Kanta Dimitra, Katsamakas Eleftherios, Gudiksen Anna Maia Berg, Jalili Mahsa
Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958 Frederiksberg, Denmark.
Nutrients. 2025 Jul 29;17(15):2473. doi: 10.3390/nu17152473.
Patients with Inflammatory Bowel Disease (IBD) exhibit a dysregulated immune response that may be further exacerbated by bioactive compounds, such as histamine. Current dietary guidelines for IBD primarily focus on symptom management and flare-up prevention, yet targeted nutritional strategies addressing histamine metabolism remain largely unexplored. This narrative review aims to summarize the existing literature on the complex interplay between IBD and histamine metabolism and propose a novel dietary framework for managing IBD progression in patients with histamine intolerance (HIT). Relevant studies were identified through a comprehensive literature search of PubMed/MEDLINE, Google Scholar, ScienceDirect, Scopus, and Web of Science. The proposed low-histamine diet (LHD) aims to reduce the overall histamine burden in the body through two primary strategies: (1) minimizing exogenous intake by limiting high-histamine and histamine-releasing foods and (2) reducing endogenous histamine production by modulating gut microbiota composition, specifically targeting histamine-producing bacteria. In parallel, identifying individuals who are histamine-intolerant and understanding the role of histamine-degrading enzymes, such as diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), are emerging as important areas of focus. Despite growing interest in the role of histamine and mast cell activation in gut inflammation, no clinical trials have investigated the effects of a low-histamine diet in IBD populations. Therefore, future research should prioritize the implementation of LHD interventions in IBD patients to evaluate their generalizability and clinical applicability.
炎症性肠病(IBD)患者表现出免疫反应失调,生物活性化合物如组胺可能会进一步加剧这种失调。目前IBD的饮食指南主要侧重于症状管理和预防病情发作,然而针对组胺代谢的靶向营养策略在很大程度上仍未得到探索。这篇叙述性综述旨在总结关于IBD与组胺代谢之间复杂相互作用的现有文献,并提出一种新的饮食框架,用于管理组胺不耐受(HIT)患者的IBD进展。通过对PubMed/MEDLINE、谷歌学术、ScienceDirect、Scopus和科学网进行全面的文献检索,确定了相关研究。提议的低组胺饮食(LHD)旨在通过两种主要策略降低体内的总体组胺负担:(1)通过限制高组胺和组胺释放食物来尽量减少外源性摄入;(2)通过调节肠道微生物群组成,特别是针对产生组胺的细菌,减少内源性组胺的产生。与此同时,识别组胺不耐受个体并了解组胺降解酶如二胺氧化酶(DAO)和组胺-N-甲基转移酶(HNMT)的作用,正成为重要的关注领域。尽管人们对组胺和肥大细胞激活在肠道炎症中的作用越来越感兴趣,但尚无临床试验研究低组胺饮食对IBD人群的影响。因此,未来的研究应优先在IBD患者中实施LHD干预措施,以评估其普遍性和临床适用性。
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