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Mast cell-derived mediators

Michael Gurish, PhD
Mariana C Castells, MD, PhD
Section Editor
Sarbjit Saini, MD
Deputy Editor
Anna M Feldweg, MD


Mast cells release various mediators upon activation, which are responsible for many of the systems of allergic disease and anaphylaxis. These mediators can be divided into three overlapping categories: preformed mediators, newly synthesized lipid mediators, and cytokines and chemokines.

This topic will review mast cell mediators. The information in this topic pertains to human mast cells whenever possible, and notation is made when data are derived purely from murine studies. The development, physiologic roles, surface receptors, and signal transduction of mast cells are reviewed separately. (See "Mast cells: Development, identification, and physiologic roles" and "Mast cells: Surface receptors and signal transduction".)


Mast cell secretory granules contain preformed mediators that are rapidly (within seconds to minutes) released into the extracellular environment upon cell stimulation. These mediators include histamine, neutral proteases, proteoglycans, and some cytokines, such as tumor necrosis factor-alpha (TNF-alpha). They are responsible for many of the acute signs and symptoms of mast cell-mediated allergic reactions, including edema, bronchoconstriction, and increased vascular permeability. Specific pharmacotherapy to inhibit and/or antagonize mast cell mediators is reviewed elsewhere. (See "Systemic mastocytosis: Management and prognosis", section on 'Pharmacotherapy for symptoms related to mast cell mediators'.)

Histamine — Histamine is produced predominantly by mast cells but also is elaborated by basophils, neutrophils [1], and platelets. It is stored in both scroll-like and lattice secretory granules of the human mast cell [2]. Human cutaneous mast cells are estimated to contain 1.9 micrograms of histamine per 106 cells [3]. Secretory granule exocytosis and release of histamine occurs rapidly after either immunoglobulin E (IgE)- or non-IgE-based stimulation [4]. The effects of histamine are mediated through H1, H2, H3, and H4 receptors located on target cells:

H1-mediated actions include increased venular permeability, bronchial and intestinal smooth muscle contraction, increased nasal mucus production, widened pulse pressure, increased heart rate and cardiac output, flushing, and T cell neutrophil and eosinophil chemotaxis [5,6]. In mice, lack of H1 receptors leads to reduced lung inflammation as a consequence of the decreased T cell influx [6].

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Literature review current through: Nov 2017. | This topic last updated: Aug 29, 2017.
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