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Review
. 2024 Nov 24;25(23):12615.
doi: 10.3390/ijms252312615.

Mast Cells in Allergic and Non-Allergic Upper Airways Diseases: Sentinel in the Watchtower

Giovanni Costanzo  1 , Marta Marchetti  1 , Andrea Giovanni Ledda  2 , Giada Sambugaro  2 , Martina Bullita  2 , Giovanni Paoletti  1   3 , Enrico Heffler  1   3 , Davide Firinu  2 , Giulia Anna Maria Luigia Costanzo  2
Affiliations
Review

Mast Cells in Allergic and Non-Allergic Upper Airways Diseases: Sentinel in the Watchtower

Giovanni Costanzo et al. Int J Mol Sci. .

Abstract

Mast cells are immune system cells with the most disparate functions, but are also among the least understood. Mast cells are implicated in several known pathological processes, tissue homeostasis, and wound repair. However, they owe their notoriety to allergic diseases, of which they represent the effector cell par excellence. In both allergic and not upper airway pathologies, mast cells play a key role. Exploring the mechanisms through which these cells carry out their physiological and pathological function may help us give a new perspective on existing therapies and identify new ones. A focus will be placed on non-allergic rhinitis, a poorly recognized and often neglected condition with complex management, where the role of the mast cell is crucial in the pathogenetic, clinical, and prognostic aspects.

Keywords: allergy; mast cells; nasal polyps; non-allergic rhinitis; rhinitis; rhinosinusitis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
In the figure, it is shown how, when pollen comes into contact with the nasal mucosa of a person sensitized to this allergen, mast cells release histamine, tryptase, prostaglandins, and type 2 cytokines, including interleukin-4 (IL-4) and IL-13. Through degranulation, mast cells also indirectly promote the synthesis of IgE in B cells and contribute to the class switch of T cells from Th0 to Th2. Both Th2 lymphocytes and mast cells themselves are a source of IL-5, a molecule that amplifies the generation, survival, and activation of eosinophils. Ultimately, mast cells contribute to the shift from the Th0 to Th2 immune response. Created in BioRender.
Figure 2
Figure 2
In the figure, the four main subgroups in non-allergic rhinitis (NAR) are shown with the respective main comorbidities: NARNE (NAR with neutrophils), NARES (NAR with eosinophilic syndrome), NARMA (NAR with mast cell), and NARESMA (NAR with eosinophils and mast cell). Acronyms: Gastroesophageal Reflux Disease (GERD); Aspirin-Exacerbated Respiratory Disease (AERD); Obstructive Sleep Apnea Syndrome (OSAS). Created in BioRender.
See this image and copyright information in PMC

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