A heretofore undisclosed crux of Eosinophilia-Myalgia Syndrome: compromised histamine degradation

  title={A heretofore undisclosed crux of Eosinophilia-Myalgia Syndrome: compromised histamine degradation},
  author={M. J. Smith and Reginald H. Garrett},
  journal={Inflammation Research},
Abstract.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… 
Part II. Eosinophilia-Myalgia Syndrome: further correlations between compromised histamine degradation, eosinophilias and myopathies
With respect to offi cial cases of Eosinophilia-Myalgia Syndrome (EMS), reliance on a fi nite impurity in L-tryptophan-containing dietary supplements (LTCDS) is insuffi cient and unnecessary to explain its multiple causes.
What If Not All Metabolites from the Uremic Toxin Generating Pathways Are Toxic? A Hypothesis
This dualism based on the example of tryptophan-derived metabolites, which comprise elements that are mainly toxic, but also beneficial compounds, is discussed, to suggest that interventions be aimed at preserving or restoring the balance between positive and negative components rather than eliminating them all without distinction.
Histamine in food: is there anything to worry about?
The alimentary tract is well equipped with enzymes that inactivate amines and the blood-brain barrier prevents them entering the brain from the circulation, but preventive measures should be undertaken against increases in food allergies.
The importance of NAD in multiple sclerosis.
The role of NAD in EAE versus TMEV demyelinating pathogenesis is contrasted to increase the understanding of the pharmacotherapeutic potential of NAD signal transduction pathways and the importance of increased SIRT1 activity in both PARP-1 inhibition and the potentially integral role of neuronal CD200 interactions through glial CD200R with induction of IDO in MS pathogenesis are speculated.
Drugs induced pulmonary arterial hypertension.
Effect of orally administered dipterinyl calcium pentahydrate on oral glucose tolerance in diet-induced obese mice
Elevated plasma Trp concentration, likely from heterogeneity in diet and/or indoleamine 2,3-dioxygenase activity, was found to correlate with higher OGTT/AUC diabetic measures, possibly via inhibition of histamine degradation.


Eosinophilia myalgia syndrome.
  • W. Blackburn
  • Medicine, Psychology
    Seminars in arthritis and rheumatism
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Tryptophan produced by Showa Denko and epidemic eosinophilia-myalgia syndrome.
Evidence from an array of scientific studies strongly supports the conclusion that ingestion of products containing L-tryptophan (LT) produced by Showa Denko KK caused the 1989 epidemic of
Myalgia and eosinophilia associated with ingestion of tryptophan. An intriguing new syndrome.
The delineation of a new syndrome associated with an identifiable etiology raises a series of nosologic questions. Issues of particular interest are the clinical overlap with known and
Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan.
The development of the syndrome may result from a confluence of several factors, including the ingestion of tryptophan, exposure to agents that activate indoleamine-2,3-dioxygenase, and possibly, impaired function of the hypothalamic-pituitary-adrenal axis.
An investigation of the cause of the eosinophilia-myalgia syndrome associated with tryptophan use.
The outbreak of the eosinophilia-myalgia syndrome in 1989 resulted from the ingestion of a chemical constituent that was associated with specific tryptophan-manufacturing conditions at one company.
Hypodense eosinophils and interleukin 5 activity in the blood of patients with the eosinophilia-myalgia syndrome.
The presence of IL-5 in the sera of patients with EMS may contribute to the development and maintenance of the eosinophilia and may regulate the conversion of the peripheral blood eosInophils to the hypodense phenotype with augmented pathobiologic potential.
Eosinophilia-Myalgia Syndrome not Associated with the Ingestion of Nutritional Supplements
A 74-year-old man referred for evaluation of a 3-month history of recurrent episodes of severe disabling myalgia, flu-like symptoms such as recurrent episode of fever, chill, cough, weakness, and dyspnea, abdominal discomfort and weight loss of unknown cause experienced a dramatic resolution of symptoms, and eosinophil counts dramatically declined.
Idiopathic and L-tryptophan-associated eosinophilic fasciitis before and after L-tryptophan contamination.
The clinical spectrum of cutaneous fibrosis associated with the ingestion of levotryptophan includes generalized morphea and EF, which are similar though not identical to their idiopathic counterparts.
Eosinophilia-myalgia syndrome or fibromyalgia with eosinophilia?
The CDC surveillance definition allowed misclassification of patients with other myalgia causing illnesses (such as fibromyalgia) as having EMS, thus overestimating the magnitude of the 1989 epidemic, according to Dr Hudson, Daniels, and Horwitz.
The cause and pathogenesis of the eosinophilia-myalgia syndrome.
Current evidence suggests that the epidemic of the eosinophilia-myalgia syndrome was caused by contaminated L-tryptophan preparations originating from a single manufacturer.