Low serum diamine oxidase (DAO) activity levels in patients with migraine

  • Joan Izquierdo-Casas
  • Oriol Comas-Basté
  • M. Luz Latorre-Moratalla
  • Marian Lorente-Gascón
  • Adriana Duelo
  • M. Carmen Vidal-Carou
  • Luis Soler-Singla
Original Article

Abstract

Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among the several multi-faced symptoms associated with histamine intolerance, headache is one of the most recognized and disabling consequences. The aim of this study was to determine the prevalence of DAO deficiency in patients with a confirmed migraine diagnosis according to the current International Headache Society (IHS) and in non-migraine subjects. DAO activity was assessed in a total of 198 volunteers recruited at the Headache Unit of the Hospital General de Catalunya, 137 in the migraine group and 61 as a control group. DAO enzyme activity in blood samples was determined by ELISA test. Values below 80 HDU/ml (Histamine Degrading Unit/ml) were considered as DAO deficient. Mean value of DAO activity from migraine population (64.5 ± 33.5 HDU/ml) was significantly lower (p < 0.0001) than that obtained from healthy volunteers (91.9 ± 44.3 HDU/ml). DAO deficiency was more prevalent in migraine patients than in the control group. A high incidence rate of DAO deficiency (87%) was observed in the group of patients with migraine. On the other hand, 44% of non-migranous subjects had levels of DAO activity lower than 80 HDU/ml. Despite the multifactorial aetiology of migraine, these results seem to indicate that this enzymatic deficit could be related to the onset of migraine.

Keywords

Headache Migraine Histamine Diamine oxidase (DAO) Histamine intolerance 

References

  1. 1.
    Ayuso P, García-Martin E, Martinez C, Agundez JA (2007) Genetic variability of human diamine oxidase: occurrence of three nonsynonymous polymorphisms and study of their effect on serum enzyme activity. Pharmacogenet Genomics 17:687–693. doi:10.1097/FPC.0b013e328012b8e4 CrossRefPubMedGoogle Scholar
  2. 2.
    Cho HJ, Cho SI, Kim HO, Park CW, Lee CH (2013) Lack of association of plasma histamine with diamine oxidase in chronic idiopatic urticaria. Ann Dermatol 25:189–195. doi:10.5021/ad.2013.25.2.189 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Chung BY, Cho SI, Ahn IN, Lee HB, Kim HO, Park CW, Lee CH (2011) Treatment of atopic dermatitis with a low-histamine diet. Ann Dermatol 23:91–95. doi:10.5021/ad.2011.23.S1.S91 CrossRefGoogle Scholar
  4. 4.
    Comas-Basté O, Latorre-Moratalla ML, Veciana-Nogués MT, Vidal-Carou MC (2016) Dietary management of histamine intolerance: influence of putrescine in the metabolism of histamine by DAO enzyme. XII Reunión de la Sociedad Española de Seguridad Alimentaria, Antequera (Spain)Google Scholar
  5. 5.
    EFSA Panel on Biological Hazards (2011) Scientific opinion on scientific opinion on risk based control of biogenic amine formation in fermented foods. EFSA J 9:2393CrossRefGoogle Scholar
  6. 6.
    Enko D, Kriegshäuser G, Halwachs-Baumann G, Mangge H, Schnedl W (2016) Serum diamine oxidase activity is associated with lactose malabsorption phenotypic variation. Clin Biochem 50:50–53. doi:10.1016/j.clinbiochem.2016.08.019 CrossRefPubMedGoogle Scholar
  7. 7.
    García-Martín E, Martínez C, Serrador M, Alonso-Navarro H, Ayuso P, Navacerrada F, Agúndez JA, Jiménez-Jiménez FJ (2015) Diamine oxidase rs10156191 and rs2052129 variants are associated with the risk for migraine. Headache 55:276–286. doi:10.1111/head.12493 CrossRefPubMedGoogle Scholar
  8. 8.
    Hoffmann M, Gruber E, Deutschmann A, Jahnel J, Hauer A (2016) Histamine intolerance in children with chronic abdominal pain. Arch Dis Child 98:832–833. doi:10.1136/archdischild-2013-305024 CrossRefGoogle Scholar
  9. 9.
    Honzawa Y, Nakase H, Matsuura M, Chiba T (2011) Clinical significance of serum diamine oxidase activity in inflammatory bowel disease: importance of evaluation of small intestinal permeability. Inflamm Bowel Dis 17:E23–E25. doi:10.1002/ibd.21588 CrossRefPubMedGoogle Scholar
  10. 10.
    International Headache Society (IHS) (2013) The international classification of headache disorders 3rd edition (beta version). Cephalalgia 33(9):629–808. doi:10.1177/0333102413485658 CrossRefGoogle Scholar
  11. 11.
    Jarisch R (2014) Histamine intolerance, histamine and seasickness. Springer Heidelberg, New YorkGoogle Scholar
  12. 12.
    Kokavec A (2016) Migraine: a disorder of metabolism? Med Hypotheses 97:117–130. doi:10.1016/j.mehy.2016.10.029 CrossRefPubMedGoogle Scholar
  13. 13.
    Komericki P, Klein G, Reider N, Hawranek T, Strimitzer T, Lang R, Kranzelbinder B, Aberer W (2011) Histamine intolerance: lack of reproducibility of single symptoms by oral provocation with histamine: a randomised, double-blind, placebo-controlled cross-over study. Wien Klin Wochenschr 123:15–20. doi:10.1007/s00508-010-1506-y CrossRefPubMedGoogle Scholar
  14. 14.
    Kovacova-Hanuskova E, Buday T, Gavliakova S, Plevkova J (2015) Histamine, histamine intoxication and intolerance. Allergol Immunopathol 43:498–506CrossRefGoogle Scholar
  15. 15.
    Kuefner MA, Schwelberger HG, Ulrich P, Hahn EG, Raithel M (2002) Total histamine degradation capacity (THDC) as an important biological marker of histamine metabolism in human colonic mucosa. Inflamm Res 51:87–88Google Scholar
  16. 16.
    Maintz L, Benfadal S, Allam JP, Hagemann T, Fimmers R, Novak N (2006) Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema. J Allergy Clin Immunol 117:1106–1112. doi:10.1016/j1jaci.2005.11.041 CrossRefPubMedGoogle Scholar
  17. 17.
    Maintz L, Novak N (2007) Histamine and histamine intolerance. Am J Clin Nutr 85:1185–1196PubMedGoogle Scholar
  18. 18.
    Maintz L, Schwarzer V, Bieber T, van der Ven K, Novak N (2008) Effects of histamine and diamine oxidase activities on pregnancy: a critical review. Hum Reprod Update 14:485–495. doi:10.1093/humupd/dmn014 CrossRefPubMedGoogle Scholar
  19. 19.
    Manzotti G, Breda D, Gioacchino M, Burastero SE (2015) Serum diamine oxidase activity in patients with histamine intolerance. Int J Immunopathol Pharmacol 1:7. doi:10.1177/0394632015617170 Google Scholar
  20. 20.
    Meza-Velázquez R, López-Márquez F, Espinosa-Padilla S, Rivera-Guillen M, Ávila-Hernández J, Rosales-González M (2016) Association of diamine oxidase and histamine N-methyltransferase polymorphisms with presence of migraine in a group of Mexican mothers of children with allergies. Neurologia. doi:10.1016/j.nrl.2016.02.025
  21. 21.
    Miyoshi J, Miyamoto H, Goji T, Taniguchi T, Tomonari T, Sogabe M, Kimura T, Kitamura S, Okamoto K, Fujino Y, Muguruma N, Okahisa T, Takayama T (2015) Serum diamine oxidase activity as a predictor of gastrointestinal toxicity and malnutrition due to anticancer drugs. J Gastroenterol Hepatol 30:1582–1590. doi:10.1111/jgh.13004 CrossRefPubMedGoogle Scholar
  22. 22.
    Mušič E, Korošec P, Šilar M, Adamič K, Košnik M, Rijavec M (2013) Serum diamine oxidase activity as a diagnostic test for histamine intolerance. Wien Klin Wochenschr 125:239–243. doi:10.1007/s00508-013-0354-y CrossRefPubMedGoogle Scholar
  23. 23.
    Rosell-Camps A, Zibetti S, Perez-Esteban G, Vila-Vidal M, Ramis L, Garcia T (2013) Histamine intolerance as a cause of chronic digestive complains in pedriatic patients. Rev Esp Enferm Dig 105:201–207. doi:10.4321/S1130-01082013000400004
  24. 24.
    Siebenhaar L, Melde A, Magerl T, Zuberier T, Church MK, Maurer M (2016) Histamine intolerance in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 30:1774–1777. doi:10.1111/jdv.13778 CrossRefPubMedGoogle Scholar
  25. 25.
    Steinbrecher I, Jarisch R (2005) Histamin und Kopfschmerz. (Histamine and headache.) Allergologie 28:84–91CrossRefGoogle Scholar
  26. 26.
    Takimoto Y, Yoshiuchi K, Shimodaira S, Akabayashi A (2014) Diamine oxidase activity levels in anorexia nervosa. Int J Eat Disord 47:203–205CrossRefPubMedGoogle Scholar
  27. 27.
    Vlieg-Boerstra BJ, Van der Heide S, Oude JNG, Kluin-Nelemans JC, Dubois AEJ (2005) Mastocytosis and adverse reactions to biogenic amines and histamine-releasing foods. What is the evidence? Neth J Med 63:244–249PubMedGoogle Scholar
  28. 28.
    Wagner N, Dirk D, Peveling-Oberhag A, Reese I, Rady-Pizarro U, Mitzel H, Staubach P (2016) A popular myth—low-histamine diet improves chronic spontaneous urticaria – fact or fiction? J Eur Acad Dermatol Venereol. doi:10.1111/jdv.13966
  29. 29.
    Wantke F, Gotz M, Jarisch R (1993) Histamine-free diet: treatment of choice for histamine-induced food intolerance and supporting treatment for chronic headaches. Clin Exp Allergy 23:982–985CrossRefPubMedGoogle Scholar
  30. 30.
    Worm M, Fielder E, Döle AS, Schink T, Hemmer W, Jarisch R, Zuberbier T (2009) Exogenous histamine aggravates eczema in a subgroup of patients with atopic dermatitis. Acta Derm Venereol 89:52–56. doi:10.2340/00015555-0565 CrossRefPubMedGoogle Scholar
  31. 31.
    Zaeem Z, Zhou L, Dilli E (2016) Headaches: a review of the role of dietary factor. Curr Neurol Neurosci Rep 16:101. doi:10.1007/f11910-016-0702-1 CrossRefPubMedGoogle Scholar

Copyright information

© University of Navarra 2017

Authors and Affiliations

  • Joan Izquierdo-Casas
    • 1
    • 2
  • Oriol Comas-Basté
    • 3
  • M. Luz Latorre-Moratalla
    • 3
  • Marian Lorente-Gascón
    • 2
  • Adriana Duelo
    • 4
  • M. Carmen Vidal-Carou
    • 3
  • Luis Soler-Singla
    • 1
    • 2
  1. 1.Department of NeurologyHospital General de CatalunyaSant Cugat del VallèsSpain
  2. 2.Department of Basic SciencesUniversitat Internacional de CatalunyaSant Cugat del VallèsSpain
  3. 3.Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, School of Pharmacy and Food SciencesUniversity of BarcelonaSanta Coloma de GramenetSpain
  4. 4.Department of NutritionInstituto Clínico del Déficit de DAO (ICDDAO)Sant Cugat del VallèsSpain

Personalised recommendations