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MAY 3, 2024
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HISTAMINE101 SHORTSTORIES BODY PARTS: THE OCCASIONAL SERIES
Everyone has heard the word histamine. But what is it? What is its role in the body? Simply put, histamine is a signaling chemical that’s part of our immune system. One reference work describes histamine as “ammonia-like,” and it is a key player in a natural and beneficial response to injuries and invaders. But if histamine is so beneficial, why are there such things as antihistamines and histamine blockers? We’ll get to that in a minute. Invaders detected by the immune system are sometimes ignored as harmless and benign. In other cases, a response is launched, one that we might casually refer to as an allergic reaction. Let’s say the invasion arrived at the end of a bee’s stinger. The skin at the sting site gets red and swollen. It feels hot. It itches. It’s no fun at all. As unfun as that scenario is, imagine someone escaping from that bee sting by running through bushes they later discover to be covered in poison ivy. The small site of discomfort the bee sting victim has is multiplied by 100 in the poison ivy victim. There are red, swollen, itchy welts all over their arms, legs and torso. Although their sites of misery are of different size and origin, both people will be plagued for days with the symptoms of allergic reactions. And what is the bringer of all the misery that results from the bee and the poison ivy? It starts with one word: histamine. When elements of the immune system go on alert because foreign antigens or bacteria
A graphic depiction of a mast cell showing Y-shaped Immunoglobulin E (IgE) antibodies reacting to foreign antigens by releasing histamine granules (green dots).
have been detected, troops aren’t sent out in tanks, or even fire trucks or ambulances. It’s true! Instead, mast cells (discovered by Paul Ehrlich in 1877) are among the troop transports employed. They travel around the bloodstream, bristling with sophisticated detection equipment like IgE antibodies (as shown above). When antigens are detected by IgE, mast cells deploy histamine, triggering various chemical reactions which make the work of the immune system easier. For example, vasodilation is one of the primary body reactions when histamine is released. Tiny blood vessels at the site of some invasion — like a bee sting or a poison ivy welt — expand and their walls become more porous, allowing blood to seep out into the problem area. Naturally, that blood Please see HISTAMINE page 4
WE DO E C I F F O HOUSE CALLS!
A DOCTOR’S “NOT IN MY JOB DESCRIPTION” MOMENT We had a patient who had undergone surgery and needed to be admitted overnight. He adamantly refused admission because he lived alone and had brought his dog with him to the hospital. The dog was in his car in the parking lot. The man really needed to be observed overnight, so he agreed to let me take the dog home with me that night and bed him down in our barn, which was enclosed in a paddock in the backyard. Since I had to work late, I called my husband, described the car and the dog and asked him to come to the hospital to pick up the dog, which he reluctantly did. On arriving home after midnight, I was greeted at my bedroom door by the patient’s Golden Retriever along with my own 3 dogs. “Honey, what happened to him staying in the barn?” “He didn’t like it.” “What do you mean?” I said. “His owner assured me that the dog would be very happy in the barn.” “I think he wanted an upgrade. Every time I left him in the barn he jumped the paddock fence and beat me to our back door, where he politely waited for me to let him in, so I did.” The next morning when we discharged the patient my husband brought the dog back to the car in the parking lot. I never saw the patient or the dog again. +
Be sure to see Part II of the rotator cuff story that led off our last issue. See page 3
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