The role of homeopathic treatment in histamine intolerance ... · PDF fileThe role of...

The role of homeopathic treatment in

histamine intolerance due to diamine

oxydase deficiency

Dr. Mariana Carmen Zapucioiu

Dr. Gabriela Mihaela Ion

ROMANIA

AUTHORS:

DR. CARMEN ZAPUCIOIU, CLINICAL RESEARCH

DIRECTOR

Presenter

DR. ION GABRIELA, CLINICAL RESEARCH DIRECTOR

DR. MIRELA PAVELESCU

Copyright® CEDH France - All rights reserved, including reproduction and translation rights

Allergic diseases are among the most frequent immunological disorders.

Allergies are becoming more common

Asthma = 10%

Bronchial asthma = the most common chronic childhood disease


Histamine

Histamine is a biogenic amine.

It is found in animal tissues, plants, bacteria, and venoms.

In humans, histamine is located in the lungs, skin and

gastrointestinal mucosa.

- Formula: C5H9N3

- Melting point: 83.5°C

- Molecular mass: 111.15 g/mol

- Boiling point: 209.5°C

- 2-(1H-imidazole-4-yl) ethanamine

Soluble in: water


Discovered in 1910 by Dale and Laidlaw.

Identified in 1932 as a mediator of anaphylactic reactions.

Biogenic amine is synthesized under the control of pyridoxal

phosphatase and L histidine phosphatase from Histidine,

with vitamins B6 and C as co-factors.

It is synthesized by: mast cells, basophils, platelets,

histamino-gene neurons, and entero-chromatophile cells.

It is stored in intracellular vesicles and released upon

stimulation.

Histamine


The metabolism of Histamine

Histamine and histamine intolerance – Laura Maintz and Natalija Novak American Journal of Clinical Nutrition, 2007


Diamine oxidase

Diamine oxidase (DAO) or histaminase is the main

enzyme involved in the degradation of ingested

histamine.

Reduced DAO activity can cause symptoms

mimicking an allergic reaction to food and drugs that

influence the amount of histamine in the body.


Histamine intolerance

Histamine intolerance the result of an imbalance between

histamine levels and histamine degradation capacity.

About 1% of the population is affected by histamine

intolerance (HIT) and 80% of patients are middle-aged

(Missbicher A. Georg Thieme Vertag 2004).

Clinical symptoms resembling food allergies or other causes

of food intolerance (sulphites, lactase deficiency, etc.) make it

difficult to identify and diagnose histamine intolerance.

This is not an IgE-mediated disease, so specific IgE serum

and skin tests are negative.


Histamine exerts its effects by binding to 4 types of

target cell receptors (H1, H2, H3, H4), causing:

Muscle fiber contraction

Vasodilation

Increased vascular permeability

Mucus secretion

Histamine


Effects of histamine on plasma concentration

Histamine clinical effect

ng/ml

0–1 Reference

1–2 Gastric acid secretion, heart rate

3–5 Tachycardia, migraine, flush, hives, pruritus

6–8 Blood pressure

7–12 Bronchospasm

100 Cardiac arrest

Histamine and histamine intolerance 1, 2, 3

Laura Maintz and Natalija Novak, American Journal of Clinical Nutrition,

2007.


Type III Allergies

Food allergies

Intolerance

Pseudo-allergy

Type I Allergies

Common symptoms


1.Genetic causes due to enzymatic deficiency of MTHFR,

DAO, MAO, HNMT PEMT.

2.Pathogens blocking methylation or producing histamine.

3. Nutritional deficiencies: B12, folate, B6, B2, B1, Zn, Cu, C,

methionine.

4. Excess nutrients: Histidine, protein in excess in general.

5. Medications: long-term use of antibiotics, antacids,

antihistamines.

Histamine intolerance has multiple causes


6. Stress, anxiety, lack of sleep

7. Hormonal deficiency

8. Excess estrogen hormones

9. Lifestyle with excess alcohol

10. Diet high in fermented foods, fish, or citrus

11. Environmental factors: pollen, house dust.

Histamine intolerance has multiple causes


HISTAMINE INTOLERANCE

by MAO - requires vitamin B2 and iron

HNMT - requires SAM as a cofactor

DAO - requires vitamin B6 and

copper

Methylation by HNMT

HNMT = histamine N-

methyltransferase

SAM = S adenosine

methionine

Oxidative deamination

by DAO

MAO = mono amine oxidase

HNMT histamine N-methyltransferase [ Homo sapiens

(human) ]

Gene ID: 3176, updated 4 Oct 2015


Summary of histamine-mediated symptoms. Adapted with permission from Maintz L et al. Dtsch Artzebl 2006; 103:A3477 - 83


Laboratory tests for DAO:

Synevo

Sanador

Ixia

Diamine oxidase activity

(histamine intolerance)

Serum / REA (radioextraction)

DAO serum activity

14-33 IU/mL: normal enzyme

activity

< 3 IU/mL: marked reduced enzyme

activity (possible genetic deficiency)

3-10 IU/mL: reduced enzyme

activity

10-14 IU/mL: borderline enzyme

activity; It is possible to record

clinical symptoms when the body is

loaded with histamine, e.g. fluoride

allergies or a high-histamine diet

(latent deficiency);


- Allergic bronchial asthma

- Non-allergic bronchial asthma

- Recurrent Wheezing

- Children aged 0-18 years

- Both sexes

- DAO determination

Criteria for inclusion in the study


- Determination of eosinophil cationic protein

= EPC

- Respiratory allergen panel

- Food allergen panel

- Imupro Test

- Specific IgE

- Eosinophilia

- Allergy skin tests, spirometry, FeNO

determination

Criteria for inclusion in the study


High EPC level = delayed allergic reaction of 6-24 hours = influx of eosinophils into the region

EPC - better reflects the allergic inflammatory process than total IgE

EPC - is correlated with the severity of allergic disease


- Age > 18 years

- Absence of DAO determination

- Other diseases than those mentioned

in the criteria for inclusion

Study exclusion criteria


= medical history

= satisfaction questionnaire on disease progress

for patients and family members

= clinical examination

= successive determinations of DAO, Eosinophils,

total IgE, EPC at :

- Time 0 = diagnosis

- 1 month after start of homeopathic treatment

- 3 months after start of treatment

- 6 months after start of treatment

- After 1 year

Study protocol


DAO - has been tested on - 375 patients

- Study period: 1 Jan 2013 – 1 Aug 2015

- moderate and severe DAO deficiency -

45 patients = 12%

- Slight DAO deficiency - 52 patients = 13.8%


Sex distribution for moderate

and severe DAO deficiency:

- Girls = 27 cases = 60%

- Boys = 18 cases = 40%


Age group distribution for moderate and

severe DAO deficiency:

- 0-1 year = 0 cases = 0%

- 1-3 years = 3 cases = 6.66%

- 3-7 years = 33 cases = 73.33%

- 7-14 years = 6 cases = 13.32%

- Over 14 years = 3 cases = 6.66%

Age

3-7 years


DAO values for studied patientsDAO No OF CASES %

<3 Severely reduced

enzyme activity,

possible genetic

mutation

4 1

3 – 10 Moderately reduced

enzyme activity

41 10.9

10 – 14 Enzyme activity

borderline, mild

impairment

52 13.8

> 14 Normal value 278 74.1


Environmental distribution for moderate to

severe DAO deficiency:

- URBAN: 36 cases - broader area

- RURAL: 9 cases


SYMPTOMS CASES %

RED EYES 25 55.5

NASAL OBSTRUCTION 30 66.6

SKIN RASHES 24 53.3

WHEEZING 28 62.2

SNEEZING 22 48.8

RUNNY NOSE 26 57.7

COUGH 45 100

ITCHING SENSATION IN THE

THROAT

37 82.2

Distribution of symptoms for moderate and

severe DAO deficiency


Clinical diagnosis of moderate and severe

DAO deficiencyCLINICAL

DIAGNOSIS

No OF CASES %

ALLERGIC

BRONCHIAL

ASTHMA

23 51.1

NON-ALLERGIC

BRONCHIAL

ASTHMA

17 37.7

RECURRENT

WHEEZING

5 11.1


Treatment used in moderate and severe

DAO deficiency

- All patients received diet instructions for the DAO test +

allergy testing (skin, panels, specific IgE, Imupro test).

- 21 patients received allopathic treatment.

- 24 patients received allopathic + homeopathic treatment.


The homeopathic treatment was represented by:

- Histaminum - for all patients for:

- 1 month - 15 CH - 5 granules/day-7/7

- 3 months - 15 CH - 5 granules/day-3/7



- Constitutional type remedies

- Blatta orientalis, house dust and mites - for people allergic to dust

mites.

- Pollen - pollen allergy.

- Influenzinum + Aviaire + Oscillococcinum - prophylactic during the

cold season.


Results O 1 month 3 months 6 months 12 months

DAO - for patients

treated with

homeopathic +

allopathic

treatment

Reduced Identical to Time

0

Increase by

1-2 IU

Increase by

2-3 IU

60% = normal

or borderline

DAO values

Clinical course of

patients treated

with homeopathic +

allopathic treatment

Disease

symptoms

10% improvement 50% improvement 60%

improvement

80%

improvement

DAO for patients

receiving allopathic

treatment only

Reduced Identical to Time

0

Identical to or less

than at Time 0

Increase by 1-2

IU

30% cases =

normal or

borderline values

Clinical course of patients

receiving only allopathic

treatment

Disease

symptoms

5% improvement 20% improvement 30% improvement 40% improvement

Evaluation of clinical progress is based on clinical examination and the subjective

assessment is made by the patient and family.


Patients with borderline DAO values - who have

received treatment with:

- Diet

+

- Allopathic treatment

+

- Homeopathic treatment

100% - clinical and para-clinical improvement


Changes in other parameters:

• Eosinophil cationic protein = EPC = shows a pattern similar to DAO.

• Eosinophils are reduced significantly after 3 months of treatment, in both types of treatment.

• Total IgE - is improved by 20% both in patients with joint treatment and in those with conventional treatment.

• Specific IgE does not change during the first year of treatment in the case of the allopathic treatment, and improves by 20% in the case of the joint allopathic + homeopathic treatment.


Current pharmacological understanding

COMPLEMENTARY ALTERNATIVE MEDICINE CONVENTIONAL MEDICINE

HOMEOPATHIC SCIENCE

DERIVATIVES OF MINERALS

OF ANIMALS

OF PLANTS

MOLECULAR BIOLOGY

NEUROPEPTIDES

CYTOKINE

HORMONES

GROWTH FACTORS

© Dipartimento Scientifico Guna S.p


Current treatments should apply to pathophysiological

mechanisms and integrate:

MOLECULAR

BIOLOGY

HOMEOPATHY

PSYCHO - NEURO -

ENDOCRINO -

IMMUNOLOGY


In conclusion

• Up until now:

• Histaminum hidrocloricum is a form of histamine used as a

homeopathic remedy in the treatment of insect bites, food

allergies, pollen allergies, and nasal congestion.

• Remedy for bronchitis, stomach, muscle and joint pain.

• There are no references in the literature regarding the

changing para-clinical parameters for DAO, EPC, and

eosinophils during homeopathic treatment with Histaminum.

• Our contribution: This is the first study to include such an

approach, based on para-clinical investigations.


In conclusion, homeopathic treatment combined with allopathic treatment for histamine intolerance has shown that:

• Histamine intolerance due to diamine oxidase deficiency in asthmatic symptoms in children can benefit from this treatment with very good results from both clinical and para-clinical perspectives.

• Specific IgE and total IgE are marginally influenced by treatment with Histaminum.

• The EPC corresponds to the patient's progress and DAO values.

• Clinical symptoms improve before para-clinical symptoms.

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