Studies Confirm Links Between Mast Cells and Viral Disease Like COVID 19
As the SARS CoV2 virus behind COVID 19 continues to mutate and sweep over us a wave at a time, research into the role of mast cells in this and other viral diseases continues to find connections. With those connections, we can begin to offer some support for our immune defenses. In a review from December of last year, a group of researchers combed the medical literature for any studies that looked at the roles of mast cells and basophils (another immune cell) in viral diseases. Normally, these immune cells are more widely known for their role in allergic conditions, but in their article they provide a review of what we know about these cells and viral conditions.
Focusing for now on mast cells, we remind ourselves that these cells reside primarily on our tissues and connect the innate and acquired arms of our immune system. While the innate arm is poised and ready to execute a quick, broad attack on anything that bears resemblance to an invader, the adaptive arm acts in a more targeted fashion and therefore requires a little time to mount a defense. The quick acting innate immunity and the slower adaptive immunity work well together to defend us from most infections, but they must communicate in order to manage this combined defense. Mast cells help carry out this coordination.
As many viruses enter our bodies, they need time and our cells’ machinery to reproduce, so they must disrupt the immune defense system. The better they do this, the better they reproduce and spread. That makes it very unsurprising that viruses would impact on the mast cells in their central role of cross-communication.
In the review, the authors considered mast cells in regards to not only SARS CoV2, but also HIV, flu, and dengue fever. In reviewing the work of others, they found that mast cells are stimulated by SARS CoV2 infections to release various immune messengers called cytokines. This stimulation occurs through a variety of mechanisms mentioned in the article, but more importantly, as the variety and strength of the stimulation builds, ultimately overstimulation of mast cells is shown to contribute to cytokine storms. This cytokine storm process is known to contribute to the severity of COVID 19 in many patients.
One interesting finding concerns the ACE2 receptor being on mast cells. A lot of research has focused on the role of ACE2 binding with spike protein from the virus to trigger hyper-inflammatory states. Mast cells also have ACE2 receptors and are triggered to release inflammatory mediators when spike binds their ACE2 receptors. The role of mast cells in COVID 19 severity is further bolstered by the epidemiologic finding that atopic (allergic) patients appear to have lower COVID 19 severity. This could be related to their use of mast cell stabilizers and antihistamines which would block some of mast cell’s effects.
Without getting into the weeds of the science or looking further into the other viral processes reviewed in the article, I must say that these findings support what we have been seeing in our clinic in caring for COVID and Post COVID patients. Many of our patients who already had mast cell activation suffered flares of this condition when infected with COVID. Many patients who we ultimately diagnosed with Post COVID syndrome that included mast cell activation often could remember prior milder mast cell type symptoms before the infection that were amplified by the virus. Furthermore, many therapies that had helped our mast cell patients also helped our Post COVID patients.
Overall, I would agree with this article and encourage further research into these areas. While I don’t have the time nor resources to do such research myself, I appreciate those who do that research so we can apply their discoveries to our patients suffering from mast cell activation symptoms and/or Post COVID struggles. Helping our patients restore healthier, more abundant lives always includes incorporating the latest research findings that offer hope to those who have been hopeless and find the root cause to their chronic illness.
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Original Article:
Gammeri, L., Sanfilippo, S., Alessandrello, C., Gangemi, S., & Minciullo, P. L. (2024). Mast Cells and Basophils in Major Viral Diseases: What Are the Correlations with SARS-CoV-2, Influenza A Viruses, HIV, and Dengue?. Cells, 13(24), 2044. https://doi.org/10.3390/cells13242044
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.
