Login to Access Video or Poster Abstract: MP29-13
Sources of Funding: none

Introduction

The cause of Painful Bladder Syndrome / Interstitial Cystitis is currently unknown.Histamine seems to play a major role in IC as neurogenic inflammation is one of the hypothesis of IC.Antihistamines are part of the guideline recommendations, foods high in histamine (e.g. Shorter-Moldwin Food Sensitivity Questionnaire) aggravate IC symptoms._x000D_ Objective: Within this retrospective study the role of histamine overload in the gut and vagina is highlighted._x000D_

Methods

Between September 2012 and October 2016 a total of 80 women (range 19 to 75 years, mean age 47) were surveyed.Histamine in fecal samples was measured with a commercially available ELISA kit (LDN Labor Diagnostika Nord GmbH &Co. KG, Nordhorn, Germany).The results were compared to an age-matched cohort of 57 healthy women.Additionally, vaginal swabs were analysed for histamine producing bacteria of the Enterococcus and Enterobacteriaceae family. Furthermore a complete gut microbiota analysis was done in all women._x000D_

Results

Stool results:_x000D_ In 55 of the 80 analysed women elevated histamine levels were found in fecal samples compared to a control-group of 57 healthy women.Moreover in most of the patients the protective anaerobic indicator microbiota (mainly lactobacilli and bifidobacteria) was also diminished._x000D_ Vaginal swab results:_x000D_ In 39 out of the 55 women with the elevated histamine level the presence of Enterococcus ssp. and / or Enterobacteriaceae in vaginal swabs was also detected. In 12 women only the presence of Enterococcus ssp. and / or Enterobacteriaceae was found. 4 women did neither show elevated histamine levels nor the presence of histamine producing bacteria in vaginal swabs._x000D_ _x000D_

Conclusions

There are paralleles between IC and histamine intolerance: 1% of the population affected, 80% female and middle aged, symptom improvement in pregnancy because of a 500 fold higher level of the diamine oxidase (histamine eliminating enzyme).Histamine intolerance is a poorly described disease which can present with a variety of symptoms also found as comorbidities in IC patients like e.g. migraine, irritable bowel syndrome and urticaria.Histamine can increase intestinal permeability causing a leaky gut which prompts the body to initiate immune reactions causing autoimmune diseases and can also lead to pain through a toll-like receptor (TLR)-4 inflammatory response.That TLR-4 plays a role in pain has recently been demonstrated in IC patients by the MAPP research group.Moreover histamine alone as shown in mice can also cause pelvic pain.

Funding

none