Mast cells and Allergy.

Mast Cells:
Mast cells are long-lived tissue-resident cells with an important role in many inflammatory
settings including host defense to parasitic infection and in allergic reactions. Mast cells are
located at the boundaries between tissues and the external environment, for example, at mucosal
surfaces of the gut and lungs, in the skin and around blood vessels. Mast cells are key players in
the inflammatory response as they can be activated to release a wide variety of inflammatory
mediators, by many different antigens including allergens, pathogens and physiological
mediators. These different chemical mediators include histamine, interleukins, proteoglycans,
and various enzymes.
History:
Mast cells were first described by Ehrlich
in his 1878 doctoral thesis on the basis of
their unique staining characteristics and
large granules, that gave them their name,
“Mastzellen” which means well-fed cells,
because their cytoplasm was stuffed with
granular material. Mast cells are now
considered to be part of the immune
system.

Development of Mast Cells:

Mast cells derive from the bone marrow but unlike other white blood cells, mast cells are
released into the blood as mast cell progenitors and do not fully mature until they are recruited
into the tissue where they undergo their terminal differentiation. Stem cell factor (SCF) is a
cytokine essential for mast cell development, proliferation and survival. SCF also promotes the
release of histamine and tryptase, which are involved in the allergic response.
Staining:
They contain in their cytoplasm numerous granules that do not stain with routine stains like
hematoxylin-eosin. The granules stain with methylene blue, which is present in the Giemsa
stain, with toluidine blue, and with Alcian blue.

Types:
Human mast cells are classically divided into two types.
• Mast cells that contain tryptase and chymase are referred to as TC mast cells. Such cells
tend to be located in sub mucosal tissues. Increased numbers of these cells are found in fibrotic
disease.
• Mast cells that contain tryptase but not chymase are referred to as T mast cells (MCt) and
are increased in allergic and parasitic diseases.

Functions:
• Mast cells are reservoirs of preformed inflammatory mediators and rapidly synthesizes others
on activation.
• Mediators contributes to the changes in anaphylaxis and delayed hypersensitivity reactions.
• Primes B-cell for antibody formation.
•They play a role in the defense against parasites; stimulate chemotaxis, activation and
proliferation of eosinophils; promote phagocytosis.
• stimulate connective tissue repair and angiogenesis.

Role of Mast cells in Allergy:

Mast cells are allergy cells responsible for immediate allergic reactions. They cause allergic
symptoms by releasing products called “mediators” stored inside them or made by them. In
allergic reactions, this release occurs when the allergy antibody IgE, which is present on the
mast cell surfaces, binds to proteins that cause allergies, called allergens. This triggering is
called activation, and the release of these mediators is called degranulation.

Mast cell Activation

Antigen-dependent aggregation of Fce Rl bound IgE on the surface of mast cells is a primary
mechanism of activation of Mast cells and subsequent release of preformed proinflammatory
mediators, as well as of newly synthesized mediators
 Non-IgE-driven signals that activate mast cells include Toll-like receptor ligands such as
lipopolysaccharide and nucleic acids, the anaphylatoxins C3a and C5a, and certain chemokines
and cytokines.

Mast cell degranulation

Degranulation of mast cells occurs after

crosslinking of IgE on the cell surface.
Degranulation generally occurs within
minutes of exposure of the cell membrane to
the secretagogue, and usually consists of the
extrusion of entire granules, but some
granules may undergo intracellular
disintegration.

Mechanism of Allergy:
 When an individual is immunologically primed, further contact with allergen leads to
secondary boosting of the immune response.
 These allergens combine with antibodies and initiate the bridging reaction.
  This leads to the degranulation’s of mast cell which further release mediators like
histamine, bradykinin, SRS-A, ECF-A etc.
 These mediators then lead to the symptoms and causes distension of blood capillaries.

Treatment:
Measurement of mast cell tryptase can be undertaken in specialized clinical laboratories.
Elevated levels reflect recent (within hours) degranulation of mast cells and can be useful where
the diagnosis of anaphylaxis is uncertain. Tryptase rather than histamine is measured as it is
more stable and has a somewhat longer half-life than the biologically active histamine molecule.

Conclusion:
In conclusion, mast cells may not only contribute to the chronic airway inflammatory response,
remodeling and symptomatology, but they may also have a central role in the initiation of the
allergic immune response, that is providing signals inducing IgE synthesis by B-
lymphocytes and inducing Th2 lymphocyte differentiation.
Reference:
 www.birmingham.ac.uk/Documents/Essentialimmunology/Chapter3.pdf
 www.immunology.org/public-information/bitesized-immunology/cells/mast-cells
 www.slideshare.net/daulatramdhaked/mast-cell
 www.researchgate.net/ Mechanism-of-allergic-inflammation

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