Successful mast-cell-targeted treatment of chronic dyspareunia, vaginitis, and dysfunctional uterine bleeding

Afrin, Lawrence B.; Dempsey, Tania T.; Rosenthal, Lila S.; Dorff, Shanda R.

doi:10.1080/01443615.2018.1550475

Cited by 15 publications

(15 citation statements)

References 16 publications

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“…42 In one study, it was postulated mast cells could be targeted to minimise these recurring in ammatory processes underlying endometriosis. 43 Mast cell activation is also associated with other endometriosis co-morbidities such as dyspareunia, 44 dysfunctional uterine bleeding, 45 an increased risk of pelvic pain 46 and has an increased effect on women. 39 As endometrial tissue and lesions are rich in mast cells, a diet free from A1 casein may therefore mitigate endometriosis pain by reducing mast cell activation and subsequent histamine release in endometrial tissues.…”

Section: Discussionmentioning

confidence: 99%

Dietary Practices of Women with Endometriosis: A Cross-Sectional Survey

Armour

Middleton²,

Lim

et al. 2021

The Journal of Alternative and Complementary Medicine

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Background: Endometriosis causes deleterious effects on the lives of sufferers across multiple domains impacting quality of life. Commonly utilised pharmaceutical interventions offer sub-optimal e cacy in addition to potentially intolerable side effects for many women. There is some evidence for dietary therapies reducing endometriosis symptoms but little data on dietary preferences / strategies used, and their impact, in a community setting. Methods: A cross-sectional online survey was conducted between October and December 2017 to investigate the self-management strategies employed by women with endometriosis. Participants were aged 18-45 years, living in Australia and had a surgically con rmed diagnosis of endometriosis.Results: Four hundred and eighty-four responses were included for analysis, with 76% of women reporting the use of general self-management strategies within the last six months. Of these, 44% of respondents reported using dietary strategies for symptom management. Reducing or eliminating gluten, reducing or eliminating dairy and the low FODMAP diet were the most commonly reported dietary strategies utilised.Respondents reported a 6.4/10 effectiveness score for reduction in pelvic pain with dietary changes, with no difference in pain reduction between the various diets used. Further, women self-reported signi cant improvements in co-morbidities such as gastrointestinal disturbance (39%), nausea and vomiting (15%) and fatigue (15%). Conclusions:Dietary modi cations are a very common self-management strategy employed by people with endometriosis, with the greatest bene t reported on gastrointestinal symptoms. Reducing or eliminating gluten, dairy or FODMAPs, or a combination of these, were the most common strategies. No single diet appeared to provide greater self-reported bene ts than others.

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Section: Discussionmentioning

confidence: 99%

Dietary Practices of Women with Endometriosis: A Cross-Sectional Survey

Armour

Middleton²,

Lim

et al. 2021

The Journal of Alternative and Complementary Medicine

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“…Generally, those favoring the consensus-2 criteria have observed non-trivial overlaps among the populations with these diseases (e.g. [31][32][33][34][35]), hinting at commonalities in these diseases' mechanistic roots, and those favoring the consensus-1 criteria have published contrary assertions (e.g. [23,24,36]).…”

Section: Molderings Et Al Proposal For Diagnostic Criteria For Mcasmentioning

confidence: 99%

Diagnosis of mast cell activation syndrome: a global “consensus-2”

Ackerley²,

et al. 2020

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The concept that disease rooted principally in chronic aberrant constitutive and reactive activation of mast cells (MCs), without the gross MC neoplasia in mastocytosis, first emerged in the 1980s, but only in the last decade has recognition of “mast cell activation syndrome” (MCAS) grown significantly. Two principal proposals for diagnostic criteria have emerged. One, originally published in 2012, is labeled by its authors as a “consensus” (re-termed here as “consensus-1”). Another sizable contingent of investigators and practitioners favor a different approach (originally published in 2011, newly termed here as “consensus-2”), resembling “consensus-1” in some respects but differing in others, leading to substantial differences between these proposals in the numbers of patients qualifying for diagnosis (and thus treatment). Overdiagnosis by “consensus-2” criteria has potential to be problematic, but underdiagnosis by “consensus-1” criteria seems the far larger problem given (1) increasing appreciation that MCAS is prevalent (up to 17% of the general population), and (2) most MCAS patients, regardless of illness duration prior to diagnosis, can eventually identify treatment yielding sustained improvement. We analyze these proposals (and others) and suggest that, until careful research provides more definitive answers, diagnosis by either proposal is valid, reasonable, and helpful.

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“…Before and after surgeries, MC activity should be reduced as much as possible by medications and other maneuvers (e.g., avoidance of triggers, such as temperature shock from a cold operating room or infusion of refrigerated fluids) ideally determined at an earlier, non-emergent point to be ideal for this task. Of note, though systemic medications may be sufficient, sometimes topical medications may be needed, or at least more helpful, for controlling bleeding in topically accessible sites (e.g., a nasal spray of an H 1 blocker or cromolyn for epistaxis, or a vaginal douche or suppository of such drugs for menorrhagia [50]). Routine procedures for arresting surgical bleeding rarely are effective when that bleeding is induced by MC mediators [20], so alternative approaches often are needed.…”

Section: Treatment Options In Mast Cell Mediator-induced Bleedingmentioning

confidence: 99%

Effects of Primary Mast Cell Disease on Hemostasis and Erythropoiesis

Seidel¹,

Hertfelder

Oldenburg

et al. 2021

IJMS

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Mast cell disease is an epigenetically and genetically determined disease entity with very diverse clinical manifestations in potentially every system and tissue due to inap pro priate release of variable subsets of mast cell mediators together with accumulation of either morphologically normal or altered mast cells. Easy bruising, excessive bleeding, and aberrancies of erythropoiesis can frequently be observed in patients with mast cell disease. A thorough history, including a family history, will guide the appropriate work-up, and laboratory evaluations may provide clues to diagnosis. In recent years, our understanding of the involvement of coagulation and anticoagulant pathways, the fibrinolytic system, and erythropoiesis in the pathophysiology of mast cell disease has increased considerably. This review summarizes current knowledge of the impact of the disturbed hemostatic and erythropoietic balance in patients with mast cell disease and describes options of treatment.

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Successful mast-cell-targeted treatment of chronic dyspareunia, vaginitis, and dysfunctional uterine bleeding

Cited by 15 publications

References 16 publications

Dietary Practices of Women with Endometriosis: A Cross-Sectional Survey

Dietary Practices of Women with Endometriosis: A Cross-Sectional Survey

Diagnosis of mast cell activation syndrome: a global “consensus-2”

Effects of Primary Mast Cell Disease on Hemostasis and Erythropoiesis

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