Cardiovascular symptoms in patients with systemic mast cell activation disease

Kolck, Ulrich W.; Haenisch, Britta; Molderings, Gerhard J.

doi:10.1016/j.trsl.2015.12.012

Cited by 6 publications

(4 citation statements)

References 106 publications

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“…Moreover, left ventricular hypertrophy occurred in five of these twelve patients (Kolck, 2009). The same study group also noted that despite some signs of heart failure in MCAS patients, the prevalence of symptomatic chronic heart failure in this setting seemed not to be greater than in the general population (Kolck, Haenisch, & Molderings, 2016). Unfortunately, none of the above-listed studies reported about serum tryptase levels in the studied patients.…”

Section: Chronic Heart Failurementioning

confidence: 88%

Mast cell tryptase – Marker and maker of cardiovascular diseases

Mohajeri

Kovanen

Bianconi

et al. 2019

Pharmacology & Therapeutics

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Section: Chronic Heart Failurementioning

confidence: 88%

Mast cell tryptase – Marker and maker of cardiovascular diseases

Mohajeri

Kovanen

Bianconi

et al. 2019

Pharmacology & Therapeutics

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“…The effects that MCA can have on the cardiovascular system have been extensively described ( 23 ). In our cohort of patients with long-COVID, the benefits of the treatment with antihistamines appear to be particularly interesting regarding cardiovascular symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…In our cohort of patients with long-COVID, the benefits of the treatment with antihistamines appear to be particularly interesting regarding cardiovascular symptoms. The main cardiovascular manifestations are due to the pathological production and release of many mediators, such as histamine, tryptase, vasoactive intestinal polypeptide, and phospholipid metabolites, that usually cause tachycardia and hypotension ( 23 ). Beta-blockers are often used to reduce tachycardia, especially in patients with normal blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation

Salvucci,

Codella,

Coppola

et al. 2023

Front. Cardiovasc. Med.

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IntroductionLong-COVID is a broadly defined condition and there are no effective therapies. Cardiovascular manifestations of long-COVID include high heart rate, postural tachycardia, and palpitations. Previous studies have suggested that mast cell activation (MCA) may play a role in the pathophysiology of long-COVID, including in the mechanisms of its cardiovascular manifestations. The present study aimed to evaluate the effectiveness of a treatment with blockers of histamine receptors in patients with long-COVID who did not respond to other therapies.MethodsIn all, 14 patients (F/M = 9/5; 49.5 ± 11.5 years) and 13 controls (F/M = 8/5; 47.3 ± 8.0 years) with long-COVID symptoms attributed to MCA were evaluated. Patients were treated with fexofenadine (180 mg/day) and famotidine (40 mg/day). Fatigue, brain fog, abdominal disorders, and increased heart rate were evaluated in treated and untreated patients at baseline and 20 days later.ResultsLong-COVID symptoms disappeared completely in 29% of treated patients. There was a significant improvement in each of the considered symptoms (improved or disappeared) in all treated patients, and the improvement grade was significantly greater in treated patients compared to controls. No significant differences in the outcomes were observed in the controls.ConclusionsOur data confirm that histamine receptors blockade may be an effective target to successfully treat long-COVID. Our finding supports the underlying role of MCA in the pathophysiology of long-COVID.

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“…Both diseases are characterized by increased mast cell activation and accumulation of mast cells in a variety of tissues [6]. The symptoms of MCAS and SM patients are very diverse and include abdominal, neurological, cardiological, respiratory, and dermatological complaints [7][8][9][10][11]. The severity of symptoms ranges from mild over severe to life-threatening [12,13].…”

Section: Introductionmentioning

confidence: 99%

Cluster-Analytic Identification of Clinically Meaningful Subtypes in MCAS: The Relevance of Heat and Cold

et al. 2023

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Background Mast cell activation syndrome (MCAS) is a clinically heterogeneous disease with allergy-like symptoms and abdominal complaints. Its etiology is only partially understood and it is often overlooked. Aims The aim of this study was to identify subgroups of MCAS patients to facilitate diagnosis and allow a personalized therapy. Methods Based on data from 250 MCAS patients, hierarchical and two-step cluster analyses as well as association analyses were performed. The data used included data from a MCAS checklist asking about symptoms and triggers and a set of diagnostically relevant laboratory parameters. Results Using a two-step cluster analysis, MCAS patients could be divided into three clusters. Physical trigger factors were particularly decisive for the classification as they showed remarkable differences between the three clusters. Cluster 1, labeled high responders, showed high values for the triggers heat and cold, whereas cluster 2, labeled intermediate responders, presented with high values for the trigger heat and low values for cold. The third cluster, labeled low responders, did not react to thermal triggers. The first two clusters showed more divers clinical symptoms especially with regard to dermatological and cardiological complaints. Subsequent association analyses revealed relationships between triggers and clinical complaints: Abdominal discomfort is mainly triggered by histamine consumption, dermatological discomfort by exercise, and neurological symptoms are related to physical exertion and periods of starvation. The reasons for the occurrence of cardiological complaints are manifold and triggers for respiratory complaints still need better identification. Conclusion Our study identified three distinct clusters on the basis of physical triggers, which also differ significantly in their clinical symptoms. A trigger-related classification can be helpful in clinical practice for diagnosis and therapy. Longitudinal studies should be conducted to further understand the relationship between triggers and symptoms.

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Cardiovascular symptoms in patients with systemic mast cell activation disease

Cited by 6 publications

References 106 publications

Mast cell tryptase – Marker and maker of cardiovascular diseases

Mast cell tryptase – Marker and maker of cardiovascular diseases

Antihistamines improve cardiovascular manifestations and other symptoms of long-COVID attributed to mast cell activation

Cluster-Analytic Identification of Clinically Meaningful Subtypes in MCAS: The Relevance of Heat and Cold

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