Mast cell mediators in allergic inflammation and mastocytosis

Mast cells possess an array of potent inflammatory mediators that induce acute symptoms, such as urticaria, angioedema, bronchoconstriction, diarrhea, vomiting, hypotension and cardiovascular collapse, which can result in death. In contrast, mast cell mediators can be beneficial in the setting of acute infections, cardiovascular diseases, and cancer. The balance between the detrimental and beneficial roles of mast cells and their mediators is not completely understood. Although the symptoms of acute mediator release can be reversed with epinephrine and mediator blockers, the continued release of histamine, proteases, prostaglandins, leukotrienes, cytokines, and chemokines can lead to chronic and debilitating symptoms in patients with mastocytosis. Identification of the molecular factors and mechanisms that control the release of mast cell mediators will benefit all patients with mast cell activation syndromes and mastocytosis.