Document Detail

A heretofore undisclosed crux of eosinophilia-myalgia syndrome: compromised histamine degradation.
MedLine Citation:
PMID:  16307217     Owner:  NLM     Status:  MEDLINE    
In contrast to early epidemiological evidence offering links between eosinophilia-myalgia syndrome (EMS) and microimpurities of L-tryptophan-containing dietary supplements (LTCDS), this account shows why reliance on a finite impurity from one manufacturer is both unnecessary and insufficient to explain the etiology of EMS. Excessive histamine activity has induced blood eosinophilia and myalgia (Greek: mys, muscle + algos, pain). Termination of the multiple actions of histamine is dependent on particular amine oxidases and histamine-N-methyltransferase. Histamine metabolism is rapid when these degradative reactions are operative. The latent effects of incurred histamine can be potentiated and aggravating when these mechanisms are impaired. Overloads of tryptophan supplements cause - among other relevant side-effects - an increased formation of formate and indolyl metabolites, several of which inhibit the degradation of histamine. Moreover, (non-EMS) subjects with hypothalamic-pituitary- adrenal (HPA) axis dysregulation have also manifested greatly increased sensitivities to incurred tryptophan and histamine. A final common pathway for syndromes characterized by eosinophilia with myalgia is now evident.
M J Smith; R H Garrett
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Inflammation research : official journal of the European Histamine Research Society ... [et al.]     Volume:  54     ISSN:  1023-3830     ISO Abbreviation:  Inflamm. Res.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-24     Completed Date:  2006-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508160     Medline TA:  Inflamm Res     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  435-50     Citation Subset:  IM    
Division of Natural Products, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Parkway, College Park, Maryland 20740-3835, USA.
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MeSH Terms
Amino Acids / metabolism,  toxicity
Eosinophilia-Myalgia Syndrome / chemically induced,  metabolism*
Histamine / metabolism*
Hypothalamo-Hypophyseal System / drug effects
Indoles / metabolism
Mast Cells / metabolism
Serotonin / metabolism
Tryptophan / metabolism,  toxicity
Reg. No./Substance:
0/Amino Acids; 0/Indoles; 50-67-9/Serotonin; 51-45-6/Histamine; 73-22-3/Tryptophan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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