract
Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 [...] Read more.
Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 patients with only lactose intolerance (LIT). Then, we identified 106 LIT patients with additional histamine intolerance (HIT). Additionally, 45 LIT and HIT patients also had fructose malabsorption (FM). A hydrogen (H2) breath test was performed to evaluate LIT and FM. A serum diamine oxidase value of <10 U/mL and a response to a histamine-reduced diet was used to identify HIT. Using pairwise comparison with the Kruskal–Wallis test to associate the area under the curve (AUC) of LIT patients and, LIT with HIT, to LIT with HIT and FM it was found, that the exhaled hydrogen values were significantly higher in patients with two-fold and triple combined food intolerance/malabsorption (p < 0.004 and p < 0.001, respectively). Within the pool of 170 LIT patients with >20 ppm increase of expiratory H2 from baseline, there were 74 LIT-only patients, 60 LIT with HIT patients, and 36 LIT patients with additional HIT and FM. With the Kruskal–Wallis test AUCs demonstrated a significant difference between all three groups (p = 0.024). In patients with LIT, the presence of additional food intolerance/malabsorption, significantly increases expiratory H2 values. We demonstrate evidence, which may suggest HIT to embody an own GI disorder as food intolerance/malabsorption. Full article
(This article belongs to the Special Issue Unfolding New Evidence on Histamine Intolerance)
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Review

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Review
Histamine Intolerance—The More We Know the Less We Know. A Review
Nutrients 2021, 13(7), 2228; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072228 - 29 Jun 2021
Cited by 1 | Viewed by 2843
Abstract
The intake of food may be an initiator of adverse reactions. Food intolerance is an abnormal non-immunological response of the organism to the ingestion of food or its components in a dosage normally tolerated. Despite the fact that food intolerance is spread throughout [...] Read more.
The intake of food may be an initiator of adverse reactions. Food intolerance is an abnormal non-immunological response of the organism to the ingestion of food or its components in a dosage normally tolerated. Despite the fact that food intolerance is spread throughout the world, its diagnosing is still difficult. Histamine intolerance (HIT) is the term for that type of food intolerance which includes a set of undesirable reactions as a result of accumulated or ingested histamine. Manifestations may be caused by various pathophysiological mechanisms or a combination of them. The problem with a “diagnosis” of HIT is precisely the inconstancy and variety of the manifestations in the same individual following similar stimuli. The diagnosing of HIT therefore requires a complex time-demanding multidisciplinary approach, including the systematic elimination of disorders with a similar manifestation of symptoms. Among therapeutic approaches, the gold standard is a low-histamine diet. A good response to such a diet is considered to be confirmation of HIT. Alongside the dietary measures, DAO supplementation supporting the degradation of ingested histamine may be considered as subsidiary treatment for individuals with intestinal DAO deficiency. If antihistamines are indicated, the treatment should be conscious and time-limited, while 2nd or 3rd generation of H1 antihistamines should take precedence. Full article
(This article belongs to the Special Issue Unfolding New Evidence on Histamine Intolerance)
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Review
Histamine Intolerance Originates in the Gut
Nutrients 2021, 13(4), 1262; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041262 - 12 Apr 2021
Cited by 2 | Viewed by 2576
Abstract
Histamine intolerance (HIT) is assumed to be due to a deficiency of the gastrointestinal (GI) enzyme diamine oxidase (DAO) and, therefore, the food component histamine not being degraded and/or absorbed properly within the GI tract. Involvement of the GI mucosa in various disorders [...] Read more.
Histamine intolerance (HIT) is assumed to be due to a deficiency of the gastrointestinal (GI) enzyme diamine oxidase (DAO) and, therefore, the food component histamine not being degraded and/or absorbed properly within the GI tract. Involvement of the GI mucosa in various disorders and diseases, several with unknown origin, and the effects of some medications seem to reduce gastrointestinal DAO activity. HIT causes variable, functional, nonspecific, non-allergic GI and extra-intestinal complaints. Usually, evaluation for HIT is not included in differential diagnoses of patients with unexplained, functional GI complaints or in the here-listed disorders and diseases. The clinical diagnosis of HIT is challenging, and the thorough anamnesis of all HIT-linked complaints, using a standardized questionnaire, is the mainstay of HIT diagnosis. So far, DAO values in serum have not been established to correlate with DAO activity in the gut, but the diagnosis of HIT may be supported with determination of a low serum DAO value. A targeted dietary intervention, consisting of a histamine-reduced diet and/or supplementation with oral DAO capsules, is helpful to reduce HIT-related symptoms. This manuscript will present why histamine should also be taken into account in the differential diagnoses of patients with various diseases and disorders of unknown origin, but with association to functional gastrointestinal complaints. In this review, we discuss currently increasing evidence that HIT is primarily a gastrointestinal disorder and that it originates in the gut. Full article
(This article belongs to the Special Issue Unfolding New Evidence on Histamine Intolerance)
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