, Volume 27, Issue 1-2, pp 8-16

Mast cells, neuropeptides and inflammation

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We have demonstrated that, unlike mast cells of the lung, adenoids, tonsils and intestine, whose primary role is thought to be IgE-mediated host defence, human skin mast cells respond to neuropeptide stimulation with a rapid release of histamine and minimal generation of PGD2 and LTC4. This ability of skin mast cells to release mediators in response to neuropeptide stimulation is evidence in favour of a neuro-immune interaction within human skin which may have evolved to promote angiogenesis [70] or control cutaneous blood flow [71]. In this context, it is interesting to note that mast cells are found in particularly high numbers in the blush areas of the neck and face [72].

A knowledge of the functional heterogeneity of human mast cells, and of their responsiveness to neuropeptides in particular, will prove to be of great importance to our understanding of the role of mast cells in health and disease. Enhanced responsiveness of skin mast cells to neuropeptides may contribute to the aetiology of some forms of urticaria as suggested by the presence of enhanced weal responses of patients with chronic idiopathic urticaria to various non-immunological stimuli [73–76]. Furthermore, the high ratios of histamine to PGD2 (>1000∶1) [31, 32] in the venous effluent of thermally-challenged limbs of patients with heat- or cold-induced urticaria suggests mast cell activation by a neuropeptide rather than an immunological stimulus. However, the caveat applies that these two mediators may have been metabolised to different extents before reaching the sampling site.