Evidence check: COMT in the context of allergy

COMT (catechol-O-methyltransferase) is an enzyme that degrades catecholamines (dopamine, adrenaline, noradrenaline) and also estrogens. In the context of allergy, COMT is discussed mainly indirectly: through its role in regulating inflammatory processes and histamine breakdown. The common Val158Met polymorphism reduces enzyme activity and has been linked to increased pain sensitivity and stress reactivity – both of which can modulate allergic responses. However, direct evidence for COMT in allergy is weak. Some studies report associations with asthma or atopic dermatitis, but effect sizes are small and not consistently replicated. COMT is also mentioned in histamine intolerance contexts, as it might theoretically influence histamine levels, but robust clinical data are lacking. From a personalized medicine perspective, a COMT test alone is insufficient to assess allergy risk. The evidence is predominantly mechanistic, based on preclinical or small association studies. For reliable allergy diagnostics, IgE testing and provocation tests remain the gold standard. A COMT genetic test may provide complementary insight but should not be overinterpreted.