title: Allergic predisposition, histamine and histamine receptor expression (H1R, H2R) are associated with complicated courses of sigmoid diverticulitis.
abstract: BACKGROUND
  We aimed to evaluate our hypothesis that allergic predisposition and expression of histamine receptors might contribute to complicated courses of sigmoid diverticulitis.
  
  
  METHODS
  Expression of histamine and histamine receptors (H1R, H2R) was analysed on protein level (immunohistochemistry/immunofluorescence (IF)) as well as mRNA level (reverse transcription-PCR (RT-PCR) in surgical specimen of patients (n = 101) having undergone resection for sigmoid diverticulits (n = 57 complicated diverticulitis/n = 44 non-complicated diverticulitis).
  
  
  RESULTS
  The mean number of comorbid diseases per patient was 1.76 ± 1.25. Thirty-nine of 101 patients (38.6%) exhibited allergic predisposition (grass poll, food, drug, pets, etc.). Comorbid diseases were significantly associated with complicated diverticulitis (p = 0.027). Complicated sigmoid diverticulitis was significantly associated with high H1R and H2R expression (p < 0.001). Furthermore, an association of complicated diverticulitis with allergic predisposition was found (odds ratio = 3.2, p = 0.0097). IF double-labelling experiments showed a strong correlation of increased histamine expression with expression of H1R and H2R on intestinal enterocytes (histamine/H1R, rho = 0.841, p < 0.0001 and histamine/H2R, rho = 0.806, p < 0.0001). The results of increased H1R and H2R expression in complicated sigmoid diverticulitis were also detected on mRNA level in a subset of patients (RT-PCR, p = 0.009).
  
  
  CONCLUSIONS
  Our findings suggest that allergic predisposition might be another important risk factor for complicated courses of acute sigmoid diverticulitis and linked with histamine receptor expression. Supportive therapies with antihistaminic drugs might become an option. Allergic predisposition might be worth considering when indicating surgery for sigmoid diverticulitis.
authors.affiliation: Department of General-, Visceral-, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany. B.von.Rahden@gmail.com
authors.forename: Burkhard H A
authors.initials: BH
authors.lastname: von Rahden
authors.forename: Christian
authors.initials: C
authors.lastname: Jurowich
authors.forename: Stefan
authors.initials: S
authors.lastname: Kircher
authors.forename: Maria
authors.initials: M
authors.lastname: Lazariotou
authors.forename: Matthias
authors.initials: M
authors.lastname: Jung
authors.forename: Christoph-Thomas
authors.initials: CT
authors.lastname: Germer
authors.forename: Martin
authors.initials: M
authors.lastname: Grimm
mesh_terms: D000368:Aged; D004198:Disease Susceptibility; D004239:Diverticulitis, Colonic / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D005260:Female; D015870:Gene Expression; D006632:Histamine / Q000378:metabolism*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000378:metabolism*; D011969:Receptors, Histamine H1 / Q000235:genetics / Q000378:metabolism*; D011970:Receptors, Histamine H2 / Q000235:genetics / Q000378:metabolism*; D012810:Sigmoid Diseases / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D018709:Statistics, Nonparametric
chemical_list: D012333:RNA, Messenger; D011969:Receptors, Histamine H1; D011970:Receptors, Histamine H2; D006632:Histamine