Mast cell

Mast cells are considered to have originated nearly 500 million years ago, in urochordates, making them one of the most ancient types of immune cells. Mast cells (MCs) are specialized immune cells derived through hematopoiesis, the formation of blood cell components. Mast cells develop from circulating mast cell progenitors (MCps). Once they are recruited to a given type of connective or mucosal tissue, they specialize and become resident mast cells. Mature MCs exhibit context-specific effector properties related to tissue types and diseases, and are highly varied. Mast cells in different tissues, such as gut and skin, will exhibit different physical, behavioral, and biochemical characteristics and functions. Mast cells may have dual methods of origin in the hematopoietic system. Tissue-resident immune cells may be either fetal-derived or the progeny of adult HSCs. During embryonic development, mast cell progenitors (MCps) form in a series of developmentally discrete waves. (E7.5-E8.5). eMPPs and HSCs start producing mature hematopoietic cells in in the fetal liver around E12.5 and E14.5 respectively. ==Structure==

Mast cells are highly versatile immune cells that first appear during fetal development. Individual mast cells likely reflect the processes by which they originally develop as well as the microenvironments where they mature. Once mast cell progenitors reach a destination tissue, they mature into resident granulated mast cells. Mature resident mast cells are categorized based on their tissue location, granule protease content, and functional characteristics. In rodents, the two major categories of mature mast cells are connective tissue-resident mast cells (CTMCs) and mucosal mast cells (MMCs). Connective tissue mast cells contain heparin and large amounts of histamine and carboxypeptidase in their granules, and are distributed in the skin, peritoneal cavity, intestinal submucosa, and perivascular space around blood vessels. Mucosal mast cells predominantly contain chondroitin sulfate with small amounts of histamine and carboxypeptidase and are distributed in the mucosa of the lung and gastrointestinal tract. CTMCs express high levels of mouse mast cell protease (mMCP)-4,-5 (chymases) and -6,-7 (tryptases), but not mMCP-1 and-2 (chymases), whereas MMCs express mMCP-1 and -2 and not mMCP-4,-5 and -6. In humans, three main categories of MCs have been identified based on the proteases they express. MCT expresses tryptase and resides primarily in mucosa of the lung and small intestine. MCTC expresses tryptase, chymase, and carboxypeptidase and resides primarily in the skin, lymph nodes, and lung and gut submucosa. ~98% of all mast cells in the mucosa of the human small intestine are MCT, while only ~13% of MCs in submucosa are MCT. A third form, MCC, expresses chymase but not tryptase. MCT somewhat resembles rodent MMC, while MCTC somewhat resembles rodent CTMC. ==Function==

Mast cells are seen as "first responders" that deal with pathogens by alerting other immune cells and coordinating immune responses in the innate and acquired immune systems. When activated, a mast cell can either selectively release (piecemeal degranulation) or rapidly release (anaphylactic degranulation) compounds or mediators from storage granules into the local environment. In addition to the rapid release of pre-formed stored mediators, mast cells can also secrete newly synthesized mediators. Dysfunction of mast cells is linked to a variety of diseases Signaling pathways for mast cell activation Specific signaling pathways of mast cells in different tissues provide mechanisms by which the immune system detects and is organized to deal with potential threats. Mast cells use a variety of cell surface receptors to detect pathogens. The best known pathway involves FcεRI, a high-affinity receptor for the Fc region of IgE antibodies, involved in allergies. As a molecular target, FcεRI initiates various outcomes in mast cells (MCs) in response to antigens (Ags). Ags bind to immunoglobulin E (IgE) that is bound to FcεRI to cause the crosslinking of IgE–FcεRI complexes and trigger mast cell activation. Activation leads within minutes to degranulation of mast cells and the release of mediators such as histamine, serotonin, and leukotrienes, followed over a period of hours by the secretion of cytokines, chemokines, and growth factors. FcεRI regulates the Ag–IgE interaction, driving allergic responses. FcεRI clustering controls signal transduction and the quality of MC responses. Under resting conditions in the cell membrane, the IgE–FcεRI complex diffuses freely. Multivalent Ag binding to IgE reorganizes FcεRI within seconds to minutes, forming large aggregates on the cell surface, and causing a transition in the receptor from a diffuse to an immobile state. Small aggregates remain mobile on the cell surface, whereas large aggregates abruptly become immobile. Changes in the mobility, kinetics, and size of FcεRI clusters may govern signal initiation and termination. In addition to IgE-dependent MC activation, forms of IgE-independent MC activation have been studied. One of these involves MRGPRX2, a G protein-coupled receptor (GPCR). The MRGPRX2 activation pathway in humans involves four primate-specific families of MRGPRX genes (MRGPRX1-X4) as well as the MrgprD-H families, while the MrgprA, MrgprB and MrgprC families are specific to rodents. MRGPRX2 recognizes a wide variety of basic amino acids and low-molecular-weight compounds without amino acid sequence motifs. Metabolic mechanisms in IgE mediated and non-IgE mediated MC activation are not well understood. Healthy mitochondrial respiration involves maximal production of adenosine triphosphate (ATP) and minimal production of reactive oxygen species (ROS). • Pre-formed mediators stored in granules • biogenic amines (histamine, serotonin, dopamine) • Newly synthesized inflammatory mediators • lipid mediators (eicosanoids, thromboxane, LTB4, LTC4, PAF, PGD2) • neuropeptides (CRH, VIP) • growth factors (PDGF, GnRH) • chemokines (MCP-1, eotaxin, TARC, RANTES) • cytokines (IL-1, IL-3, IL-6, IL-18, SCF, TGF-β) Enzymes Enzymes are involved in internal processes within mast cells including signaling pathways for mast cell activation and other mechanisms regulating cellular functions. They can include: ==Physiology==

IgE-dependent activation , in the cytoplasmic region. Each γ chain has one ITAM on the cytoplasmic region. The signaling cascade from the receptor is initiated when the ITAMs of the β and γ chains are phosphorylated by a tyrosine kinase. This signal is required for the activation of mast cells. Type 2 helper T cells,(Th2) and many other cell types lack the β chain, so signaling is mediated only by the γ chain. This is due to the α chain containing endoplasmic reticulum retention signals that causes the α-chains to remain degraded in the ER. The assembly of the α chain with the co-transfected β and γ chains mask the ER retention and allows the α β γ complex to be exported to the golgi apparatus to the plasma membrane in rats. In humans, only the γ complex is needed to counterbalance the α chain ER retention. This antigen stimulated phosphorylation causes the activation of other proteins in the FcεR1-mediated signaling cascade. LAT and Protein kinase C activation An important adaptor protein activated by the Syk phosphorylation step is the linker for activation of T cells (LAT). LAT can be modified by phosphorylation to create novel binding sites. IgE-independent activation The most versatile IgE-independent receptor is known as MrgprB2 in mice and MRGPRX2 in humans. These receptors can recognize many different, mostly positively charged compounds. MrgprB2 is expressed in connective tissue mast cells but not in mucosal mast cells of mice. Binding of ligands to MrgprB2 results in activation of G-protein-signaling pathways. Mast cell activation induces the release of antibacterial mediators including ROS, TNF-α and PRGD2 which institute the recruitment of other immune cells to inhibit bacterial growth and biofilm formation. ==Clinical significance==

Allergic disease MCs are linked to allergic diseases including allergic asthma, food allergies and atopic dermatitis (eczema). Other forms of cutaneous mediated in large part by mast cells include itch (from various causes), and allergic conjunctivitis. Allergies generally result from reduced tolerance to environmental factors which causes Type 2 inflammation characterized by increased TH2 cytokines and IgE antibodies. Allergens are recognized by specific IgE antibodies bound to FcεRI receptor on the surface of tissue MCs, triggering degranulation and the release of mediators including histamine and tryptase. Calcium triggers the secretion of histamine from mast cells after previous exposure to sodium fluoride. The secretory process can be divided into a fluoride-activation step and a calcium-induced secretory step. It was observed that the fluoride-activation step is accompanied by an elevation of cyclic adenosine monophosphate (cAMP) levels within the cells. The attained high levels of cAMP persist during histamine release. It was further found that catecholamines do not markedly alter the fluoride-induced histamine release. It was also confirmed that the second, but not the first, step in sodium fluoride-induced histamine secretion is inhibited by theophylline. Vasodilation and increased permeability of capillaries are a result of both H1 and H2 receptor types. Stimulation of histamine activates a histamine (H2)-sensitive adenylate cyclase of oxyntic cells, and there is a rapid increase in cellular [cAMP] that is involved in activation of H+ transport and other associated changes of oxyntic cells. Antihistamine drugs act by blocking histamine action at nerve endings. Cromoglicate-based drugs (sodium cromoglicate, nedocromil) block a calcium channel essential for mast cell degranulation, stabilizing the cell and preventing release of histamine and related mediators. Leukotriene antagonists (such as montelukast and zafirlukast) block the action of leukotriene mediators. Anaphylaxis A systemic allergic response can cause life-threatening anaphylaxis. Products released from these granules include histamine, serotonin, heparin, chondroitin sulphate, tryptase, chymase, carboxypeptidase, and TNF-α. Chronic urticaria Chronic urticaria (CU) is characterized by wheal and flare symptoms of the skin lasting more than six weeks at a time. Symptoms of CU appear to be caused by the degranulation of mast cells in skin. CU has two subtypes: chronic inducible urticaria (CIndU, identifiable triggers) and chronic spontaneous urticaria (CSU, unpredictable triggers). In type I CSU, IgE autoantibodies are directed against self-antigens. In type IIb CSU, autoantibodies are directed against IgE or FcεRI. The incidence and prevalence of MCAD's subcategories of mastocytosis and MCAS have not yet been established through epidemiological studies. Mastocytosis Mastocytosis involves both excessive accumulation and activation of mast cells and is considered a primary type of mast cell activation disorder (MCAD). Symptoms of mastocytosis depend upon the organs involved. Although not always present, mutations in KIT appear to result in uncontrolled growth of MCs. The KITD816V mutation is present in over 90% of mastocytosis patients. It is located in exon 17 in the intracellular tyrosine kinase 2 (TK2) domain. Three criteria are considered a standard for an MCAS diagnosis: Since many clinical conditions can display symptoms similar to those resulting from MC activation, caution is recommended in the diagnosis of MCAS. It is essential to confirm that symptoms derive from MC activation and mediator release, not other mechanisms. Given a diagnosis of MCAS as described above, various subclassifications of MCAS have been proposed depending on the presence of specific pathologies or triggers. MCAS may be considered primary (if KIT genetic mutations or clonal MCs in bone marrow are detected), secondary (if IgE-mediated or non-IgE-mediated allergy mechanisms are present), combined (involving multiple variants), or idiopathic (if specific causes cannot be identified). or an initiator for a subcategory of MCAS. Preliminary research Mast cells have been suggested to play a role in a wide variety of additional conditions, with differing degrees of evidence. They are suggested to play important roles in angiogenesis, atherosclerosis, fibrosis, and tissue regeneration. MCs are present in the nervous system, where they are known to interact with microglia, astrocytes, neurons, and endothelial cells, and may affect permeability of the blood-brain barrier. MCs are suspected of playing a role in brain inflammation in disorders such as Alzheimer's disease, Parkinson's disease and Amyotrophic lateral sclerosis. A connection to neurodevelopmental problems in autism spectrum disorder (ASD) has also been suggested. In some areas the role of MCs is uncertain or is being reassessed. This includes autoimmune and inflammatory disorders involving the joints, muscles, and tendons such as rheumatoid arthritis, psoriatic arthritis, heterotopic ossification, and gout. In the gastrointestinal tract, mast cells communicate bidirectionally with neurons by producing histamine, serotonin and tryptase. Mast cell-neuron interactions may be linked to pain and inflammation in food allergies and irritable bowel syndrome (IBS). It appears that MCs affect the evolution of digestive system tumors. However, MCs appear to both promote and inhibit tumor progression through a variety of mast cell-derived mediators and interactions with immune cells, cancer cells, and bacteria. ==Drug treatments==

Given the heterogeneity of mast cells and the complexity of the processes by which they release mediators, many compounds can affect mast cell behavior with both intended and unintended results. These include antihistamines, vitamins, glucocorticosteroids, monoclonal antibodies (mAbs), and flavonoids. ==History==

Mast cells were first described by Friedrich von Recklinghausen. In 1863 he reported the presence of granulated cells in connective tissues, observed in unstained cells of various species. They were later rediscovered and named in 1878 when Paul Ehrlich described the cells in terms of their unique staining characteristics and large granules. These granules led him to the incorrect belief that they existed to nourish surrounding tissue, so he named them Mastzellen or well-fed cells (). In 1937, Holmgren and Wilander found that tissues rich in mast cells also contained large amounts of heparin. In 1952, Riley and West identified mast cells as a storage location for histamine. That mast cells released both heparin and histamine was demonstrated by Rocha e Silva in 1947. As a result of such work MCs became a major focus of allergy research. By 1999, mast cells were considered to be critical sentinel cells in the immune system. Toluidine blue is one of the most common stains for acid mucopolysaccharides and glycoaminoglycans, components of mast cells granules. It is used in tissue sections to highlight components. Mast cell granules exhibit metachromasia, characteristic changes in color when stains bind to particular substances in biological tissues. In mast cell granules, toluidine blue attaches to glycosaminoglycans such as heparin and displays a purple color while other cells retain the color of the blue stain. Mature connective tissue mast cells display the effect of staining more quickly and intensively than mucosal cells and immature connective tissue mastocytes. The combined use of alcian blue and safranin О can be used to simultaneously detect both connective and mucosal mast cells. Heparin-containing mastocyte granules are stained pink and red by safranin, while those that do not contain heparin are stained blue by alcian blue. Hematoxylin & Eosin (H&E) staining is non-effective for selective mast cell staining because hematoxylin does not bind to mast cell granule components. It can be used to counterstain cellular nuclei of mastocytes. Newer diagnostic tools include the measurement of mast cell mediators in urine. Such mediators can be more easily obtained during symptoms and at baseline. Mediators that are unstable molecules (e.g. histamine, cysteinyl leukotrienes, and prostaglandin D2) are difficult to use as biomarkers. Surface markers which bind to receptors on the MC surface include FcεRI, CD117, CD63, CD69, CD203c, and CD107a/b. They can be detected by flow cytometry and some may be used for the detection of cells in mastocytosis. However, they have not been validated as biomarkers of MC activation. It may be difficult to differentiate adult mast cells and stem or progenitor cells because both express markers like CD117 and FcεRI. ==See also==