RESEARCH PAPERS – Comorbidities
Neuropsychiatric Manifestations of Mast Cell Activation Syndrome and Response to Mast-Cell-Directed Treatment: A Case Series
Leonard B. Weinstock, Renee M. Nelson and Svetlana Blitshteyn (2023). This is a small study that explores the comorbidity of psychiatric conditions and MCAS. The study includes 8 patients with both a psychiatric and MCAS diagnosis and highlights how, treating MCAS improved the psychiatric symptoms. The study highlights how psychiatric patient's refractory to standard therapy that also have systemic symptoms should be assessed for MCAS. It calls for more studies to investigate the prevalence of MCAS in psychiatric patients not responding to standard treatments to get a better picture of this association and the potential therapeutic benefits for the patients.
Immunological dysfunction and mast cell activation syndrome in long COVID
Stevent Sumantri, Iris Rengganis (2023). This article explores the similarities between long COVID and MCAS; long COVID-19 is persistent inflammatory state that causes abnormal mast cell activation and the release of inflammatory cytokines. This connection opens therapeutic opportunities for patients with long COVID that have clinical symptoms consistent with MCAS.
Mast Cells and Vitamin D Status: A Clinical and Biological Link in the Onset of Allergy and Bone Diseases
Giuseppe Murdaca, Alessandro Allegra, Alessandro Tonacci, Caterina Musolino, Luisa Ricciardi, Sebastiano Gangemi (2022). This article analyses the relationships between mast cells and vitamin D, highlighting their roles in allergic diseases, bone metabolism, and skin conditions. It discusses how vitamin D influences mast cell activation, degranulation, and pro-inflammatory mediator release. Therefore, the findings suggest that vitamin D is a potential therapeutic strategy for managing mast cell driven conditions such as MCAS.
Depression, psychosocial correlates, and psychosocial resources in individuals with mast cell activation syndrome
Jennifer Nicoloro SantaBarbara, Marci Lobel (2022). This article examines the psychological and emotional experiences of 125 participants with MCAS. Clinical depression was found to be common in the sample (64% prevalence), as well as feelings of loneliness and defectiveness, which contributed to high illness intrusiveness. The study concludes that while stigma and self-efficacy overlap with other variables, loneliness and disease-specific stressors emerge as significant risks, and optimism acts as a resilience factor.
Mast cell activation and the link with long COVID
Soumya Arun, Abbie Storan, Bethan Myers (2022). This article provides a comprehensive overview of MCAS biomarkers, diagnosis and management before relating the disease to long COVID. It discusses the overlap in symptoms, the potential exacerbation or incitement of MCAS by COVID-19 infection, common environmental triggers, and similarities in relapse-remission cycles in people with long COVID and people with MCAS. It also discusses improvements with similar medications in both diseases, but emphasises that despite these similarities, other underlying pathologies may also be associated with long COVID aside from mast cell disorders.
Mast Cell Activation Syndrome in COVID-19 and Female Reproductive Function: Theoretical Background vs. Accumulating Clinical Evidence
Dariusz Szukiewicz, Piotr Wojdasiewicz, Mateusz Watroba, Grzegorz Szewczyk (2022). This article discusses the importance of mast cells in the female reproductive system and discusses the mechanism of potential disorders related to MCAS. While it suggests that COVID-19 hyperinflammation may involve MCAS, it finds that current evidence does not indicate a significant impact on female reproductive function
Mast cell activation disease and immunoglobulin deficiency in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorder
Isabelle Brock, Walter Prendergast, Anne Maitland (2021).
Mast cell activation may explain many cases of chemical intolerance
Claudia S. Miller, Raymond F. Palmer, Tania T. Dempsey, Nicholas A. Ashford & Lawrence B. Afrin (2021). This article discusses the similarities between Mast Cell Activation Syndrome (MCAS) and Toxicant-Induced Loss of Tolerance (TILT), suggesting that both conditions share overlapping symptoms due to mast cell activation. It proposes that MCAS may provide a biological mechanism for TILT, with both conditions exhibiting multi-system symptoms triggered by environmental exposures. The article concludes that more research should be done to improve our understanding of the connection between TILT and MCs, and of new links between environmental exposures and illness.
Some cases of hypermobile Ehlers-Danlos syndrome may be rooted in mast cell activation syndrome
Lawrence B Afrin (2021).
Mast Cell Activation Disorder and Postural Orthostatic Tachycardia Syndrome: A Clinical Association
Ritsuko Kohno, David S Cannom, Brian Olshansky, Shijun Cindy Xi, Darshan Krishnappa, Wayne O Adkisson, Faye L Norby, Artur Fedorowski, David G Benditt (2021). This study examines the frequency with which findings suggesting mast cell activation (MCA) disorder occurred in patients diagnosed with postural orthostatic tachycardia syndrome (POTS). It notes a broader symptom profile in MCA cases, including allergic and gastrointestinal issues. It identifies prostaglandins combined with other markers, such as histamine, as useful but not definitive diagnostic indicators and concludes that MCA should be considered in POTS-like cases with atypical symptoms.
Mast cell activation symptoms are prevalent in Long-COVID
Leonard B Weinstock, Jill B Brook, Arthur S Walters, Ashleigh Goris, Lawrence B Afrin, Gerhard J Molderings (2021).
COVID-19 infection in patients with mast cell disorders including mastocytosis does not impact mast cell activation symptoms
Matthew P Giannetti, Emily Weller, Iván Alvarez-Twose, Inés Torrado, Patrizia Bonadonna, Roberta Zanotti, Daniel F Dwyer, Dinah Foer, Cem Akin, Karin Hartmann, Tiago Azenha Rama, Wolfgang R Sperr, Peter Valent, Cristina Teodosio, Alberto Orfao, Mariana Castells (2021).
Mast Cell Activation Syndrome: A Primer for the Gastroenterologist
Leonard B Weinstock, Laura A Pace, Ali Rezaie, Lawrence B Afrin, Gerhard J Molderings (2021). This article reviews gastrointestinal comorbidities in MCAS, including links to conditions such as Postural Orthostatic Tachycardia Syndrome (POTS) and hypermobile Ehlers_Danlos Syndrome (hEDS). It finds that gastrointestinal symptoms in MCAS are inflluenced by mast cell activation, autonomic dysfunction, and connective tissue abnormalities, requiring comprehensive diagnostic and therapeutic approaches.
The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria
Zuberbier T, Abdul Latiff AH, Abuzakouk M, et al. The international EAACI/GA²LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77:734–766. doi:10.1111/all.15090
Cosegregation of postural orthostatic tachycardia syndrome, hypermobile Ehlers-Danlos syndrome, and mast cell activation syndrome
Vadas P, Guzman J, McGillis L, Mittal N, Walsh S. Cosegregation of postural orthostatic tachycardia syndrome, hypermobile Ehlers-Danlos syndrome, and mast cell activation syndrome. Ann Allergy Asthma Immunol. 2020;125(6):719-720. doi:10.1016/j.anai.2020.08.015
The relationship between mast cell activation syndrome, postural tachycardia syndrome and Ehlers-Danlos syndrome
Wang E, Ganti T, Vaou E, Hohler A. The relationship between mast cell activation syndrome, postural tachycardia syndrome, and Ehlers-Danlos syndrome. Allergy Asthma Proc. 2021;42(3):243-246. doi:10.2500/aap.2021.42.210022
Mast cell activation syndromes and anaphylaxis: Multiple diseases part of the same spectrum
González-de-Olano D, Matito A, Alvarez-Twose I. Mast cell activation syndromes and anaphylaxis: Multiple diseases part of the same spectrum. Ann Allergy Asthma Immunol. 2020;124(2):143-145.e1. doi:10.1016/j.anai.2019.11.023
Patient characteristics of suspected mast-cell activation syndrome with sinonasal obstruction: a single institution experience
Kim JH, Xi S, Ference EH, Ge M, Liu MM, Wrobel BB. Patient characteristics of suspected mast-cell activation syndrome with sinonasal obstruction: a single institution experience. Int Forum Allergy Rhinol. 2020;10(8):996-1000. doi:10.1002/alr.22558
Depression, psychosocial correlates and psychosocial resources in individuals with mast cell activation syndrome.
Nicoloro SantaBarbara J, Lobel M. Depression, psychosocial correlates, and psychosocial resources in individuals with mast cell activation syndrome [published online ahead of print, 2021 May 18]. J Health Psychol. 2021;13591053211014583. doi:10.1177/13591053211014583
Mast cell activation syndrome as a significant comorbidity in sickle cell disease
Afrin LB. Mast cell activation syndrome as a significant comorbidity in sickle cell disease. Am J Med Sci. 2014;348(6):460-464. doi:10.1097/MAJ.0000000000000325
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