Human mast cells in anaphylaxis: from research to diagnosis

Purpose of review Mast cell degranulation in anaphylaxis can result from both IgE-dependent and IgE-independent mechanisms. The two conditions differ in terms of phenotype, diagnosis and specific therapeutic targets. Recent findings Genetic factors and IgE-sialylation might enhance IgE-dependent degranulation. MRGPRX2-dependent signal might have a synergistic effect on IgE-dependent degranulation. The data on IgG-dependent anaphylaxis highlight the significance of histamine release from mast cells. Recent advances in the field have led to the development of novel targeting treatments for both IgE-dependent and IgE-independent mast cell degranulation. Summary In-vitro analysis of human mast cells offers the possibility of studying the mechanisms underlying mast cell degranulation in anaphylaxis. The implementation of this analysis in clinical practice can advance diagnosis. Moreover, mechanistic and preclinical studies support the development of targeted treatments for IgE-dependent and IgE-independent anaphylaxis.