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Assessment of in vivo mast cell reactivity in patients with systemic mastocytosis.
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2017 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 47, no 7, p. 909-917Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with systemic mastocytosis (SM) have clinical signs of mast cell (MC) activation and increased levels of MC mediators. It is unclear whether the increased mediator levels are caused by increased numbers of tissue MCs, or whether these cells in affected individuals have a hyperactive phenotype.

OBJECTIVE: To determine reactivity of the skin and the airways to directly acting mediators and indirectly acting mast cell secretagogues in subjects with SM.

METHODS: were measured, as well as ex vivo basophil histamine release.

RESULTS: Mast cell mediators in the blood and urine were significantly higher in patients with SM than in HC and A controls. Responsiveness to local activation of skin MCs (by morphine) and airway MCs (by mannitol) was similar in SM and HC groups. Likewise, end-organ responsiveness in the skin to histamine, and in the airways to methacholine, was similar in all three subject groups. There was no evidence of increased basophil reactivity in SM patients.

CONCLUSIONS AND CLINICAL RELEVANCE: Mast cells in the skin and airways of subjects with SM do not exhibit hyper-reactivity towards the MC-activating stimuli morphine and mannitol, respectively. Therefore, the highly elevated baseline levels of MC mediators in SM are most likely due to increased MC numbers, rather than altered MC responsiveness. The underlying mechanisms could involve leakage of MC mediators, or dysfunctions in mediator synthesis, storage and release. One clinical implication of our study is that there is no contraindication to perform skin tests using morphine in subjects with mastocytosis.

Place, publisher, year, edition, pages
2017. Vol. 47, no 7, p. 909-917
Keywords [en]
histamine, mannitol, mast cell reactivity, mastocytosis, prostaglandin D2, tryptase
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-343002DOI: 10.1111/cea.12914PubMedID: 28258965OAI: oai:DiVA.org:uu-343002DiVA, id: diva2:1185439
Funder
Swedish Research CouncilSwedish Cancer SocietyStockholm County CouncilSwedish Heart Lung Foundation
Note

De två sista författarna delar sistaförfattarskapet.

Available from: 2018-02-24 Created: 2018-02-24 Last updated: 2018-03-16Bibliographically approved

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Nilsson, G

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