Department of Environmental Dermatology and Venereology, Medical University of Graz, Graz, Austria.
Wien Klin Wochenschr. 2011 Jan;123(1-2):15-20. doi: 10.1007/s00508-010-1506-y. Epub 2010 Dec 20.
The term histamine intolerance stands for a range of symptoms involving various effector organs after the consumption of histamine-rich food. Our intention was to objectify and quantify histamine-associated symptoms and to analyse whether oral administration of the histamine-degrading enzyme diamine oxidase (DAO) caused a reduction of symptoms.
Four Austrian centres participated. Patients suspected to be histamine intolerant were recruited. The first step consisted in the open oral provocation of these patients with 75 mg of liquid histamine. Patients who developed symptoms were tested in a randomised double blind crossover provocation protocol using histamine-containing and histamine-free tea in combination with DAO capsules or placebo. Main and secondary symptoms (strongest and weaker symptoms based on a ten-point scale) were defined, the grand total of all symptoms of the individual provocation steps was determined and changes in symptoms after administration of DAO were measured.
Thirty nine patients reacted to the open histamine provocation and were enrolled in the blinded part. Here, both the main and secondary symptoms were not reproducible. Subjects reacted sometimes unexpectedly and randomly. Regarding the total symptom scores, the differences between the three treatment groups were statistically significant. The intake of DAO demonstrated a statistically significant reduction of histamine-associated symptoms compared to placebo (P = 0.014).
Oral provocation with 75 mg of liquid histamine failed to reproduce histamine-associated single symptoms in many patients. One may suggest that histamine-intolerant subjects reacted with different organs on different occasions. As a consequence, reproducibility of single symptoms alone may not be appropriate to diagnose histamine-intolerance whereas a global symptom score could be more appropriate. The fact, that the intake of DAO capsules compared to placebo led to a statistically significant reduction of total symptom scores, may indirectly point in the same direction.
“组胺不耐受”一词代表了食用富含组胺的食物后涉及各种效应器官的一系列症状。我们的目的是客观化和量化与组胺相关的症状，并分析口服组胺降解酶二胺氧化酶（DAO）是否会减轻症状。
四个奥地利中心参与了这项研究。招募了疑似组胺不耐受的患者。第一步是对这些患者进行开放的口服组胺激发，给予 75mg 液体组胺。出现症状的患者在随机双盲交叉激发方案中接受含有组胺和不含组胺的茶与 DAO 胶囊或安慰剂联合测试。主要和次要症状（根据 10 分制定义的最强和较弱症状），确定个体激发步骤的所有症状总和，并测量 DAO 给药后症状的变化。
39 名患者对开放的组胺激发有反应，并被纳入盲法部分。在这里，主要和次要症状都不可重复。受试者有时会出人意料且随机地反应。关于总症状评分，三组之间的差异具有统计学意义。与安慰剂相比，DAO 的摄入显示出与组胺相关的症状有统计学意义的减轻（P = 0.014）。
口服给予 75mg 液体组胺未能在许多患者中重现与组胺相关的单一症状。人们可能会认为，组胺不耐受的患者在不同场合会以不同的器官反应。因此，单独重现单一症状可能不适合诊断组胺不耐受，而整体症状评分可能更合适。与安慰剂相比，DAO 胶囊的摄入导致总症状评分具有统计学意义的降低，这一事实可能间接指向同一方向。
