The role of mast cells is complex. They are an important component of the innate immune system. Emerging research supports the role of mast cells in the adaptive immune system as well. Mast cells are both sensors and effectors in communication among nervous, vascular and immune systems. They interact bi-directionally with the nervous system. They are found on the brain side of blood vessels adjacent to astrocytes and microglia and are involved in cross-talk with the various components of the nervous system while also maintaining their role in the immune system. Autoimmunity and Neuroinflammation are two major consequences of aberrant mast cell activity.
To understand how mast cell activation syndrome (MCAS) promotes an autoimmune or autoimmune-like response and ultimately neuroinflammation in patients presenting with neuropsychiatric illness.
Eight patients between the ages of 5-25 were evaluated for persistent neuropsychiatric illness unresponsive to treatment including psychiatric medication. Testing was performed for evaluation of mast cell activation syndrome. Additional testing for general autoimmune markers, auto-neuronal antibodies and other markers of inflammation were also performed.
All patients were confirmed to have mast cell activation syndrome by the consensus-2 criteria. All patients had evidence of at least one autoimmune marker as well, and 6 out of 8 of them had specific anti-neuronal antibodies. Treatment with mast cell targeted therapy had a significant effect on the neuropsychiatric manifestations in these patients.
Patients with neuropsychiatric symptoms should be evaluated by the proper healthcare professional for mast cell activation syndrome and mast cell targeted treatment should be initiated if the diagnosis is confirmed.
- Define mast cell activation syndrome (MCAS) and the function of mast cells in the innate and acquired immune system and how that impacts the development of autoimmunity.
- Recognize the role of mast cells in the nervous system and how mast cell activation contributes to neuroinflammation and neuronal autoimmunity.
- Identify mast cell targeted treatment within scope for your profession or recognizing when to refer for neuropsychiatric manifestations in patients unresponsive to traditional interventions.