MCAD Resources

Edited in December 2022 to add: We have just become aware that there is an international shift in the nosology (classification and description) of the many forms of mast cell diseases, since not all involve (over) activation. So, the term Mast Cell Diseases or MCD is now the over-arching umbrella term to include all we know about now, plus any future discoveries. (It used to be MCAD.)

Not all with forms of Mastocytosis have mast cell activation and vice-versa.  And the recently uncovered Hereditary Alpha Tryptasemia Syndrome (aka HaTS, alternatively Familial Tryptasemia) confirmed in 2016 is sort of its own category at this time.

I am slowly reworking and rewriting all of my pages to slowly reflect this, but I have a lot of material to work through with no help while I’m disabled. So I thank you for your patience as I catch up. End edit.

Here’s a general collection of useful and informative websites to drill down further on all forms of Mast Cell Diseases (including all forms of Mastocytosis and MCAS and now also HaTS) known collectively as MCD and food issues that so many of us experience in addition to the Ehlers-Danlos Syndromes. Scroll down further for some of the best introductory articles for doctors regarding diagnostics and treatment.

Unfortunately, the more newly recognized MCAS (since about 2010) is a very complex condition that is hard to describe, and especially hard to diagnose unfortunately. There are no easy simple tests, and patience and perseverance is in order for everyone – doctors and patients alike, sorry. I highly recommend joining The Mast Cell Diseases Society for support with same. (Free to join.)  Last Updated March 15, 2024.

Emergency Protocols for Mast Cell patients via TMS <–Link (there are more below this section)

• The Mast Cell Diseases Society (US based worldwide support and research network, formerly known as The Mastocytosis Society until 2019)
• AAAAI/ACAAI Allergy Practice Parameters Site
• The Canadian Mastocytosis Site (includes good info on MCAS too)
• Mast Attack (by Lisa Klimas, patient)
• Mast Cell Aware
• Mast Cell Master (Dr. Theoharides’ site)
• Mast Cell Hope new in 2021
• Pretty Ill (Dr. Diana Driscoll’s site)
• Allergic Child (addresses both allergies and MCAD)
• Masto Kids support for parents of kids with mastocytosis
• Mast Cell Nutrition (Wendy Busse, MSc, RD, Canada)
• The Low Histamine Chef (started by the late Yasmina Ykelenstam)
• Foods Matter
• The Food Intolerance Network of Australia
• Histamine Intolerance
• Swiss Histamine Intolerance Group (also recognizes MCAS)
• Brigham and Women’s Hospital Center for Mastocytosis and MCAS
• Mayo Clinic Program for the Study of Mast Cell and Eosinophilic Disorders

There’s now an educational book available on MCAD from a leading US hematologist as of May 2016:

Never Bet Against Occam: Mast Cell Activation Disease and The Modern Epidemic of Chronic Illness and Medical Complexity Afrin, L. MD 2016 Elsevier Press

Good introductory info for all

I highly recommend reading these blog posts on diagnosing all forms of MCAD, which make it clear both how hard it is to get a distinct result, and how heterogeneous (widely varying) and hard to diagnose the conditions are for everybody:

http://www.mastattack.org/2015/05/mast-cell-disease-fact-sheet/
http://mastattack.blogspot.com/2014/07/diagnosis-of-mast-cell-diseases.html?m=1
http://www.mastattack.org/2015/04/initial-diagnosis-and-treatment-of-mast-cell-activation-disease-general-notes-for-guidance/

Important note January 2021 regarding COVID-19 vaccines: it is recommended to try to get your vaccinations. That said, MCAD patients with known high levels of reactivity to medications or past vaccinations may wish to pre-medicate with Benadryl or other antihistamines in concert with your doctors knowledge and advice. Some may even need to receive the vaccine in the hospital or doctor’s office for safe observation. Talk to your doctors about your individual case. (I succeeded with pre-medication myself in 2021 and 2022. Consult TMS for further guidance if your doctor can’t help.)

Anaphylaxis presentation and grading charts

Not all anphylaxis (ana) is throat-closing. Learn the early warning signs to help stave off a reaction that is.

These are just some sample charts below, google for more, there’s no single consensus, and everyone’s body reacts differently at different times to different triggers and conditions including to non-proteins like sunlight, pressure, and vibration. Some poorly known experience from the field:

Some people’s blood pressure (BP) may just suddenly drop hard and they begin having literal Stage IV cardiac issues that can kill them even without “traditional” hives and airway trouble at first, if at all. So they can be missed as having anaphylaxis because of the absence of throat or tongue swelling or any skin signs (hives, flushing).

Others have their BP spike quite high, and either stay high, or also suddenly drop, sometimes quite far and hard, again, in a dangerous way. Talk to your doctors about yours and when to epi! Every. Body. Is. Literally. Different.

Terminology note:

“Anaphylactoid reaction” is an outdated term referring to reactions which are essentially identical in effect to the newer term “nonimmunologic anaphylaxis” and can present identically to an allergic reaction. The difference in terminology is merely a matter of hair-splitting around the drivers of the reactions.

“Allergic reaction” is a very narrow definition of a reaction based strictly on IgE-mediated “true” allergies, triggered by organic protein “allergens” they can easily test for. These can only be triggered by organic proteins, not chemicals.

The former (“anaphylactoid reaction”) is a now outdated term that was used to described all other reactions of the same nature in the absence of a known IgE allergen. The newer preferred term for this is “anaphylactic reaction”.

Because they can affect you just the same! I.e, the “driver” (nature of the trigger) doesn’t matter, the resulting anaphylactic reaction is the same – over-activation of mast cells and basophils usually leading to shock and potentially even death for some.

Most people with any form of MCAD soon learn this is one of the MAIN REASONS TO SUSPECT MCAS or Mastocytosis or HaTS: the fact that you DO react to non-proteins, like sunlight, vibration, pressure, cold, heat, scents, etc.

I.e, Things you cannot test for IgE antibodies levels of at the allergy office~! Some never have any “true” IgE-mediated “allergies”, but have to literally live in safe trigger-free bubbles just the same.

This is precisely what makes diagnosing MCAS SO hard – the best they can do is try to capture evidence of elevated mast cell mediators in blood or urine “after the fact”, and this is notoriously inaccurate for many reasons.

People have been literally dying, and disbelieved because there was no easy bio-marker or sufficient elevation of one despite all the signs of anaphylaxis you could want. This really really needs to change and is always under discussion by TMS, AAAAI et al. Sadly, there is no global consensus yet. (2022)

Ring and Messmer Anaphylaxis Grading Scale from 1977

[Image description: a graphic of the 1977 Ring and Messmer Anaphylaxis Grading Scale showing a table with the headings listed as Grade, Skin, Abdomen, Respiratory Tract, Cardiovascular System across the top from left to right. Four rows labeled simply I, II, III and IV top to bottom are in the left most column, indicating Grades of anaphylaxis.

Skin signs by grade have Itch, Flushing, Urticaria and Angioedema listed under all four Grades 1-IV.

Abdomen lists the following for the respective grades I-IV:

1.  — (nothing)
2. Nausea, Cramps
3. Vomiting, Defecation
4. Vomiting, Defecation

Respiratory Tract lists the following for the respective grades I-IV:

1. — (nothing)
2. Rhinorrhea, Hoarseness, Dyspnea
3. Laryngeal edema, Bronchospasm, Cyanosis
4. Respiratory arrest

Cardiovascular System lists the following for the respective grades I-IV:

1. — (nothing)
2. Tachycardia (rise >or= 20/min), Hypotension (> or = 20 mmHg drop in SBP), Arrhythmia
3. Shock
4. Circulatory arrest                                              — end image description]

• Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis  2020 Shaker, Wallace, Golden et al -J Allergy Clin Immunol.
• Anaphylaxis symptoms and diagnosis via AAAAI 2019
• Understanding Diagnostic Criteria for Anaphylaxis, Anaphylactic Shock, Kounis Syndrome Critical to Initiating Lifesaving Treatment 2016 Anton Helman, MD, CCFP(EM), CAC, FCFP via ACEP Now (best most succinct outline I’ve seen, JG 2019)
• Anaphylaxis vs Anaphylactoid reactions via World Allergy Org 2018
• Anaphylaxis with Hypertension (not uncommon!) AAAAI 2015
• Anaphylaxis reactions presenting with Hypertension 2016 Somazgul, Kutlu et al
• Allergy, Asthma and Clinical Immunology discussion of Anaphylaxis (2011)
• Anaphylaxis – a practical parameter update 2015 – Lieberman, Nicklas, Randolf MD et al El Sevier publications
• The Definition of Anaphylaxis – Klimas, L 2016
• Ring and Messmer Anaphylaxis Grading Scale via Mast Attack (Klimas) – this is one of the most cited
• Perioperative anaphylaxis grading system: “Making the grade” 2016 Rose, Green, Crilly et al
• World Allergy Organization Guidelines for the Assessment and Management of Anaphylaxis 2011 Simons, Ardusso et al
• Google Images search results for “anaphylaxis + grading + chart” (Note: take all you find with a grain of salt. Know that some may be outdated now and also every experience of anaphylaxis is different for different people, and even sometimes for the same person on different occasions or from different causes or triggers. It is NOT an exact science, unfortunately as much as we would like it to be. Talk to an allergist/immunologist or your doctor to help know how best to manage your symptoms and when to use your rescue meds and Epi.)
• A nice chart from an unknown source via Wiley online (gotten from a Facebook comment 2024)

Google for more and for any unfamiliar terms and talk to your doctors! Loss of airway is the biggest flag for most, but not all.

New COVID-19 related articles:

• Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome 2020 Afrin, Weinstock, Molderings
• COVID-19, Mast Cells, Cytokine Storm, Psychological Stress, and Neuroinflammation – Kempuraj, Selvakumar, Ahmed et al July 2020

Emergency Protocol

Emergency protocol form for Masto/MCAS patients to fill out and carry via The Mast Cell Diseases Society:
Link: http://tmsforacure.org/documents/ER_Protocol.pdf

 Caution: Patients on beta blockers may need glucagon WITH any shot of Epi. (Disregard if NOT on beta blockers).

(See TMS Emergency Protocol document above for more, including cautions re: anesthetics/surgery)

Link to: Emergency Protocol for Those With Severe Corn Allergy    

Best Introductory Articles for Doctors 

• What are Mast Cell Diseases via The Mast Cell Diseases Society (TMS) (last updated 2021)
• Diagnosis of mast cell activation syndrome: a “global consensus-2” 2020 Afrin, Molderings et al 
• Proposed Diagnostic Algorithm for Patients With Suspected Mast Cell Activation Syndrome 2019 Valent, Akin, Bonadonna et al
• Mast Cell Diseases in Practice and Research: Issues and Perspectives Raised by Patients and Their Recommendations to the Scientific Community and Beyond 2022 Jennings, Finnerty, Hobart et al
• Testing For Mast Cell Activation Syndrome: Measuring Tryptase 2019 Afrin, Dempsey
• Mast Cell Disorders: From Infancy to Maturity November 2018 Wilcock, Bahri,  Bulfone‐Paus, Arkwright
• Mast Cell Activation Syndromes – Akin, Cem MD 2017
• Often seen, rarely recognized: mast cell activation disease – a guide to diagnosis and therapeutic options 2016 Afrin, Butterfield et al
• Mast Cell Disorders Are Associated with Decreased Cerebral Blood Flow And Small Fiber Neuropathy 2021 (preprint) Novak, Gianetti, Weller et al
• Anaphylactic reactions presenting with hypertension 2016 Solmazgul, Kutlu, Dogru et al
• Systemic Mastocytosis with Normal Serum Tryptase (in 10% of pts) 2019 Journal of Dermatology, Margaret Hammond MD
• Mast Cell Activation Syndromes 2016 Bonamichi-Santos, Castells
• Pharmacological Treatment Options for Mast Cell Activation Disease Molderings et al 2016
• Mast Cell-Meidated Mechanisms of Nociception 2015 Aich, Afrin and Gupta
• Mast Cell Activation Disease and the Modern Epidemic of Chronic Inflammatory Disease  $ Afrin, L 2016
• Mast cells are associated with the onset and progression of Celiac disease 2017 – Frossi, Tripodo, Guarnatta
• Patient perceptions in Mast Cell Disorders 2016 – Jennings, Slee, Zack et al
• Characterisation of Mast Cell Activation Syndrome 2017 Afrin, Self, Menk et al Am J Med Sci PDF (same as next item, better format)
• Characterisation of Mast Cell Activation Syndrome 2016 Afrin, Self, Menk et al Blood
• Mast Cells, Mastocytosis and Related Disorders  $ – Valent, Theoharides, Akin NEMJ July 9, 2015 (need subscription)
• The Presentation, Diagnosis and Treatment of MCAS Sept 2014, Afrin free
• The Spectrum of Mast Cell Disorders $ (Sept 2014, Theoharides et al)
• A concise, practical guide to diagnostic assessment of Mast Cell Activation Disease (2014 Afrin, Molderings) If this link goes down, check here for update: http://www.wjgnet.com/ (one of best, clearest articles on all forms of MCAD)
• Mast Cell Activation Disease: a concise and practical guide for diagnostic workup and therapeutic options (2011) free (still one of the best, most concise summaries, highly recommended)
• Mast Cells Activation Syndromes: Definition and Classification Valent, P 2012 free
• Presentation, Diagnosis and Management of Mast Cell Activation Syndrome (Afrin, L. 2013 pp155-232)  2013 Nova Publishers free
• Mast Cell Mediators: Their Differential Release and The Secretory Pathways Involved – Moon, Befus, Kulka 2014 Frontiers in Immunology
• A Practical Guide for Treatment of Pain in Patients with Systemic Mast Cell Activation Disease 2017 Wirz, Molderings
• Capture of Dr. L. Afrin’s 2011 talk to Canadian Masto Society free
• Mast Cell Activation Syndrome: a newly recognized disorder with systemic clinical manifestations 2010 free
• Neuroinflammation and the blood brain barrier (Theoharides, MD) free
• Utility of Continuous Diphenhydramine (Benadryl)Infusion in Severe MCAS Patients – L. Afrin Dec 2015 free
• Mas-Related G Protein-Coupled Receptor-X2 (MRGPRX2) in Drug Hypersensitivity Reactions 2018 Porebski, Kewiecien, Pawica et al (a non-IgE receptor that can drive some anaphylaxis)
• Comparative analysis of mutation of tyrosine kinase kit in mast cells from patients with systemic mast cell activation syndrome and healthy subjects Molderings et al 2010 $ (Springer)
• Mast Cell Disorders – Andrew M Smith MD, EDNF Conference 2012 free
• Mast Cell Activation Syndrome: a review 2013 free
• Immunology and Clinical Manifestations of Non-Clonal Mast Cell Activation Syndrome Cardet et al 2013
• Definitions, Criteria and Global Classification of Mast Cell Disorders with Special Reference to Mast Cell Activation Syndromes: A Consensus Proposal 2012 Valent, Akin et al
• Twenty-first Century Mast Cell Stabilizers 2013 British Journal of Pharmacology
• Familial Occurrence of Systemic Mast Cell Activation Disease 2013 Molderings et al
• Clinical, biological and molecular characteristics of clonal mast cell disorders presenting with systemic mast cell activation symptoms – Alvarez-Twose 2010
• Systemic Effects of Ingested Lactobacillus Rhamnosus: Inhibition of Mast Cell Membrane Potassium (IKCa) Current and Degranulation 2012 Forsythe, Wang et al
• Utility of hydroxyurea in Mast Cell Activation Syndrome, Afrin, L 2013
• Roads Less Travelled: Sexual Dimorphism and Mast Cell Contributions to Migraine Pathology, Loewendorf, Matynia et al 2016
• Mast cell degranulation and de novo histamine formation contribute to sustained post-exercise vasodilation in humans 2016 Journal of Applied Physiology Romero, McCord et al
• Characterization of Mast Cell Activation Syndrome 2016 Afrin, Self et al Blood
• Hormonal Link to Autoimmune Allergies 2012 Shilpa Shah Univ. of Mumbai
• Groundbreaking Research Links Autism with Histamine, Inflammation and Mast Cell Activation – 2017 (based on 2013 info) via Wake Up World
• The emerging role of mast cells in liver disease – 2017 Jarido, Kennedy, Hargrave et al
• Mast cell interactions with the nervous system: relationship to mechanisms of disease 1997 Dines, Powell
• Emerging roles of granule recycling in mast cell plasticity and homeostasis – forthcoming paper 2017 Flores, Balseiro-Gomez, Ales U of Seville
• Adipose tissue as a dedicated reservoir of functional mast cell progenitors – 2010 Pogio, DeToni-Costas et al
• Midostaurin: a magic bullet that blocks mast cell expansion and activation 2017 Valent, Akin, Hartmann et al
• Mast Cell Activation May Underlie ‘Chronic Fatigue Syndrome’ – Tucker, M 2018 Medscape
• Controlling Mast Cell Activation and Homeostasis: Work Influenced by Bill Paul That Continues Today – April 2018 Kaslin, Kiwanuka, Haque et al
• Advances in the understanding and clinical management of mastocytosis and clonal mast cell activation syndromes 2016 David González-de-Olano, Almudena Matito, […], and Luis Escribano et al
• The Three-Herb Formula Shuang-Huang-Lian stabilizes mast cells through activation of mitochondrial calcium uniporter 2017 Yuan Gao, Rui Hou, […], and Yun Qi
• Postural orthostatic tachycardia syndrome and the potential role of mast cell activation 2018 TaylorA.Doherty, Andrew A. White

Video: Mast Cell Activation Disease: Current Concepts with Particular Notes on Hypermobility and Chronic Pain – Lawrence Afrin, MD 2018 via EDS Wellness/Mast Cell Research
Video: Mast Cell Activation Syndrome webinar with Dr. Larry Afrin, US Hematologist via Chronic Pain Partners June 22, 2016 (since he published Never Bet Against Occam, book)
Video: Introduction to MCAD (June 2015) – Jan Groh for PNW TMS Chapter
Video: Allergies and Mast Cell Activation in EDS Patients Anne Maitland, MD 2014
Video: Mast Cell Activation Syndrome in EDS Patients (Part 2) Anne Maitland, MD 2016
Video: Mast Cell Disorders – free webinar by Dr. Theoharides via Chronic Pain Partners June 2, 2015
Video: My Mystery Symptoms and Mast Cells – featuring Dr. Theoharides and two patients in discussion 2015

Find more up to date videos on both MCAD and EDS at https://chronicpainpartners.com

The Mastocytosis Society MCAD Symptomatology Video on Youtube (3 parts, 45 min total):

• Part I: http://youtu.be/zaPo0r37wEc
• Part II: http://youtu.be/w0ORhV9J5xU
• Part III: http://youtu.be/ME979bUD1J8

HATS – Hereditary Alpha-Tryptasemia Syndrome (new since 2016)

Video: Update from Josh Milner MD of the NIH on study of CTDs (like/including EDS)/MCAD/POTS aka “Familial Tryptasemia” – high tryptase level not required 2015 via Dysautonomia International. See articles below for study results published since October 2016:

• NIH Scientists uncovering genetic explanation for frustrating syndrome Oct 2016
• FAQ’s about the above from the NIH  (added 10/19/16)
• One Gene Mutation Links Three Mysterious, Debilitating Diseases 2016 (Mental Floss)
• NIH Scientists identify a genetic disorder that may affect 1 in 20 (Diana Crowe Science) 2017
• Trypped up by Tryptase? Webinar with Josh Milner, MD via EDS Awareness Aug 2017
• DNA test for elevated tryptase condition now available 2018 via NIH
• Hereditary Alpha Tryptasemia: Genotyping and Associated Clinical Features 2018 Lyons JJ
• Hereditary alpha-tryptasemia modifies clinical phenotypes among individuals with congenital hypermobility disorders 2022 Vasquez, Chovanec, Kim et al

Video: The Bulk of The Iceberg Revealed: Mast Cell Activation Syndrome Dr. L Afrin in South Africa Aug 2014 (slow to load and often buffers)
Podcast on Coffee Klatch: Dr Theoharides – Mast Cell Disorders – April 2015 – announcing connection between autism and MCDs

More on Mast Cells and Connective Tissue Issues:

• The Importance of Mast Cells in Dermal Scarring 2014 Wilgus, Wulff
• Some cases of hypermobile Ehlers-Danlos syndrome may be rooted in mast cell activation 2021 Afrin, L.
• Mechanobiology in the Comorbidities of Ehlers Danlos Syndrome April 25, 2022 Shaina P.Royer and Sangyoon J. Han
• Human Mast Cell beta-Tryptase Is a Gelatinase 2003 Fajardo and Pejler

GI Issues and MCAD

• GI issues with MCAD via JACI online
• Mastocytosis Enterocolitis via The Food Doc
• Mast Cells in Gastrointestinal Disease
• Mast cell-nerve axis with a focus on the human gut 2012
• Mastocytosis and intestinal malabsorption 1970 $
• Mast Cells and Irritable Bowel Syndrome: From the Bench to the Bedside 2016 Zhang, Song and Hou
• Mast cells are associated with the onset and progression of Celiac disease 2017 – Frossi, Tripodo, Guarnatta

Mast Cell Mediators

• Mast Cell Mediators: Their Differential Release and the Secretory Pathways Involved 2014 Frontiers of Immunology – Moon, Befus, Kulka
• Mast Cell Mediators via Mast Attack blog
• Mast Cell-Derived Mediators – Gurish, Castells, MD via Up To Date

Mental Health and Mast Cell Activation Diseases (Masto, HaTS and MCAS)

• Mixed organic brain syndrome as a manifestation of mastocysosis 1986
• Mast Cell Activation in Brain Injury, Stress, and Post-traumatic Stress Disorder and Alzheimer’s Disease Pathogenesis 2017 Kempuraj, Selvakumar, Thangavel et al
• Mast cells’ involvement in inflammation pathways linked to depression: evidence in mastocytosis Molecular Psychiatry 2016
• Many patients find they have signs of histadelia (high arousal, emotional states, depression) from high histamine levels and Histamine Intolerance too.
  Others may find their depression and anxiety affected by their methylation levels as well
• The histamine (mast cell) depression link via Low Histamine Chef YY 2014
• Mast cell activation disease: An underappreciated cause of neurologic and psychiatric symptoms and diseases Pubmed Afrin, Pohlau et al 2015
• Mast cells and neuroinflammation 2014 Dong, Zhang, Qian
• Mast cells, glia and neuroinflammation: partners in crime? Skaper, Facci, Giusti 2014
• Brain mast cells link the immune system to anxiety-like behavior Nautiyal, Ribeiro et al 2008
• Microglia and mast cells: two tracks on the road to neuroinflammation Skaper et al 2012
• Mast cells in neuroinflammation and brain disorders 2017 Hendriksen, van Bergeijk et al
• Mast cells in the brain – Old cells, new target 2017 Traina, Giovanna $

Migraines and Mast Cells

• The role of mast cells in migraine pathophysiology 2005 Theoharides, T
• From too much histamine to too much migraine (effects of both intolerance and MCAD)
• Roads Less Travelled: Sexual Dimorphism and Mast Cell Contributions to Migraine Pathology, Loewendorf, Matynia et al 2016

Enlightening Histamine Articles

• Histamines naturally occurring in foods and why and how to avoid
• Histamine intolerance vs allergy – how to distinguish (Dr. Joneja)
• From too much histamine to too much migraine (effects of both intolerance and MCAD)
• Histamine in Foods via the Allergy & Immunology Associates of Michigan
• Dear Mark: Histamine Intolerance Q blog post on Mark’s Daily Apple
• Serum diamine oxidase activity in patients with histamine intolerance 2016 Manzotti, Breda et al
• A natural antihistamine solution from Dr. Janice Joneja
• Histamine, Inflammation and PMS and PMDD symptoms – Dr. Shannon Reive-Schmidt 2015
• The Curious Link Between Estrogen and Histamine Intolerance – 2016 Lara Briden, ND

The Interaction of Hormones and MCAD

• How Estrogen Dominance Affects Mast Cell Activation Syndrome & Histamine Intolerance
• The role of female sex hormones on MC activity
• Mast Cells in Endometriosis – Tufts University 2004
• Sexual dimorphism in the mast cell transcriptome and the pathophysiological responses to immunological and psychological stress 2016 Mackey, Ayyadurai, Phol et al, Biology of Sex Differences
• Mast cell and eosinophil distribution and activation in human endometrium throughout the menstrual cycle 1995 Jeziorska et al
• Roads Less Travelled: Sexual Dimorphism and Mast Cell Contributions to Migraine Pathology, Loewendorf, Matynia et al 2016
• Hormonal Link to Autoimmune Allergies 2012 Shilpa Shah Univ. of Mumbai
• The neuroendocrinology of mast cells: Challenges and controversies Theoharides 2017
• Progesterone inhibits mast cell secretion 2006 Vasiadi et al

Miscellaneous Links

• My Chemical Free House (blog)
• I Am The Bottom Line – complex patient advocate and health care attorney
• Progesterone and progestins (not MCAS specific, just good info for women and folks with female dominant hormone panels)
• An autoimmune form of urticaria
• IgE-mediated mast cell activation promotes inflammation and cartilage destruction in osteoarthritis 2019 Wang, Lepus, Robinson et al
• Vitamin D contributes to mast cell stabilization 2017 Liu, Li, Qiu et al
• Comprehensive list of corn allergens
• Mast Cells in Allergic Asthma and Beyond 2010 Reuter, Stassen et al
• Mast Cell Activation via Always Well Within
• Autoimmune Epilepsy Gaining Attention – MedScape 2015
• Monitoring Prostaglandin D2 in Vivo – Thorax 2004
• Mast Cell Activation Syndrome and Histamine: When Your Immune System Runs Rampant – Dr. Hoffman, The Hoffman Centre November 2017 (good Cliff notes intro)
• Probiotic Lactobacillus Rhamnosus downregulates FCER1 and HRH4 expression in human mast cells WJG Feb 2011
• Mast Cell and Irritable Bowel Syndrome – from the bench to the bedside 2015
• The role of the Annexin-A1/FPR2 system in the regulation of mast cell degranulation provoked by compound 48/80 and in the inhibitory action of nedocromil 2016
• NIH scientists discover genetic cause of rare allergy to vibration NIH 2016
• Researchers discover new cell type that may explain severe food allergies in some 2015
• Identification of a mast-cell-specific receptor crucial for pseudo-allergic drug reactions Nature 2015
• Abnormal overexpression of mastocytes in skin biopsies of fibromyalgia patients Clinical Rheumatology 2010 via $pringer
• Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder PubMed 2016
• Hymenoptera Allergy and Mast Cell Activation Syndromes 2016
• Immune Modulation of the HPA Axis During Viral Infection 2005 Silverman, Pearce et al
• Mast Cell and Autoimmune Disease 2015 Yunzhi Xu and Guangjie Chen
• Food Intolerance Network – Salicylates Fact Sheet
• Mast Cell Tryptase Contributes to Pancreatic Cancer Growth through Promoting Angiogensis via Activation of Angeiopoeitin-1 Xiangje Guo et al 2016
• “Magic Masto Lotion” via Masto Kids
• 2016 Wellapalooza Physician Presentation Slides (Afrin and Snow, MD)
• Mast Cell Activation Disorders on the Rise 2014 Mark L Fuerst, Medpage
• Human Mast Cell Tryptases: Variation of Form and Function (excerpt) Castells
• Do mast cells hold the key to chronic and unexplained disease? McClure, J. MD Group Health Research Institute 2016
• Prostaglandins, Radiation, and Thermoregulation – Kandasamy, Hunt, chapter in Eicosanoids and Other Bioactive Lipids in Cancer and Radiation InjuryVolume 67 of the series Developments in Oncology pp 189-197 $
• Shared genetic variants suggest common pathways in allergy and autoimmune disease – 2016 Kreiner, Waage et al $
• Mast Cell Activation Syndrome: What do allergies, infections and low platelets have to do with anxiety, depression, ADHD and autism? 2015 Dr. Carlene Wentworth
• AMP-activated protein kinase negatively regulates FcεRI-mediated mast cell signaling and anaphylaxis in mice. 2013 – Hwang, Li, Lu et al Journal of Clinical Allergy & Immunology
• Fasting mitigates immediate hypersensitivity: a pivotal role of endogenous D-beta-hydroxybutyrate – Nutrition & Metabolism 2014 Nakamura et al
• Prevention of anaphylaxis related to mast cell activation syndrome with omalizumab – 2012 Bell, Jackson
• The 1,4-benzodiazepine Ro5-4864 (4-chlorodiazepam) suppresses multiple pro-inflammatory mast cell effector functions 2013
  Omid Sascha Yousefi, Thomas Wilhelm, […], and Michael Huber
• Regulation of plasma histamine levels by the mast cell clock and its modulation by stress – Nakamura, Ishimaru 2017
• Role of Mast Cells in Progressive Renal Diseases – 2008 Holdsworth and Summers
• The Staining of Mast Cells: A Historical Overview 2018 Ribatti, D
• Mitochondrial Uncoupling Protein 2 Inhibits Mast Cell Activation and Reduces Histamine Content* 2009 Tagen, Elorza Kempuraj et al (inc. Theoharides)
• The Zombie Research Institute – may explain the real driver behind “masto naps” or “masto comas” for some of us… (maybe IgG gluten sensitivity)
• Mast Cells in Stress, Pain, Blood-Brain Barrier, Neuroinflammation and Alzheimer’s Disease 2019 Duraisamy Kempuraj1,2*, Shireen Mentor2, Ramasamy Thangavel1,2,  et al.
• Relationship between Vitamin C, Mast Cells and Inflammation 2016, Shaik, Conti
• Research Article: Imperatorin Suppresses Anaphylactic Reaction and IgE-Mediated Allergic Responses by Inhibiting Multiple Steps of FceRI Signaling in Mast Cells: IMP Alleviates Allergic Responses in PCA 2019 Zhemin Xian, Guangyu Jin, Hongmei Li, Jingzhi Jiang, Chongyang Wang, Lianhua Zhu, Zhehu Jin, Liangchang Li, Hongmei Piao, Mingyu Zheng, and Guanghai Yan

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Please notify me of any broken links, thanks! Jan (info@ohtwist.com) Updated 2/11/22