The role of diet in chronic urticaria
Keywords:
Chronic urticaria, hives, dietary, histamine, microbiotaAbstract
Background Chronic urticaria symptoms are benign and self-limiting. However, chronic urticaria with systemic symptoms can be life-threatening and may be an early sign of anaphylactic shock. This systematic review was conducted to recognize and understand the clinical features of urticaria and the role of diet modification in chronic urticaria to minimise the side effect of long-term therapy. Methods A primary literature search using preferred reporting items for systematic reviews and meta-analyses (PRISMA) was conducted using PubMed and Science Direct databases in January 2021. Results A total of 10 articles were included in this study. Some diets and conditions were recommended to be avoided in patients with chronic urticaria are galactose-α-1,3-galactose allergy (α-gal), Anisakis simplex, pseudo allergens, gluten, food additives and histamine. Supplementation with diamine oxidase, vitamin D and probiotics was beneficial. Conclusion Diet modification in chronic urticaria patients receiving long-term medical therapy must be done to reduce drug side effects. Consumption of foods suspected of causing urticaria should be avoided for three consecutive weeks, especially for pseudoallergenic foods and histamine-containing foods. Moreover, patients should avoid consuming certain foods that can cause nutritional deficiencies, so further consultation with a nutritionist is needed.References
Vestergaard C, Toubi E, Maurer M, Triggiani M, Ballmer-Weber B, Marsland A, et al. Treatment of chronic spontaneous urticaria with an inadequate response to H1-antihistamines: An expert opinion. Eur J Dermatol. 2017;27(1):10–9.
Son JH, Chung BY, Kim HO, Park CW. A Histamine-Free Diet Is Helpful for Treatment of Adult Patients with Chronic Spontaneous Urticaria. Ann Dermatol. 2018; 30(2):164–72. Available from: https://pubmed.ncbi.nlm.nih.gov/29606813/
Sánchez J, Sánchez A, Cardona R. Dietary Habits in Patients with Chronic Spontaneous Urticaria: Evaluation of Food as Trigger of Symptoms Exacerbation. Dermatol Res Pract. 2018;2018. Available from: /pmc/articles/PMC6029436/
Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol. 2014;134(6):1527–34. Available from: https://pubmed.ncbi.nlm.nih.gov/24166134/
Hon KL, Leung AKC, Ng WGG, Loo SK. Chronic Urticaria: An Overview of Treatment and Recent Patents. Recent Pat Inflamm Allergy Drug Discov. 2019;13(1):27–37. Available from: https://pubmed.ncbi.nlm.nih.gov/30924425/
Rafikasari A, Fetarayani D, Setyaningrum T. Profil Pasien Urtikaria. Berk Ilmu Kesehat Kulit dan Kelamin. 2019;31(3):222–7. Available from: https://e-journal.unair.ac.id/BIKK/article/view/10677
Sachdeva S, Gupta V, Amin SS, Tahseen M. Chronic urticaria. Indian J Dermatol. 2011;56(6):622. Available from: https://www.e-ijd.org/article.asp?issn=0019-5154;year=2011;volume=56;issue=6;spage=622;epage=628;aulast=Sachdeva
Magerl M, Altrichter S, Borzova E, Giménez-Arnau A, Grattan CEH, Lawlor F, et al. The definition, diagnostic testing, and management of chronic inducible urticarias - The EAACI/GA(2) LEN/EDF/UNEV consensus recommendations 2016 update and revision. Allergy. 2016;71(6):780–802. Available from: https://pubmed.ncbi.nlm.nih.gov/26991006/
Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy [Internet]. 2014 [cited 2022 Sep 1];69(7):868–87. Available from: https://pubmed.ncbi.nlm.nih.gov/24785199/
Bernstein JA, Lang DM, Khan DA, Craig T, Dreyfus D, Hsieh F, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol [Internet]. 2014 [cited 2022 Sep 1];133(5):1270-1277.e66. Available from: https://pubmed.ncbi.nlm.nih.gov/24766875/
Ayvaz HH, Kuyumcu A. Effect of the Mediterranean diet in patients with chronic spontaneous urticaria. Rev Assoc Med Bras [Internet]. 2021 [cited 2022 Sep 1];67(5):675–80. Available from: https://pubmed.ncbi.nlm.nih.gov/34550255/
Zhang X, Zhang J, Chu Z, Shi L, Geng S, Guo K. Gut Microbiome Alterations and Functional Prediction in Chronic Spontaneous Urticaria Patients. J Microbiol Biotechnol [Internet]. 2021 May 1 [cited 2022 Sep 1];31(5):747–55. Available from: https://pubmed.ncbi.nlm.nih.gov/33746191/
Rezazadeh A, Shahabi S, Bagheri M, Nabizadeh E, Jazani NH. The protective effect of Lactobacillus and Bifidobacterium as the gut microbiota members against chronic urticaria. Int Immunopharmacol [Internet]. 2018 Jun 1 [cited 2022 Sep 1];59:168–73. Available from: https://pubmed.ncbi.nlm.nih.gov/29655058/
Siebenhaar F, Melde A, Magerl M, Zuberbier T, Church MK, Maurer M. Histamine intolerance in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol [Internet]. 2016 Oct 1 [cited 2022 Sep 1];30(10):1774–7. Available from: https://pubmed.ncbi.nlm.nih.gov/27329741/
Yacoub MR, Ramirez GA, Berti A, Mercurio G, Breda D, Saporiti N, et al. Diamine Oxidase Supplementation in Chronic Spontaneous Urticaria: A Randomised, Double-Blind Placebo-Controlled Study. Int Arch Allergy Immunol [Internet]. 2018 Jul 1 [cited 2022 Sep 1];176(3–4):268–71. Available from: https://pubmed.ncbi.nlm.nih.gov/29698966/
Mony A, Chandrashekar L, Rajappa M, Munisamy M, Sahoo JP, Selvarajan S. Effect of vitamin D supplementation on clinical outcome and biochemical profile in South Indian population with vitamin D-deficient chronic urticarial - A randomised double-blind placebo controlled trial. Clin Chim Acta [Internet]. 2020 May 1 [cited 2022 Sep 1];504:1–6. Available from: https://pubmed.ncbi.nlm.nih.gov/31926152/
Bi XD, Lu BZ, Pan XX, Liu S, Wang JY. Adjunct therapy with probiotics for chronic urticaria in children: randomised placebo-controlled trial. Allergy Asthma Clin Immunol [Internet]. 2021 Dec 1 [cited 2022 Sep 1];17(1). Available from: https://pubmed.ncbi.nlm.nih.gov/33865434/
Wagner N, Dirk D, Peveling-Oberhag A, Reese I, Rady-Pizarro U, Mitzel H, et al. A Popular myth - low-histamine diet improves chronic spontaneous urticaria - fact or fiction? J Eur Acad Dermatol Venereol [Internet]. 2017 Apr 1 [cited 2022 Sep 1];31(4):650–5. Available from: https://pubmed.ncbi.nlm.nih.gov/27624921/
Thomsen SF, Pritzier EC, Anderson CD, Vaugelade-Baust N, Dodge R, Dahlborn AK, et al. Chronic urticaria in the real-life clinical practice setting in Sweden, Norway and Denmark: baseline results from the non-interventional multicentre AWARE study. J Eur Acad Dermatol Venereol [Internet]. 2017 Jun 1 [cited 2022 Sep 1];31(6):1048–55. Available from: https://pubmed.ncbi.nlm.nih.gov/28294420/
Bronsnick T, Murzaku EC, Rao BK. Diet in dermatology: Part I. Atopic dermatitis, acne, and nonmelanoma skin cancer. J Am Acad Dermatol [Internet]. 2014 Dec 1 [cited 2022 Sep 1];71(6):1039.e1-1039.e12. Available from: https://pubmed.ncbi.nlm.nih.gov/25454036/
Di Landro A, Cazzaniga S, Parazzini F, Ingordo V, Cusano F, Atzori L, et al. Family history, body mass index, selected dietary factors, menstrual history, and risk of moderate to severe acne in adolescents and young adults. J Am Acad Dermatol [Internet]. 2012 Dec [cited 2022 Sep 1];67(6):1129–35. Available from: https://pubmed.ncbi.nlm.nih.gov/22386050/
Weng X, Li X, Shen Y, Wang X. The association between serum vitamin D levels and urticaria: a meta-analysis of observational studies. G Ital Dermatol Venereol [Internet]. 2018 Jun 1 [cited 2022 Sep 1];153(3):389–95. Available from: https://pubmed.ncbi.nlm.nih.gov/29064205/
Siebenhaar F, Degener F, Zuberbier T, Martus P, Maurer M. High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomised, placebo-controlled, crossover study. J Allergy Clin Immunol [Internet]. 2009 Mar [cited 2022 Sep 1];123(3):672–9. Available from: https://pubmed.ncbi.nlm.nih.gov/19201016/
Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatology [Internet]. 2013 Jan [cited 2022 Sep 1];149(1):84–91. Available from: https://pubmed.ncbi.nlm.nih.gov/23407990/
Beck LA, Bernstein JA, Maurer M. A Review of International Recommendations for the Diagnosis and Management of Chronic Urticaria. Acta Derm Venereol [Internet]. 2017 Feb 1 [cited 2022 Sep 1];97(2):149–58. Available from: https://pubmed.ncbi.nlm.nih.gov/27349620/
JA B, A A, AW B, SM J, HA S, RA W, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol [Internet]. 2010 Dec [cited 2022 Sep 1];126(6 Suppl). Available from: https://pubmed.ncbi.nlm.nih.gov/21134576/
Hogan RB, Hogan RB, Cannon T, Rappai M, Studdard J, Paul D, et al. Dual-histamine receptor blockade with cetirizine - famotidine reduces pulmonary symptoms in COVID-19 patients. Pulm Pharmacol Ther. 2020 Aug 1;63.
Kang M-G, Song W-J, Park H-K, Lim K-H, Kim S-J, Lee S-Y, et al. Basophil Activation Test with Food Additives in Chronic Urticaria Patients. Clin Nutr Res [Internet]. 2014 [cited 2022 Sep 1];3(1):9. Available from: /pmc/articles/PMC3921299/
Jaros J, Shi VY, Katta R. Diet and Chronic Urticaria: Dietary Modification as a Treatment Strategy. Dermatol Pract Concept [Internet]. 2020 Jan 1 [cited 2022 Sep 1];10(1). Available from: /pmc/articles/PMC6936629/
Wilson JM, Schuyler AJ, Workman L, Gupta M, James HR, Posthumus J, et al. Investigation into the α-Gal Syndrome: Characteristics of 261 Children and Adults Reporting Red Meat Allergy. J allergy Clin Immunol Pract [Internet]. 2019 Sep 1 [cited 2022 Sep 1];7(7):2348-2358.e4. Available from: https://pubmed.ncbi.nlm.nih.gov/30940532/
Ventura MT, Napolitano S, Menga R, Cecere R, Asero R. Anisakis simplex Hypersensitivity Is Associated with Chronic Urticaria in Endemic Areas. Int Arch Allergy Immunol [Internet]. 2013 Feb [cited 2022 Sep 1];160(3):297–300. Available from: https://www.karger.com/Article/FullText/339869
Reese I, Zuberbier T, Bunselmeyer B, Erdmann S, Henzgen M, Fuchs T, et al. Diagnostic approach for suspected pseudoallergic reaction to food ingredients. J Dtsch Dermatol Ges [Internet]. 2009 Jan [cited 2022 Sep 1];7(1):70–7. Available from: https://pubmed.ncbi.nlm.nih.gov/19054425/
Antia C, Baquerizo K, Korman A, Alikhan A, Bernstein JA. Urticaria: A comprehensive review: Treatment of chronic urticaria, special populations, and disease outcomes. J Am Acad Dermatol [Internet]. 2018 Oct 1 [cited 2022 Sep 1];79(4):617–33. Available from: https://pubmed.ncbi.nlm.nih.gov/30241624/
Briguglio M, Dell’Osso B, Panzica G, Malgaroli A, Banfi G, Dina CZ, et al. Dietary Neurotransmitters: A Narrative Review on Current Knowledge. Nutrients [Internet]. 2018 May 10 [cited 2022 Sep 1];10(5). Available from: /pmc/articles/PMC5986471/
Straesser M, Palacios T, Kyin T, LB-A of A, 2017 undefined. P155 Seasonal correlations in chronic urticaria and allergic rhinitis. annallergy.org [Internet]. [cited 2022 Sep 1]; Available from: https://www.annallergy.org/article/S1081-1206(17)30811-6/fulltext
Tsai TY, Huang YC. Vitamin D deficiency in patients with chronic and acute urticaria: A systematic review and meta-analysis. J Am Acad Dermatol [Internet]. 2018 Sep 1 [cited 2022 Sep 1];79(3):573–5. Available from: https://pubmed.ncbi.nlm.nih.gov/29477737/
Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord [Internet]. 2017 Jun 1 [cited 2022 Sep 1];18(2):153–65. Available from: https://pubmed.ncbi.nlm.nih.gov/28516265/
Boonpiyathad T, Pradubpongsa P, Sangasapaviriya A. Vitamin D Supplements Improve Urticaria Symptoms and Quality of Life in Chronic Spontaneous Urticaria Patients: A Prospective Case-Control Study. Dermatoendocrinol [Internet]. 2014 [cited 2022 Sep 1];6(1). Available from: /pmc/articles/PMC4203568/
Drucker AM, Ellis AG, Bohdanowicz M, Mashayekhi S, Yiu ZZN, Rochwerg B, et al. Systemic Immunomodulatory Treatments for Patients With Atopic Dermatitis: A Systematic Review and Network Meta-analysis. JAMA Dermatology [Internet]. 2020 Jun 1 [cited 2022 Sep 1];156(6):659–67. Available from: https://pubmed.ncbi.nlm.nih.gov/32320001/
Drucker AM, Ellis AG, Bohdanowicz M, Mashayekhi S, Yiu ZZN, Rochwerg B, et al. Systemic Immunomodulatory Treatments for Patients With Atopic Dermatitis: A Systematic Review and Network Meta-analysis. JAMA Dermatology [Internet]. 2020 Jun 1 [cited 2022 Sep 1];156(6):1. Available from: /pmc/articles/PMC7177646/.