RESEARCH PAPERS – Treatment

Fluoxetine retrains allergic inflammation by targeting an FcɛRI-ATP positive feedback loop in mast cells

Tamara T Haque, Marcela T Taruselli, Sydney A Kee, Jordan M Dailey, Neha Pondicherry, Paula A Gajewski-Kurdziel, Matthew P Zellner, Daniel J Stephenson, H Patrick MacKnight, David B Straus, Roma Kankaria, Kaitlyn G Jackson, Alena P Chumanevich, Yoshihiro Fukuoka, Lawrence B Schwartz, Randy D Blakely, Carole A Oskeritzian, Charles E Chalfant, Rebecca K Martin, John J Ryan (2023). This article outlines a study on mice that tests the effects of the SSRI fluoxetine on IgE-induced activation of mast cells. It discusses how fluoxetine suppresses mast cell activation and ATP secretion, which amplifies IgE responses. The article concludes by suggesting that fluoxetine is a promising candidate for repurposing allergy treatment.

Mast Cells as a Target - A Comprehensive Review of Recent Therapeutic Approaches

Joanna Baran, Anna Sobiepanek, Anna Mazurkiewicz-Pisarek, Marta Rogalska, Aleksander Gryciuk, Lukasz Kuryk, Soman N Abraham, Monika Staniszewska (2023). This article provides a comprehensive overview of therapeutic approaches targeting mast cells, making it highly relevant to the treatment theme. It discusses the role of mast cells in the immune system, their overactivity in pathological states, and various therapeutic strategies to manage these conditions.

How can a dietician help support those with Mast Cell Activation Syndrome?

Chloe Hall (2023). This article gives an overview of dietary triggers associated with MCAS and dietary recommendations for the management of MCAS symptoms. It is targeted to dieticians, outlining their role in identifying dietary triggers in MCAS, safely re-introducing foods where anaphylaxis has occurred in the past, and in fostering a healthy relationship between MCAS patients and food.

Mast Cell Diseases in Practice and Research: Issues and Perspectives Raised by Patients and Their Recommendations to the Scientific Community and Beyond

Susan V. Jennings, Celeste C. Finnerty, Jessica S. Hobart, Mercedes Martín-Martínez, Kristin A. Sinclairf, Valerie M. Slee, Julie Agopian, Cem Akin, Ivan Álvarez-Twose, Patrizia Bonadonna, Angela S. Bowman, Knut Brockow, Horia Bumbea, Claudia de Haroo, Jie Shen Fok, Karin Hartmann, Nicole Hegmanns, Olivier Hermine, Monika Kalisiak, Constance H. Katelaris, Jacqueline Kurzs, Patrizia Marcis, David Mayne, David Mendoza, Alain Moussy, Genija Mudretzkyjz, Nicoleta Nidelea Vaiaaa, Marek Niedoszytko, Hanneke Oude Elberink, Alberto Orfao, Deepti H. Radia, Sophie Rosenmeierz ∙ Eugenia Ribadad ∙ Waltraud Schinhofenff ∙ Juliana Schwaab, Frank Siebenhaar, Massimo Triggiani, Giuseppe Tripodox, Rocio Velazquezo, Yvon Wielinkkk, Friedrich Wimazal, Timo Yigitff, Celia Zubrinich, Peter Valent (2022).This article focuses on the perspectives of those with mast cell diseases (namely mastocytosis and MCAS). It details a project aiming to expand our understanding of patient needs and to propose actions that address those needs. Issues reported include struggles relating to the rarity of mast cell diseases, the impact of the diseases on quality of life, the diagnostic process and the need for further research. It also identifies possible solutions to these challenges.

Drug-induced mast cell eradication: A novel approach to treat mast cell activation disorders?

Peter Valent, Cem Akin, Karin Hartmann, Andreas Reiter, Jason Gotlib, Karl Sotlar, Wolfgang R. Sperr, Lina Degenfeld-Schonburg, Dubravka Smiljkovic, Massimo Triggiani, Hans-Peter Horny, Michel Arock, Stephen J. Galli, Dean D. Metcalfe (2022). This article examines the potential of KIT-targeting tyrosine kinase inhibitors (TKIs) in treating MCAS by blocking mast cell activation. It highlights that while TKIs like avapritinib show promise in targeting KIT D816V-positive mast cells, their effectiveness in MCAS remains unclear. The authors suggest more research is needed to determine the long-term safety and efficacy of these treatments for MCAS patients.

High FODMAP diet causes barrier loss via lipopolysaccharide-mediated mast cell activation

Prashant Singh, Gintautas Grabauskas, Shi-Yi Zhou, Jun Gao, Yawen Zhang, Chung Owyang (2021). This article discusses how a high FODMAP (HFM) diet induces mast cell activation and colonic barrier dysfunction in rodent models and patients with IBS-D. It highlights the critical role of TLR4-dependent mast cell activation in FODMAP-induced barrier loss and the potential benefits of a low FODMAP (LFM) diet in reducing mast cell activation and improving colonic barrier function. The study provides new insights into the microbiome’s contribution to mast cell activation and its relevance for managing gastroinstestinal symptoms in IBS-D.

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.

Safe administration of chemotherapy in mast cell activation syndrome

M P Lythgoe, J Krell, I A McNeish, L Tookman (2021). This article details a case report of a 59-year-old MCAS patient with endometrial cancer who received chemotherapy, with the aim to provide a framework for safer chemotherapy administration. It discusses the challenges of administering chemotherapy in patients with MCAS, highlighting hypersensitivity risks of carboplatin and paclitaxel, the role of desensitization protocols, and the need for tailored strategies to safely treat high-risk patients.

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.

Effect of Dietary Fiber and Metabolites on Mast Cell Activation and Mast Cell-Associated Diseases

Jelle Folkerts, Ralph Stadhouders, Frank A Redegeld, See-Ying Tam, Rudi W Hendriks, Stephen J Galli, Marcus Maurer (2018). This article provides an overview of current understandings surrounding the effects of dietary fibre on the regulation of mast cell activity and mast cell-associated diseases. It discusses the potential therapeutic effects of fibre and its metabolites (including short-chain fatty acids) on mast-cell associated airway inflammation and allergic diseases. It proposes further research to explore the role of dietary fibre in preventing and treating conditions associated with mast cell activation.

Inhibitory effects of curcumin on passive cutaneous anaphylactoid response and compound 48/80-induced mast cell activation

Yun-Ho Choi 1, Guang-Hai Yan, Ok Hee Chai, Chang Ho Song (2010) This article discusses the inhibitory effects of curcumin (the active component of turmeric) on mast cell activation and histamine release in mast cell-mediated allergic responses. It highlights curcumin’s mechanisms, including suppression of calcium influx and enhancement of intracellular cAMP levels, which reduce mast cell degranulation and histamine release. The findings suggest curcumin’s potential therapeutic role in managing mast cell-associated allergic diseases.

Mast Cell Activation Syndrome and Mastocytosis: Initial Treatment Options and Long-Term Management

Castells M, Butterfield J. Mast Cell Activation Syndrome and Mastocytosis: Initial Treatment Options and Long-Term Management. J Allergy Clin Immunol Pract. 2019;7(4):1097-1106. doi:10.1016/j.jaip.2019.02.002

Omalizumab effectively prevents recurrent refractory anaphylaxis in a patient with monoclonal mast cell activation syndrome.

Jagdis A, Vadas P. Omalizumab effectively prevents recurrent refractory anaphylaxis in a patient with monoclonal mast cell activation syndrome. Ann Allergy Asthma Immunol. 2014;113(1):115-116. doi:10.1016/j.anai.2014.05.001

Timing of response and long term efficacy of Omalizumab in non-clonal mast cell activation syndrome: A case series.

Caminati M, Olivieri E, Nalin F, et al. Timing of response and long term efficacy of Omalizumab in non-clonal Mast Cell Activation Syndrome: A case series. Eur J Intern Med. 2020;71:104-106. doi:10.1016/j.ejim.2019.11.010

Mast Cell disorders and idiopathic anaphylaxis: Evaluation and Management

Khalid MB, Lieberman P. Mast cell disorders and idiopathic anaphylaxis: Evaluation and management. Allergy Asthma Proc. 2020;41(2):90-98. doi:10.2500/aap.2020.41.190023

Successful treatment of mast cell activation syndrome with sunitinib

Afrin LB, Cichocki FM, Patel K, Molderings GJ. Successful treatment of mast cell activation syndrome with sunitinib. Eur J Haematol. 2015;95(6):595-597. doi:10.1111/ejh.12606

Successful targeted treatment of mast cell activation syndrome with tofacitinib

Afrin LB, Fox RW, Zito SL, Choe L, Glover SC. Successful targeted treatment of mast cell activation syndrome with tofacitinib. Eur J Haematol. 2017;99(2):190-193. doi:10.1111/ejh.12893

Generalized Pruritus Relieved by NSAIDs in the Setting of Mast Cell Activation Syndrome

Kesterson K, Nahmias Z, Brestoff JR, Bodet ND, Kau A, Kim BS. Generalized pruritus relieved by NSAIDs in the setting of mast cell activation syndrome. J Allergy Clin Immunol Pract. 2018;6(6):2130-2131. doi:10.1016/j.jaip.2018.03.002

Hydroxychloroquine as a novel therapeutic approach in mast cell activation diseases

Espinosa E, Valitutti S, Laroche M, et al. Hydroxychloroquine as a novel therapeutic approach in mast cell activation diseases. Clin Immunol. 2018;194:75-79. doi:10.1016/j.clim.2018.07.004

Successful treatment of idiopathic mast cell activation syndrome with low-dose Omalizumab

Berry R, Hollingsworth P, Lucas M. Successful treatment of idiopathic mast cell activation syndrome with low-dose Omalizumab. Clin Transl Immunology. 2019;8(10):e01075. Published 2019 Sep 30. doi:10.1002/cti2.1075

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