According to a recent review published in the journal Autoimmunity Reviews, up to half of patients with mastocytosisMastocytosis Rare disease caused by the buildup of mast cells. Cutaneous mastocytosis primarily affects the skin and is more common in children, while systemic mastocytosis affects internal organs and is more common in adults. have depression.
Mastocytosis includes both systemic mastocytosis (SM) and cutaneous mastocytosis, the form that mainly affects the skin. In both forms, the body makes too many mast cells.
What is a mast cellMast cell A type of white blood cell produced in the bone marrow. They help defend against infections and play a key role in allergic reactions. In SM, mast cells become overactive and build up throughout the body.?
Mast cells are specialized cells of the immune system that mediate inflammatory responses and allergic reactions. They are found in the body’s connective tissue.
While depression in mastocytosis was long thought to be due to the burden of living with a chronic disease, more recent research suggests that mental health symptoms may be directly caused by overactive mast cells and the chemicals they release.
In the review, researchers described the chain of events they think is responsible for causing depression. First, something such as a gene mutation, an allergen or even stress triggers the mast cells. The activated mast cells release chemicals into the body, including histamineHistamine A chemical released by mast cells when they are activated. Histamine causes many of the allergy-type symptoms in mastocytosis, including flushing, itching and hives., that cause inflammation. These chemicals weaken the barrier that normally protects the brain and disrupt levels of chemicals in the brain, including levels of serotonin, a chemical linked to mood. The result is depression: low mood, loss of enjoyment, fatigue, brain fog, and in serious cases, thoughts of self-harm.
“We suggest that depression is an important and underrecognized comorbidity in mastocytosis, with immune-mediated mechanisms likely contributing to its onset and persistence in at least a subset of patients,” the review’s authors said.
Read more about SM signs and symptoms
Right now, most doctors treating mastocytosis focus only on the physical symptoms and don’t routinely check for depression. There are no official guidelines for treating mental health symptoms in these patients.
The researchers call for better studies to understand exactly how common depression is in mastocytosis, what causes it and for future drug trials to measure mood and thinking, not just physical health outcomes.
Early evidence suggests that some medications, like antihistaminesAntihistamines Medications that block the effects of histamine, the chemical found in mast cells that is responsible for many of the symptoms of SM, as well as many allergic reactions., mast cell stabilizers and tyrosine kinase inhibitors (TKIs), might improve mood. For example, drugs like masitinib, avapritinib and bezuclastinib have shown potential for improving mood. But scientists need much more data before making firm recommendations.
Sign up here to get the latest news, perspectives, and information about SM sent directly to your inbox. Registration is free and only takes a minute.
