Food-induced histaminosis under diamine oxidase (DAO) blockade in pigs: Further evidence of the key role of elevated plasma histamine levels as demonstrated by successful prophylaxis with antihistamines


Using a recently established porcine model, it was clearly shown that oral histamine administration is extremely dangerous in the presence of diamine oxidase (DAO) blockade. Due to the severity of the symptoms (20% death) and the clinical relevance, further interest has been focussed on strategies to prevent or alleviate food induced histaminosis. In a randomized controlled trial, 10 pigs under DAO blockade were challenged with oral histamine (60 mg). Half of these animals received a prophylactic premedication with a combination of H1- and H2-receptor antagonists. As expected, all animals developed a massive increase in plasma histamine levels, with significantly higher values in the control group (median: 123 ng/ml) compared to the antihistamine group (median: 32 ng/ml). In contrast, clinical symptoms were only observed in the control group. The maximum fall in mean arterial pressure (hypotension) was 60 mmHg (median for control group) but only 15 mmHg (median) under antihistamine pretreatment. These results firstly provide further evidence for the causal role of histamine in the new disease concept and secondly enable us to investigate appropriate therapeutic measures for patients at risk.

This is a preview of subscription content, log in to check access.


  1. [1]

    W. Lorenz, A. Doenicke, B. Schöning, Ch. Ohmann, B. Grote and E. Neugebauer,Definition and classification of the histamine-release response to drugs in anaesthesia and surgery: studies in the conscious human subject. Klin. Wschr.60, 896–913 (1982).

    PubMed  Google Scholar 

  2. [2]

    J. Sattler, D. Häfner, H.-J. Klotter, W. Lorenz and P. K. Wagner,Food-induced histaminosis as an epidemiological problem: plasma histamine elevation and haemodynamic alterations after oral histamine administratioin and blockade of diamine oxidase (DAO). Agents and Actions23, 361–365 (1988).

    PubMed  Google Scholar 

  3. [3]

    J. Sattler, H.-J. Klotter, W. Lorenz, P. K. Wagner, D. Häfner and R. Lindlar,Obere gastrointestinale (GI) Blutung: Erhöhtes Risiko kardiovasculärer Komplikationen durch Amin-resorption infolge medikamentöser Diaminoxydase (DAO)-Blockade. InLangenbecks Arch Chir. Suppl. Chir Forum, pp. 273–277 (1988).

  4. [4]

    W. Lorenz, K. Thon, E. Neugebauer, H. Stöltzing, Ch. Ohmann, D. Weber, A. Schmal, E. Hinterlang, H. Barth and J. Kusche,Reliability and practicability of the fluorometricfluoroenzymatic histamine determination in pathogenetic studies on peptic ulcer: detection limits and problems with specificity. Agents and Action21, 1–25 (1987).

    Google Scholar 

  5. [5]

    W. Lorenz, H.-J. Reimann, H. Barth, J. Kusche, R. Meyer, A. Doenicke and M. Hutzel,A sensitive and specific method for the determination of histamine in human whole blood and plasma. Hoppe — Seyler's Z. Physiol. Chem.353, 911–920 (1972).

    PubMed  Google Scholar 

  6. [6]

    H. H. Dale,Croonian lectures on some chemical factors in the control of the circulation. Lanceti, 1285–1290 (1929).

    Google Scholar 

  7. [7]

    W. Lorenz, H. D. Röher, A. Doenicke and Ch. Ohmann,Histamine release in anaesthesia and surgery: A new method to evaluate its clinical significance with several types of causal relationship. Clin Anaesthesiology2, 403–406 (1984).

    Google Scholar 

  8. [8]

    J. Sattler, R. Hesterberg, W. Lorenz, U. Schmidt, M. Crombach and C.-D. Stahlknech,Inhibition of human and canine diamine oxidase by drugs used in an intensive care unit: relevance for clinical side effects? Agents and Actions16, 91–94 (1985).

    PubMed  Google Scholar 

  9. [9]

    J Sattler and W. Lorenz,Nahrungsmittelinduzierte Histaminose: Ein Krankheitsbild mit Diaminoxydasehemmung verschiedener Herkunft. Münch. Med. Wochenschr.129, 551–556 (1987).

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Dr. J. Sattler.

Additional information

Supported by a grant from the Deutsche Forschungsgemeinschaft (DFG, Lo199/15-1).

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Sattler, J., Lorenz, W., Kubo, K. et al. Food-induced histaminosis under diamine oxidase (DAO) blockade in pigs: Further evidence of the key role of elevated plasma histamine levels as demonstrated by successful prophylaxis with antihistamines. Agents and Actions 27, 212–214 (1989).

Download citation


  • Histamine
  • Arterial Pressure
  • Clinical Relevance
  • Diamine
  • Causal Role