What Triggers Mast Cells?
Mast cells can release up to 200 different chemical mediators when stimulated through the allergic pathways (IgE mediated) and through other pathways as well. Some triggers are common across many mast cell disease patients and some may be specific to you. Most patients will not react to all of these triggers, but triggers may change over time for a patient. Here are some triggers of mast cells that have been identified in the medical literature.
Physical stimuli
Heat
Cold
Sudden changes of temperature (including jumping into cold water)
Rubbing/pressure of skin lesions
Scalp trauma (in children with scalp involvement)
Vibration
Sunlight
Exercise
Inhalants (perfumes, smoke, chemicals, natural scents)
Emotional factors
Stress*
Anxiety
Sleep deprivation
Pain
Infectious diseases
Viral (Especially respiratory and gastrointestinal)
Bacterial (bronchitis, pneumonia)
Fungal
Medications and Medical Procedures
Non-steroidal anti-inflammatory drugs (NSAIDS)
Morphine, codeine and derivatives
Anaesthetics and surgery-related medications including but not limited to tetracaine, procaine, methylparaben preservative, d-tubocurarine, metocurine, etomidate, thiopental, succinylcholine, enflurane
Beta-lactams
Vaccinations
Antibiotics (IV Vancomycin in particular, but varies across patients)
Contrast Dyes (as for MRIs or other scans)
Amphotericin B
Food and drink
Drink (Alcohol is a common trigger)
Foods (varies from patient to patient)
Venoms
Insect and other Venoms (Wasp*, bees, snakes, jellyfish, fire ants etc.)
*Different articles identify stress and wasp venom as the most common trigger of mast cell mediator symptoms in patients with MCDs.
Sources:
Bonadonna P et al, Drug hypersensitivity in clonal mast cell disorders: ENDA/EAACI position paper. Allergy. 2015 Jul;70(7):755-63.
Bonadonna P et al. Mastocytosis and insect venom allergy. Curr Opin Allergy Clin Immunol. 2010 Aug;10(4):347-53.
Castells M, Metcalfe DD, Escribano L, Am J Clin Dermatol. Diagnosis and treatment of cutaneous mastocytosis in children: practical recommendations. 2011 Aug 1;12(4):259-70.
Olivera A, Beaven MA, Metcalfe DD. Mast cells signal their importance in health and disease J Allergy Clin Immunol. 2018 Feb 15.
Schuch A1, Brockow K2.Mastocytosis and Anaphylaxis. Immunol Allergy Clin North Am. 2017 Feb;37(1):153-164.