Histamin İntoleransına Güncel Bakış

Yıl 2024, Sayı: 22, 446 - 458, 30.04.2024

Yeşim Öztekin

https://doi.org/10.38079/igusabder.1377431

Öz

Besin intoleransları, bazı besinlere veya bileşenlerine karşı immünolojik olmayan anormal organizma cevabıdır. Histamin intoleransı, histaminin metabolize edilememesi ve semptom yaratması ile gelişen besin intoleranslarından biridir. Diamin oksidaz (DAO) ve Histamin N metil transferaz (HNMT) enzimleri histamin metabolizmasında görev alan iki enzimdir. Çeşitli faktörlerin etkisiyle enzim üretimi veya aktivasyonlarının azalması ve histaminin parçalanamaması sonucu vücutta birikmesi ile histamin intoleransı patogenezinin geliştiği tahmin edilmektedir. Semptomlar arasında bireye göre değişmekle beraber abdominal distansiyon, karın ağrısı, kaşıntı, egzama, ürtiker, baş ağrısı, burun tıkanıklığı, rinit yer almaktadır. Özellikle sebebi bilinmeyen semptomlara sahip bireylerde DAO enzim aktivasyonun azaldığını gösteren çalışmalar mevcuttur. Farklı organları etkileyen semptomlarının olması, ayırıcı bir tanı testinin bulunmaması ve aynı histamin kaynağının farklı bireylerde farklı reaksiyonlara sebep olması histamin intoleransı tanısını zorlaştırmaktadır. Günümüzde tanı ve tedavi yaklaşımlarında histamin kısıtlı diyetler en güvenilir yöntem olarak kabul edilmektedir. Aynı semptomlarla seyredebilecek diğer hastalıkların varlığının dışlanması ve histamin kısıtlı diyete olumlu cevap, histamin intoleransı tanısını desteklemektedir. Tedavi, histamin eliminasyon diyetlerinin belirli bir süre uygulanmasını, histamin kaynaklarına beslenmede yeniden yer verilmesini ve semptomların takibini içerir. Bu derleme çalışmasında mevcut verilerle histaminin diyetsel kaynakları, metabolizması, histamin intoleransı ve ilişkili sağlık sorunları ile histamin eliminasyon diyetlerine yer verilmiştir. Besinlerde histaminin belirlenmesi ve histamin intoleransı, oldukça yeni bir kavram olduğundan, histamin intoleransı epidemiyolojisini belirlemek, tanı algoritmalarını ve olası tedavi seçeneklerini doğrulamak için daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler

Histamin, besin intoleransları, beslenme tedavisi

A Current Insight into Histamine Intolerance

Öz

Food intolerance is an abnormal non-immunological response of the organism to certain foods or their components. Histamine intolerance is one of the food intolerances that develops due to the inability to metabolize histamine, leading to symptoms. Diamine oxidase (DAO) and Histamine-N-methyltransferase (HNMT) enzymes are involved in histamine metabolism. It is estimated that a decrease in enzyme production or activation due to various factors results in the accumulation of histamine, leading to the pathogenesis of histamine intolerance. Individual differences exist in symptoms, but abdominal distension and pain, itching, eczema, urticaria, headache, nasal congestion, and rhinitis are common symptoms. Studies show that DAO enzyme activation is decreased, especially in individuals with idiopathic symptoms. The variety of symptoms and lack of differential diagnostic tests make diagnosing histamine intolerance difficult. Additionally, the same dietary histamine source can cause different symptoms in different individuals. In contemporary diagnosis and treatment approaches, histamine-restricted diets are considered the most reliable method. The exclusion of other diseases and positive responses to a histamine-restricted diet support the diagnosis of histamine intolerance. Treatment includes the administration of histamine elimination diets for a specific period, reintroducing histamine sources into the diet, and monitoring symptoms. s. This review includes current data on the dietary sources of histamine, its metabolism, histamine intolerance, and associated health problems. Today, histamine in foods and histamine intolerance are relatively new terms. Therefore, more research is required to determine diagnostic algorithms, treatment options, and the epidemiology of histamine intolerance.

Anahtar Kelimeler

Histamine, food intolerance, nutritional therapy

Etik Beyan

Not applicable

Destekleyen Kurum

-

Teşekkür

-

Kaynakça

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