Mast cell activation syndrome
Mast cells are one of the most important cells of the immune system that play a role in health and disease. They do not float in blood like other while cells. Rather, they sit as stem cells in the bone marrow, travel through the blood stream as immature cells and reside in tissues. Interestingly, when they come out into different organs, they mature to become slightly different â mast cells of the brain have different function then mast cells of the lungs or skin.
In this article:
- What Is Mast cell activation syndrome?
- Mediators
- What Triggers Mast Cell Activation Syndrome?
- Symptoms
- Diagnosis
- Other Diseases Associated With Mast Cell
- Risk Factors
- Prevention
- References
What Is Mast cell activation syndrome?
Mediators
Mast cells are filled up with many biogenic molecules and enzymes that are released to start various processes. Here are just few body functions mast cell can regulate:
- Activate other immune cells
- Protect from parasitic infections
- Regulate inflammation and tissue reconstruction
- Participate in endocrine function
- Play sexual function and pregnancy
- Maintain normal brain development and function
When mast cells are activated, they can release biogenic signaling molecules and enzymes:
- Histamine, dopamine, serotonin
- Enzymes
- Polyamines
- Tryptase
- Cytokines
- Prostaglandins
- Platelet activating factor (PAF)
The most known inflammatory process where mast cells are the main players is allergy. When activated by the protein (food, bee sting, cat allergen etc.) mast cells trigger an allergic response in the body and even a systemic reaction (anaphylaxis).
What Triggers Mast Cell Activation Syndrome?
There are many reasons why mast cell activation syndrome can start. Also, many diseases can have mast cells activated. So, sometimes there is an underlying sickness that just have symptoms that point to this diagnosis.
Symptoms
- Flushing
- Rash
- Weight gain
- Hives (urticaria)
- Headaches
- Fever
- Low blood pressure (hypotention)
- Nausea, vomiting
- Abdominal cramps, diarrhea
Diagnosis
The mast cell activation syndrome diagnosis is very complicated. If you suspect that you might have it, we recommend you find the MCAS expert who knows what labs you need. A detailed medical history including type, duration and triggers of symptoms, careful and focused physical examination, and specific laboratory tests, is necessary for a proper clinical evaluation. Family history is of great importance because the prevalence of MCD is higher among relatives of MCD patients than would be expected by chance.
Other Diseases Associated With Mast Cell
Diseases such as carcinoid syndrome, pheochromocytoma, gastrinoma, and VIPoma, which could explain many of the symptoms have to be ruled out through specific diagnostic tests.
An expert immunologist will try to rule out other diseases that can produce similar symptoms:
- Food allergy
- Systemic mastocytosis
- Leaky gut
- Orthostatic hypotension
- Anxiety and panic disorders
- Sebo
- Chemical sensitivity
- Toxic exposures
- Thyroid disease
- Chronic infections (lyme disease, mono, hepatitis)
- Drug-induced reactions
To make things even more complicated, there are several known diseases that will have mast cells activated (and scientists are not sure what comes first â mast cell problem or other reasons that activate these cells):
- Chronic inflammatory response syndrome (CIRS)
- Idiopathic anaphylaxis
- Histamine intolerance
- Fibromyalgia syndrome (FMS)
- Ehlers-Danlos Syndrome (EDS)
- Postural orthostatic tachycardia syndrome (POTS)
- Interstitial cystitis/bladder pain syndrome (IC/BPS)
- Irritable bowel syndrome (IBS)
- Kounis syndrome
- Multiple chemical sensitivity syndrome (MCSS)
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
- Post-Lyme syndrome
- Post-traumatic stress disorder (PTSD)
- Serum total tryptase, bone marrow biopsy and skin biopsy (to rule out Mastocytosis)
- Total IgE and specific IgE for allergens
- Gut microbiome test
- Thyroid function and hormones
- Allergy skin test
- Patch test for chemicals (contact sensitivity)
- CBC (total blood cell count)
- Liver tests
- Infectious disease test
The measurement of serum histamine has several shortcomings that may result in false positive tests. The assay may detect histamine released by basophils. Tests for serum PGD2 have similar drawbacks, as processing of peripheral blood samples can trigger non-MC cellular elements to release PGD2; ingestion of niacin is also associated with elevations in serum PGD2.
Sometimes doctors give you medications to see if the symptoms you have respond to antihistamines or antibiotics. Such therapy may be diagnostic.
Risk Factors
When dealing with mast cell activation it is important to eliminate every possible trigger factor. Common triggers include:
- Alcohol
- Food (chemical preservatives, spices, histamine foods)
- Drugs (antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, neuromuscular blockers)
- Radiocontrast media
- Insect stings
- Physical stimuli (pressure, friction, heat, cold)
- Hormones (testosterone, estrogen, thyroxin)
- Chronic and acute stress
- Infections (viral and bacterial)
Prevention
Mast cell activation syndrome awareness helps many people to understand this syndrome. While there is no one single explanation of why this disease develops, there is a lot you can do to prevent it. We know that people who pay attention to recommendations of healthy living rarely develop mast cell problems. As we explained, mast cell is an essential player in health and its function is to protect us. If mast cells are hyper-activated, it is trying to eliminate some intruding agent of body dysfunction. Healthy diet, regular exercise and antioxidants in food will help you to lower your symptoms or even cure the disease. Many people seek natural medicine doctors who look at the body as a whole system and use holistic natural remedies to restore the balance. Functional medicine approach gathers the best from Eastern and Western medicine and will help you to improve the quality of life without use of chronic medications. It is best to find real experts who practice evidence-based treatments and will help you to heal best.