Mast cell activation syndrome, or MCAS for short, is a disorder that occurs when mast cells release too much of their mediator substances at incorrect times. Mast cells are part of the immune system and are found in blood vessels throughout the body and in bone marrow. The mechanism behind MCAS is largely unknown, which is why it is often referred to as an idiopathic condition. Some research has found that a large majority of those with MCAS also have a relative with the condition, so it’s postulated that it could be linked to genetics.
What triggers mast cell activation?
When the body undergoes periods of stress or is exposed to a dangerous scenario, mast cells trigger a release of their mediator substances. These mediators are tasked with causing inflammation so that the body can heal from the injury that occurred or an infection. The triggered release causes a person to experience symptoms of anaphylaxis, or an allergic reaction.
Symptoms of MCAS can affect many parts of the body. The primary symptoms and areas of the body affected by MCAS include:
- Eyes. The eyes can become both itchy and watery.
- Heart and blood vessels. The condition can trigger low blood pressure or an increase in heart rate.
- Lungs. Problems with the lungs can include wheezing or trouble with normal breathing.
- Mouth and throat. The mouth and throat can present with typical allergy symptoms such as itchiness, and swelling of the tongue, lips, and throat could occur and lead to an air blockage.
- Nervous system. Nervous system issues can occur such as headache, dizziness, confusion, or fatigue.
- Nose. The nose can be runny or itchy, accompanied by sneezing.
- Skin. The skin can be flushed and/or itchy and develop hives, or increased perspiration may occur.
- Stomach and intestines. Gastrointestinal issues can occur such as cramping, diarrhea, nausea, or abdominal pain.
These symptoms are all typical in an allergic reaction because it is essentially the same process as MCAS. If something a person is allergic to enters their system, the mast cells release those same mediators. One such mediator is histamine, which is tasked with the role of getting rid of allergens such as pollen. MCAS occurs when the release of the mediators occurs despite there being no allergen present and when the mast cells release those mediators too often.
How do you calm a mast cell activation?
Currently, there is no cure for MCAS; however, there are treatment options that can help people manage the condition. The main treatment option for those with MCAS is antihistamines – specifically, H1 or H2 antihistamines. Both H1 and H2 antihistamines work by binding and stabilizing certain histamine receptors to help calm the effects of having too many histamines in the system.
Another treatment option is a mast cell stabilizer, which is designed to stop mast cells from releasing the mediator substances. Other options include antileukotrienes, which block the effects of a specific type of mediator in mast cells known as leukotrienes, and corticosteroids. Corticosteroids are typically last in line when it comes to treatment options and are used to help with wheezing or edema symptoms. If the symptoms present the same as a severe allergic reaction, the person experiencing them will have to have an injection of epinephrine.
Lyme disease and MCAS
Lyme disease has a myriad of different co-infections, one of which is mast cell activation syndrome. Many people with Lyme disease are aware of the risk of developing certain coinfections; however, unlike MCAS, the typical infections that go along with Lyme disease are often infectious in nature. However, it’s thought that the Borrelia bacteria that causes Lyme disease is what prompts MCAS to develop.
Research has shown that the Borrelia bacteria triggers mast cells to behave in a dysfunctional manner by releasing histamine in response. When the mast cells release their substances, and thus cause inflammation throughout the body, it further exacerbates the Lyme disease infection. This inflammation could be the reason that some patients with both Lyme disease and MCAS experience the variety of mild and severe symptoms that often come with Lyme disease.
Can Lyme disease cause mast cell disorders?
As previously mentioned, Lyme disease-causing bacteria can pose serious problems throughout the body that can lead to a host of other conditions. When it comes to mast cells and Lyme disease, studies suggest having Lyme could be a direct cause of a mast cell disorder because of the way the body tries to fight against it.
MCAS can be serious or mild, depending on the person, but there are treatment options available. For those with Lyme disease, paying attention to potential symptoms of MCAS is vital when it comes to treatment.
Featured image by Erik Karits on Unsplash