Histamine Metabolism in IBD: Towards Precision Nutrition

TL;DR

This paper explores how histamine metabolism might influence IBD and proposes a low-histamine diet as a potential precision nutrition strategy for managing the condition.

Contribution

The paper introduces a novel dietary framework targeting histamine metabolism for IBD patients with histamine intolerance.

Findings

A low-histamine diet may reduce histamine burden by limiting high-histamine foods and modulating gut microbiota.

Histamine-degrading enzymes like DAO and HNMT are critical in managing histamine intolerance in IBD.

No clinical trials have yet evaluated the effects of low-histamine diets in IBD populations.

Abstract

Patients with Inflammatory Bowel Disease (IBD) exhibit a dysregulated immune response that may be further exacerbated by bioactive compounds, such as histamine. Current dietary guidelines for IBD primarily focus on symptom management and flare-up prevention, yet targeted nutritional strategies addressing histamine metabolism remain largely unexplored. This narrative review aims to summarize the existing literature on the complex interplay between IBD and histamine metabolism and propose a novel dietary framework for managing IBD progression in patients with histamine intolerance (HIT). Relevant studies were identified through a comprehensive literature search of PubMed/MEDLINE, Google Scholar, ScienceDirect, Scopus, and Web of Science. The proposed low-histamine diet (LHD) aims to reduce the overall histamine burden in the body through two primary strategies: (1) minimizing exogenous intake by limiting high-histamine and histamine-releasing foods and (2) reducing endogenous histamine production by modulating gut microbiota composition, specifically targeting histamine-producing bacteria. In parallel, identifying individuals who are histamine-intolerant and understanding the role of histamine-degrading enzymes, such as diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), are emerging as important areas of focus. Despite growing interest in the role of histamine and mast cell activation in gut inflammation, no clinical trials have investigated the effects of a low-histamine diet in IBD populations. Therefore, future research should prioritize the implementation of LHD interventions in IBD patients to evaluate their generalizability and clinical applicability.

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