Extroverts generally love being the center of attention, and if mast cells are extroverts, they’re very happy right now, because they are getting a ton of attention from researchers and headlines. While mast cells have been around in our bodies for centuries and known for decades, the past 10 years seem to be the decade of the mast cell. This is especially true as COVID brought more attention to mast cell activation disorder which often manifests in long COVID patients. Today, researchers provide us some ideas for calming down mast cells in anaphylaxis patients.
If you have experienced anaphylaxis or watched it, you will never forget the sheer terror of feeling your body shut down especially if your throat swells closed or your lungs tighten up and prevent oxygen intake. For some, this is how an otherwise benign substance, even foods, can become a threat to life. The immune system mistakes the benign substance for a threat and releases all immune hands-on deck to fight it, including histamine. Besides the throat and lungs described, a person’s blood pressure can drop, full body hives can occur, they can experience a diarrheal GI system flush-out, and more.
As stated earlier, mast cells are gaining more and more attention as research reveals their central role in this process. Initially, IgE, a type of antibody produced by B Cells in our immune system was the primary suspect in anaphylaxis. While this IgE antibody plays a significant role, the recurring revelations of mast cell involvement make this immune cell more and more famous. These cells live in the “surfaces” of our bodies like skin, nasal cavity, oral cavity, the entire GI tract, the bladder, and even the covering of the brain. They live around blood vessels as they release their chemicals onto these blood vessels to increase blood flow and release of other cells through those vascular walls into the tissue surrounding the blood vessels. These chemicals cause the swelling, the blood pressure drop, and the constriction of lung airways that we see in anaphylaxis and other allergic diseases.
The new research by Duke scientists revealed greater insight into the mechanisms by which mast cells are activated and release their chemicals. Prior research clearly indicated that the mast cells stored little granules of these chemicals so they could release them in larger quantities when triggered. They found that a component within these cells played a critical role in triggering the release of these chemicals (mainly histamine). An assembly of proteins called an inflammasome helped move these granules from the center of the cell to the surface for release.
If you have read much about COVID over the past few years, the term inflammasome may sound familiar. Inflammasomes had been found to play a critical role in the severity of COVID infections. Overactive inflammasomes tended to produce more severe viral infections and the hyper-inflammatory cascade. Now we see that inflammasomes are contributing to anaphylactic over-responses.
As the Duke researchers now search for various drugs to suppress these inflammasomes and hopefully lower the risk of anaphylaxis, we can look at some already available natural remedies and be pleasantly surprised at what we have available. Several of these noted in the referenced paper have shown benefit in our mast cell patients (who have mast cell activation disorder, a condition similar but still different than traditional anaphylaxis) and in COVID patients during acute and post COVID situations.
Quercetin sources from a variety of plants inhibits a protein in inflammasomes, lowering mast cell activation. Ginsenosides from ginseng can lower inflammasome activation through lowering reactive oxygen species. Artemesinin that we used for parasites and Lyme therapy works through NF-kappa B to lower inflammasome activation. Resveratrol sourced from wine, grapes, and Japanese knotweed lowers autophagy activated inflammasome activity. Astaxanthin from seafood and algae can inhibit inflammasome activation. These are just a few of the 27 phytochemicals listed in the referenced paper (Ding et al 2020).
As researchers continued to search the magic-bullet drug, we find many of these phytochemicals to be very helpful in calming our allergic patients, our mast cell patients, and our anaphylaxis patients. While these natural options do not mean anaphylaxis patients can go eat peanuts or whatever triggers their reactions, it does seem to lessen the intensity of accidental exposures which happen occasionally. As we help them restore healthier more abundant lives, understanding the mechanisms behind our therapies reassures us that we are on the right path.
Primary Article:
Andrea Mencarelli, Pradeep Bist, Hae Woong Choi, Hanif Javanmard Khameneh, Alessandra Mortellaro, Soman N. Abraham. Anaphylactic degranulation by mast cells requires the mobilization of inflammasome components. Nature Immunology, 2024; 25 (4): 693 DOI: 10.1038/s41590-024-01788-y
Thanks to Science Daily:
Duke-NUS Medical School. “First step in allergic reactions, paving the way for new preventative strategies.” ScienceDaily. ScienceDaily, 4 June 2024. <www.sciencedaily.com/releases/2024/06/240604132027.htm>.
Secondary Reference:
Ding, Nan et al. “Natural Products that Target the NLRP3 Inflammasome to Treat Fibrosis.” Frontiers in pharmacology vol. 11 591393. 17 Dec. 2020, doi:10.3389/fphar.2020.591393
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
