THE RED WINE PROVOCATION TEST - INTOLERANCE TO HISTAMINE AS A MODEL FOR FOOD INTOLERANCE

Sneezing, flush, headache, diarrhea, skin itch, and shortness of breat h are symptoms occurring in patients intolerant to wine after drinking one glass of red wine. The role of histamine in wine intolerance was evaluated by a red wine provocation test in 28 patients with a history of wine intolerance and in 10 controls with good tolerance of wine. P atients were challenged with 125 ml red wine (equivalent to 50 mug his tamine); blood samples were drawn before and after 15 and 30 minutes. Plasma histamine was assessed by a radioimmunoassay. Lung function tes ts were performed before and after the wine test. Twenty-two of twenty -eight patients had symptoms showing significantly higher plasma hista mine levels 30 minutes after wine challenge (p < .01) compared with as ymptomatic controls. Basal histamine levels of patients were higher (p < .05) than in controls. A slight asthmatic attack as well as a 30% d ecrease of FEF 25 was seen in 2122 patients. Terfenadine premedication significantly eliminated symptoms in 10/12 patients (p < .05) in a su bsequent wine test. Histamine assessment was done in 52 wines (red, wh ite, and champagne) and in 17 beers by radioimmunoassay. Histamine lev els ranged from 3-120 mug/l in white wines; 15-670 mug/l in champagnes ; 60-3800 mug/l in red wines; and 21-305 mug/l in beers. Histamine is causing wine intolerance. Patients intolerant to wine seem to have dim inished histamine degradation probably based on a deficiency of diamin e oxidase.