Journal of Gastrointestinal Surgery

, Volume 16, Issue 1, pp 173–182 | Cite as

Allergic Predisposition, Histamine and Histamine Receptor Expression (H1R, H2R) Are Associated with Complicated Courses of Sigmoid Diverticulitis

  • Burkhard H. A. von Rahden
  • Christian Jurowich
  • Stefan Kircher
  • Maria Lazariotou
  • Matthias Jung
  • Christoph-Thomas Germer
  • Martin Grimm
2011 SSAT Plenary Presentation

Abstract

Background

We aimed to evaluate our hypothesis that allergic predisposition and expression of histamine receptors might contribute to complicated courses of sigmoid diverticulitis.

Methods

Expression of histamine and histamine receptors (H1R, H2R) was analysed on protein level (immunohistochemistry/immunofluorescence (IF)) as well as mRNA level (reverse transcription–PCR (RT-PCR) in surgical specimen of patients (n = 101) having undergone resection for sigmoid diverticulits (n = 57 complicated diverticulitis/n = 44 non-complicated diverticulitis).

Results

The mean number of comorbid diseases per patient was 1.76 ± 1.25. Thirty-nine of 101 patients (38.6%) exhibited allergic predisposition (grass poll, food, drug, pets, etc.). Comorbid diseases were significantly associated with complicated diverticulitis (p = 0.027). Complicated sigmoid diverticulitis was significantly associated with high H1R and H2R expression (p < 0.001). Furthermore, an association of complicated diverticulitis with allergic predisposition was found (odds ratio = 3.2, p = 0.0097). IF double-labelling experiments showed a strong correlation of increased histamine expression with expression of H1R and H2R on intestinal enterocytes (histamine/H1R, rho = 0.841, p < 0.0001 and histamine/H2R, rho = 0.806, p < 0.0001). The results of increased H1R and H2R expression in complicated sigmoid diverticulitis were also detected on mRNA level in a subset of patients (RT-PCR, p = 0.009).

Conclusions

Our findings suggest that allergic predisposition might be another important risk factor for complicated courses of acute sigmoid diverticulitis and linked with histamine receptor expression. Supportive therapies with antihistaminic drugs might become an option. Allergic predisposition might be worth considering when indicating surgery for sigmoid diverticulitis.

Keywords

Sigmoid diverticulitis Histamine H1 receptor H1R H2 receptor H2R Allergies Allergic predisposition 

References

  1. 1.
    Jacobs DO. Clinical practice. Diverticulitis. N Engl J Med 2007;357(20): 2057–2066.PubMedCrossRefGoogle Scholar
  2. 2.
    Stollman NH, Raskin JB. Diagnosis and management of diverticular disease of the colon in adults. Ad Hoc Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1999;94(11): 3110–3121.PubMedCrossRefGoogle Scholar
  3. 3.
    Rafferty J, Shellito P, Hyman NH, Buie WD. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum 2006;49(7): 939–944.PubMedCrossRefGoogle Scholar
  4. 4.
    Meagher AP, Frizelle FA, Janes S. Practice parameters for sigmoid diverticulitis. Dis Colon Rectum 2007;50(5): 683–685.PubMedCrossRefGoogle Scholar
  5. 5.
    Chapman J, Davies M, Wolff B, Dozois E, Tessier D, Harrington J, Larson D (2005). Complicated diverticulitis: is it time to rethink the rules? Ann Surg 242(4): 576–581.PubMedGoogle Scholar
  6. 6.
    Petruzziello L, Iacopini F, Bulajic M, Shah S, Costamagna G. Review article: uncomplicated diverticular disease of the colon. Aliment Pharmacol Ther 2006;23(10): 1379–1391.PubMedCrossRefGoogle Scholar
  7. 7.
    Actis LA, Smoot JC, Barancin CE, Findlay RH. Comparison of differential plating media and two chromatography techniques for the detection of histamine production in bacteria. J Microbiol Methods 1999;39(1): 79–90.PubMedCrossRefGoogle Scholar
  8. 8.
    Fujimoto K, Imamura I, Granger DN, Wada H, Sakata T, Tso P. Histamine and histidine decarboxylase are correlated with mucosal repair in rat small intestine after ischemia-reperfusion. J Clin Invest 1992;89(1): 126–133.PubMedCrossRefGoogle Scholar
  9. 9.
    Sander LE, Lorentz A, Sellge G, Coeffier M, Neipp M, Veres T, Frieling T, Meier PN, Manns MP, Bischoff SC. Selective expression of histamine receptors H1R, H2R, and H4R, but not H3R, in the human intestinal tract. Gut 2006;55(4): 498–504.PubMedCrossRefGoogle Scholar
  10. 10.
    Diaz J, Vizuete ML, Traiffort E, Arrang JM, Ruat M, Schwartz JC. Localization of the histamine H2 receptor and gene transcripts in rat stomach: back to parietal cells. Biochem Biophys Res Commun 1994;198(3): 1195–1202.PubMedCrossRefGoogle Scholar
  11. 11.
    Hill SJ, Ganellin CR, Timmerman H, Schwartz JC, Shankley NP, Young JM, Schunack W, Levi R, Haas HL. International Union of Pharmacology. XIII. Classification of histamine receptors. Pharmacol Rev 1997;49(3): 253–278.PubMedGoogle Scholar
  12. 12.
    Hollander D. Intestinal permeability, leaky gut, and intestinal disorders. Curr Gastroenterol Rep 1999;1(5): 410–416.PubMedCrossRefGoogle Scholar
  13. 13.
    Gattenlohner S, Waller C, Ertl G, Bultmann BD, Muller-Hermelink HK, Marx A. NCAM(CD56) and RUNX1(AML1) are up-regulated in human ischemic cardiomyopathy and a rat model of chronic cardiac ischemia. Am J Pathol 2003;163(3): 1081–1090.PubMedCrossRefGoogle Scholar
  14. 14.
    Grimm M, Gasser M, Bueter M, Strehl J, Wang J, Nichiporuk E, Meyer D, Germer CT, Waaga-Gasser AM, Thalheimer A (2010). Evaluation of immunological escape mechanisms in a mouse model of colorectal liver metastases. BMC Cancer 10: 82.PubMedCrossRefGoogle Scholar
  15. 15.
    Wjst M. Introduction of oral vitamin D supplementation and the rise of the allergy pandemic. Allergy Asthma Clin Immunol 2009;5(1): 8.PubMedCrossRefGoogle Scholar
  16. 16.
    Il’yasova D, McCarthy B, Marcello J, Schildkraut JM, Moorman PG, Krishnamachari B, Ali-Osman F, Bigner DD, Davis F (2009). Association between glioma and history of allergies, asthma, and eczema: a case-control study with three groups of controls. Cancer Epidemiol Biomarkers Prev 18(4): 1232–1238.PubMedCrossRefGoogle Scholar
  17. 17.
    Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr 2007;85(5): 1185–1196.PubMedGoogle Scholar
  18. 18.
    Schmidt WU, Sattler J, Hesterberg R, Roher HD, Zoedler T, Sitter H, Lorenz W. Human intestinal diamine oxidase (DAO) activity in Crohn’s disease: a new marker for disease assessment? Agents Actions 1990;30(1–2): 267–270.PubMedCrossRefGoogle Scholar
  19. 19.
    Mennigen R, Kusche J, Streffer C, Krakamp B. Diamine oxidase activities in the large bowel mucosa of ulcerative colitis patients. Agents Actions 1990;30(1–2): 264–266.PubMedCrossRefGoogle Scholar
  20. 20.
    Raithel M, Matek M, Baenkler HW, Jorde W, Hahn EG. Mucosal histamine content and histamine secretion in Crohn’s disease, ulcerative colitis and allergic enteropathy. Int Arch Allergy Immunol 1995;108(2): 127–133.PubMedCrossRefGoogle Scholar
  21. 21.
    Raithel M, Kufner M, Ulrich P, Hahn EG. The involvement of the histamine degradation pathway by diamine oxidase in manifest gastrointestinal allergies. Inflamm Res 1999;48 Suppl 1: S75-76.PubMedCrossRefGoogle Scholar
  22. 22.
    Raithel M, Ulrich P, Hochberger J, Hahn EG. Measurement of gut diamine oxidase activity. Diamine oxidase as a new biologic marker of colorectal proliferation? Ann N Y Acad Sci 1998;859: 262–266.PubMedCrossRefGoogle Scholar
  23. 23.
    Barbara G, Stanghellini V, De Giorgio R, Cremon C, Cottrell GS, Santini D, Pasquinelli G, Morselli-Labate AM, Grady EF, Bunnett NW, Collins SM, Corinaldesi R. Activated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome. Gastroenterology 2004;126(3): 693–702.PubMedCrossRefGoogle Scholar
  24. 24.
    Colecchia A, Sandri L, Capodicasa S, Vestito A, Mazzella G, Staniscia T, Roda E, Festi D. Diverticular disease of the colon: new perspectives in symptom development and treatment. World J Gastroenterol 2003;9(7): 1385–1389.PubMedGoogle Scholar
  25. 25.
    Wantke F, Gotz M, Jarisch R. Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches. Clin Exp Allergy 1993;23(12): 982–985.PubMedCrossRefGoogle Scholar
  26. 26.
    Kufner MA, Ulrich P, Raithel M, Schwelberger HG. Determination of histamine degradation capacity in extremely small human colon samples. Inflamm Res 2001;50 Suppl 2: S96-97.PubMedGoogle Scholar
  27. 27.
    Wantke F, Gotz M, Jarisch R. The red wine provocation test: intolerance to histamine as a model for food intolerance. Allergy Proc 1994;15(1): 27–32.PubMedCrossRefGoogle Scholar
  28. 28.
    Johnston CS. The antihistamine action of ascorbic acid. Subcell Biochem 1996;25: 189–213.PubMedCrossRefGoogle Scholar
  29. 29.
    Jarisch R, Wantke F. Wine and headache. Int Arch Allergy Immunol 1996;110(1): 7–12.PubMedCrossRefGoogle Scholar
  30. 30.
    Ortolani C, Pastorello EA. Food allergies and food intolerances. Best Pract Res Clin Gastroenterol 2006;20(3): 467–483.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Burkhard H. A. von Rahden
    • 1
    • 5
  • Christian Jurowich
    • 1
  • Stefan Kircher
    • 2
  • Maria Lazariotou
    • 3
  • Matthias Jung
    • 1
  • Christoph-Thomas Germer
    • 1
  • Martin Grimm
    • 1
    • 4
  1. 1.Department of General-, Visceral-, Vascular and Pediatric SurgeryUniversity Hospital WuerzburgWuerzburgGermany
  2. 2.Department of PathologyUniversity Hospital WuerzburgWuerzburgGermany
  3. 3.Department of Cardiac and Thoracic SurgeryUniversity of Wuerzburg HospitalWuerzburgGermany
  4. 4.Department of Craniomaxillofacial and Oral Surgery, Plastic OperationsGeneral Hospital NurembergNurembergGermany
  5. 5.Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäss- und KinderchirurgieUniversitätsklinikum WürzburgWürzburgGermany

Personalised recommendations