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Res."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>Histamine is the principal effector of anaphylaxis, and circulating levels correlate well with symptom severity in Hymenoptera venom\u2013induced anaphylaxis. Adrenaline, the recommended first-line therapy, does not neutralize histamine and may cause relevant adverse effects. Recombinant human diamine oxidase (rhDAO), engineered with a mutated heparin-binding motif, exhibits improved pharmacokinetics and rapid histamine-degrading activity. The primary aim of this study was to evaluate whether prophylactic or particularly therapeutic rhDAO prevents or reduces histamine-induced shock compared with adrenaline in guinea pigs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Guinea pigs received subcutaneous histamine (1\u00a0mg\/kg) with or without intramuscular adrenaline or intravenous rhDAO (2\u20138\u00a0mg\/kg). Mean arterial pressure, heart rate, and arterial oxygen partial pressure (PaO\u2082) were monitored. Plasma histamine and rhDAO levels were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Histamine injection raised plasma levels above 200 ng\/ml and consistently induced shock with 42% mortality. Prophylactic and therapeutic rhDAO completely degraded circulating histamine, reduced shock incidence from 100% to 0% at the highest doses, shortened tachycardia, improved PaO\u2082 and decreased mortality. Intramuscular adrenaline (0.005 or 0.01\u00a0mg\/kg) did not improve hemodynamics, oxygenation or survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Recombinant hDAO prevented and treated histamine-induced shock and hypoxia, whereas adrenaline was ineffective. These findings support clinical development of rhDAO for life-threatening histamine-mediated conditions, including anaphylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00011-026-02297-4","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T15:49:53Z","timestamp":1781970593000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recombinant human diamine oxidase prevents histamine-induced hypoxia, shock and death in guinea pigs"],"prefix":"10.1007","volume":"75","author":[{"given":"Felix","family":"Kosta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Weiss-Tessbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Gludovacz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Reiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Murauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Jilma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Rager-Resch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"2297_CR1","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.jaci.2017.06.003","volume":"140","author":"LL Reber","year":"2017","unstructured":"Reber LL, Hernandez JD, Galli SJ. 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