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Review
. 2024 Feb;24(2):33-38.
doi: 10.1007/s11882-024-01128-y. Epub 2024 Jan 18.

Urine Mast Cell Mediators in the Evaluation and Diagnosis of Mast Cell Activation Syndrome

Dayne Voelker  1 , Thanai Pongdee  2
Affiliations
Review

Urine Mast Cell Mediators in the Evaluation and Diagnosis of Mast Cell Activation Syndrome

Dayne Voelker et al. Curr Allergy Asthma Rep. 2024 Feb.

Abstract

Purpose of review: Mast cell activation syndrome is defined by severe, episodic, and recurrent symptoms induced by mast cell mediators with objective measurement of increase in biomarkers of mast cell activation and treatment response with mast cell therapies. Increase in serum tryptase from baseline during a mast cell activation episode is currently the most accepted biomarker measurement of mast cell release. However, during symptomatic episodes, serum tryptase can be difficult to obtain as it is a venipuncture procedure. Other objective measures of mast cell activation are needed to complement serum tryptase.

Recent findings: Urine mast cell mediators can be collected at home and are non-invasive tests. There is emerging evidence for the utility of urine mast cell mediators including histamine, cysteinyl leukotrienes, and prostaglandins in the diagnosis of mast cell activation syndrome. In this review, clinically available urine mast cell mediators will be discussed including N-methylhistamine, leukotriene E4, and 2,3-dinor-11beta-prostaglandin F2 alpha. We discuss the rationale for the use of these urine mast cell mediators and examine the studies analyzing their performance for identifying mast cell activation.

Keywords: 2,3-Dinor-11beta-prostaglandin F2 alpha; Leukotriene E4; Mast cell; Mast cell activation syndrome; N-methylhistamine.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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