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Resume Les symptomes les plus souvent allegues par les patients souffrant d'intolerance aux vins sont un flush facial, des cephalees, un syndrome d'hyperreactivite nasale ou une gene respiratoire, parfois asthmatiforme, plus rarement une urticaire ou un œdeme de Quincke. Mise a part l'intolerance au dioxyde de soufre, les amines biogenes et en particulier l'histamine ont ete considerees comme les principaux responsables des reactions adverses aux vins. Il est postule que l'histamine contenue dans le vin peut traverser la barriere intestinale et induire les symptomes par l'augmentation des taux d'histamine plasmatique. A ce jour aucune etude, et notamment celles que nous avons realisees par test de provocation en double aveugle avec un vin riche en histamine versus un vin pauvre en histamine, n'apportent d'argument permettant de soutenir que les reactions d'intolerance presentees apres ingestion de vin sont liees a l'histamine, invitant a considerer d'autres facteurs soit une facilite a l'histaminoliberation par l'ethanol et l'ethanal soit l'implication d'autres amines biogenes contenues dans le vin. Les etudes precisant les mecanismes et les composes du vin en cause dans les reactions d'intolerance doivent etre encouragees pour definir des normes acceptables et poser les bases scientifiques indispensables a la maitrise technologique de ces parametres.

Background: Histamine is thought to be the main cause of adverse reactions to wines. Objective: The purpose of this study was to test the hypothesis that the level of histamine in wine affects the tolerance to wine in 16 subjects with wine intolerance. Methods: We performed a study to examine the effects of wine histamine content in 16 adults with wine intolerance. Each subject underwent 2 double-blind provocation tests with wine: 1 with a wine poor in histamine (0.4 mg/L), and 1 with a wine rich in histamine (13.8 mg/L). Blood was collected for histamine and methylhistamine RIAs at 0, 10, 30, and 45 minutes after ingestion of the wine. Methylhistamine and methylimidazolacetic acid (gas chromatography and mass spectrometry) were measured in urine 5 hours before and 5 hours after ingestion. Results: No significant differences in the occurrence of adverse reactions were noted after ingestion of either of the wines (McNemar test). At 10 minutes, a significant increase was observed in plasma histamine with histamine-poor wine. No significant changes (Wilcoxon test) were observed in the methylhistamine and methylimidazolacetic acid levels after ingestion of either histamine-poor or histamine-rich wine. Conclusion: This study demonstrates that there is no correlation between the histamine content of wine and wine intolerance. The increase of plasma histamine levels at 10 minutes with histamine-poor wine suggested the role of a histamine-releasing substance. The role of acetaldehyde is discussed. (J Allergy Clin Immunol 2001;107:375-8.)