Mast cells (MCs) recognize antigens (Ag) via IgE-bound high affinity IgE receptors (FcεRI) and trigger type I allergic reactions. FcεRI-mediated MC activation is regulated by various G protein-coupled receptor (GPCR) agonists. We recently reported that ionotropic P2X4 receptor (P2X4R) stimulation enhanced FcεRI-mediated degranulation. Since MCs are involved in Ag-independent hypersensitivity, we investigated whether co-stimulation with ATP and GPCR agonists in the absence of Ag affects MC degranulation. Prostaglandin E 2 (PGE 2 ) induced synergistic degranulation when bone marrow-derived MCs (BMMCs) were co-stimulated with ATP, while pharmacological analyses revealed that the effects of PGE 2 and ATP were mediated by EP3 and P2X4R, respectively. Consistently, this response was absent in BMMCs prepared from P2X4R-deficient mice. The effects of ATP and PGE 2 were reduced by PI3 kinase inhibitors but were insensitive to tyrosine kinase inhibitors which suppressed the enhanced degranulation induced by Ag and ATP. MC-dependent PGE 2 -triggered vascular hyperpermeability was abrogated in a P2X4R-deficient mouse ear edema model. Collectively, our results suggest that P2X4R signaling enhances EP3R-mediated MC activation via a different mechanism to that involved in enhancing Ag-induced responses. Moreover, the cooperative effects of the common inflammatory mediators ATP and PGE 2 on MCs may be involved in Ag-independent hypersensitivity in vivo. MC degranulation [6]. For instance, it has been shown that PGE 2 , which is known to mediate inflammation [7], and adenosine, which accumulates extracellularly under ischemic conditions [8], enhance Ag-mediated MC degranulation [9][10][11]. The effects of PGE 2 and adenosine are mediated by the EP3 receptor (EP3R) and A 3 receptor (A 3 R), respectively, and are commonly transmitted via the pertussis toxin (PTX)-sensitive Gi protein, suggesting a similar underlying mechanism. Indeed, several studies have demonstrated that enhancing Ag-induced MC degranulation by co-stimulation with Gi-coupled receptor agonists requires the activation of phosphoinositide 3-kinase (PI3K) γ, a PI3K subclass regulated by the Gi protein βγ subunit [10,11]. These enhanced responses are thought to be involved in exacerbating allergic reactions.In addition to Gi-coupled receptor agonists, we recently reported that extracellular ATP also enhances the Ag-induced degranulation response in bone marrow-derived MCs (BMMCs) by activating the P2X4 receptor (P2X4R), a ligand-gated ion channel [12]. Unlike Gi-coupled receptor agonists, P2X4R stimulation does not induce the PI3K signaling pathway, but enhances the Ag-induced tyrosine phosphorylation of signaling molecules including Syk and phospholipase C (PLC) γ [13]. Based on these results, we hypothesized that stimulation of MCs with ATP and Gi-coupled receptor agonists may cause MC degranulation in an IgE-independent manner. Indeed, we previously showed that co-stimulating BMMCs with ATP and adenosine induced synergistic degranulation via A 3 R [12].With respect...