Low serum diamine oxidase (DAO) activity levels in patients with migraine
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.
KeywordsHeadache Migraine Histamine Diamine oxidase (DAO) Histamine intolerance
The authors would like to thank DR Healthcare SL for its funding support. Oriol Comas-Basté is a recipient of a doctoral fellowship from the University of Barcelona (APIF2015).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 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
- 11.Jarisch R (2014) Histamine intolerance, histamine and seasickness. Springer Heidelberg, New YorkGoogle Scholar
- 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
- 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
- 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.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
- 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
- 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