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Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet.

Raithel M, Hagel A, Albrecht H, Zopf Y, Naegel A, Baenkler HW, Buchwald F, Schultis HW, Kressel J, Hahn EG, Konturek P - BMC Gastroenterol (2015)

Bottom Line: Urinary histamine and n-methylhistamine were determined by ELISA or tandem mass spectrometry, respectively, and were expressed as median (25 - 75% range, μg/mmol creatinine x m(2)BSA).In gastrointestinal food allergy significantly higher levels of urine histamine and methylhistamine excretion were found under unrestricted diet, reflecting an increased secretion of histamine due to offending foods.Measurement of urinary n-methylhistamine levels may help to find out patients with increased histamine production and/or food-allergen induced clinical symptoms, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine 1, Functional Tissue Diagnostics, Gastroenterology, University Hospital Erlangen, University Erlangen-Nürnberg, Ulmenweg 18, Erlangen, 91054, Germany. martin.raithel@uk-erlangen.de.

ABSTRACT

Background: Patients with gastrointestinal food allergy are characterised by increased production of mast cell derived mediators upon allergen contact and present often with unspecific symptoms. The aim of this study was to evaluate urinary histamine and methylhistamine excretion in patients with food allergy and to compare their values with food-tolerant controls.

Methods: In a retrospective case control study the urinary excretion parameters were analysed from 56 patients (40.9, 19 - 58 years) in whom later food challenge tests confirmed food allergy. During their diagnostic work-up urine was collected during a 12-h period under an unrestricted diet with staple foods and a hypoallergenic potato-rice-diet (each 2 days). Healthy controls underwent the same diet types to define normal excretion parameters. Urinary histamine and n-methylhistamine were determined by ELISA or tandem mass spectrometry, respectively, and were expressed as median (25 - 75% range, μg/mmol creatinine x m(2)BSA).

Results: During unrestricted diet urinary histamine was significantly higher in gastrointestinal food allergy than healthy controls (1.42, 0.9 - 2.7 vs 0.87, 0.4 - 1.3; p < 0.0001), while the difference between both groups became marginal during potato-rice diet (1.30, 0.7 - 2.1 vs 1.05, 0.5 - 1.5; p = 0.02). N-methylhistamine was found to be significantly elevated in gastrointestinal food allergy both during unrestricted diet (7.1, 5.0 - 11.2) and potato-rice diet (5.7, 3.7 - 8.7) compared to controls (p < 0.0001). Interestingly, urinary methylhistamine excretion (p < 0.004) and clinical symptom score (p < 0.02) fell significantly when the diet was switched from unrestricted to hypoallergenic food, but was not correlated with symptom scores.

Conclusions: In gastrointestinal food allergy significantly higher levels of urine histamine and methylhistamine excretion were found under unrestricted diet, reflecting an increased secretion of histamine due to offending foods. Measurement of urinary n-methylhistamine levels may help to find out patients with increased histamine production and/or food-allergen induced clinical symptoms, respectively.

No MeSH data available.


Related in: MedlinePlus

Distribution of individual urine methylhistamine (UMH) values during unrestricted diet in 56 patients with gastrointestinally mediated allergy (GMA) and 44 controls. The grey box represents normal values for UMH (mean ± 1 SD of controls).
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Fig6: Distribution of individual urine methylhistamine (UMH) values during unrestricted diet in 56 patients with gastrointestinally mediated allergy (GMA) and 44 controls. The grey box represents normal values for UMH (mean ± 1 SD of controls).

Mentions: When analysing the distribution of individual UMH excretion of controls during unrestricted diet (Figure 6, Tables 5 and 6), 12 of 88 urine samples (13.6%) showed UMH levels greater than the mean + 1 SD (4.4 + 1.8 = 6.2), while 76 urine samples (86.4%) were below this limit.Figure 6


Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet.

Raithel M, Hagel A, Albrecht H, Zopf Y, Naegel A, Baenkler HW, Buchwald F, Schultis HW, Kressel J, Hahn EG, Konturek P - BMC Gastroenterol (2015)

Distribution of individual urine methylhistamine (UMH) values during unrestricted diet in 56 patients with gastrointestinally mediated allergy (GMA) and 44 controls. The grey box represents normal values for UMH (mean ± 1 SD of controls).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389952&req=5

Fig6: Distribution of individual urine methylhistamine (UMH) values during unrestricted diet in 56 patients with gastrointestinally mediated allergy (GMA) and 44 controls. The grey box represents normal values for UMH (mean ± 1 SD of controls).
Mentions: When analysing the distribution of individual UMH excretion of controls during unrestricted diet (Figure 6, Tables 5 and 6), 12 of 88 urine samples (13.6%) showed UMH levels greater than the mean + 1 SD (4.4 + 1.8 = 6.2), while 76 urine samples (86.4%) were below this limit.Figure 6

Bottom Line: Urinary histamine and n-methylhistamine were determined by ELISA or tandem mass spectrometry, respectively, and were expressed as median (25 - 75% range, μg/mmol creatinine x m(2)BSA).In gastrointestinal food allergy significantly higher levels of urine histamine and methylhistamine excretion were found under unrestricted diet, reflecting an increased secretion of histamine due to offending foods.Measurement of urinary n-methylhistamine levels may help to find out patients with increased histamine production and/or food-allergen induced clinical symptoms, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine 1, Functional Tissue Diagnostics, Gastroenterology, University Hospital Erlangen, University Erlangen-Nürnberg, Ulmenweg 18, Erlangen, 91054, Germany. martin.raithel@uk-erlangen.de.

ABSTRACT

Background: Patients with gastrointestinal food allergy are characterised by increased production of mast cell derived mediators upon allergen contact and present often with unspecific symptoms. The aim of this study was to evaluate urinary histamine and methylhistamine excretion in patients with food allergy and to compare their values with food-tolerant controls.

Methods: In a retrospective case control study the urinary excretion parameters were analysed from 56 patients (40.9, 19 - 58 years) in whom later food challenge tests confirmed food allergy. During their diagnostic work-up urine was collected during a 12-h period under an unrestricted diet with staple foods and a hypoallergenic potato-rice-diet (each 2 days). Healthy controls underwent the same diet types to define normal excretion parameters. Urinary histamine and n-methylhistamine were determined by ELISA or tandem mass spectrometry, respectively, and were expressed as median (25 - 75% range, μg/mmol creatinine x m(2)BSA).

Results: During unrestricted diet urinary histamine was significantly higher in gastrointestinal food allergy than healthy controls (1.42, 0.9 - 2.7 vs 0.87, 0.4 - 1.3; p < 0.0001), while the difference between both groups became marginal during potato-rice diet (1.30, 0.7 - 2.1 vs 1.05, 0.5 - 1.5; p = 0.02). N-methylhistamine was found to be significantly elevated in gastrointestinal food allergy both during unrestricted diet (7.1, 5.0 - 11.2) and potato-rice diet (5.7, 3.7 - 8.7) compared to controls (p < 0.0001). Interestingly, urinary methylhistamine excretion (p < 0.004) and clinical symptom score (p < 0.02) fell significantly when the diet was switched from unrestricted to hypoallergenic food, but was not correlated with symptom scores.

Conclusions: In gastrointestinal food allergy significantly higher levels of urine histamine and methylhistamine excretion were found under unrestricted diet, reflecting an increased secretion of histamine due to offending foods. Measurement of urinary n-methylhistamine levels may help to find out patients with increased histamine production and/or food-allergen induced clinical symptoms, respectively.

No MeSH data available.


Related in: MedlinePlus