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Abstract
Mast cells are pluripotent leukocytes that reside in the mucosa and connective tissue. Recent studies show an increased prevalence of cardiovascular disease among patients with mastocytosis, which is a hematological disease that is characterized by the accumulation of mast cells due to clonal proliferation. This association suggests an important role for mast cells in cardiovascular disease. Indeed, the evidence establishing the contribution of mast cells to the development and progression of atherosclerosis is continually increasing. Mast cells may contribute to plaque formation by stimulating the formation of foam cells and causing a pro-inflammatory micro-environment. In addition, these cells are able to promote plaque instability by neo-vessel formation and also by inducing intraplaque hemorrhage. Furthermore, mast cells appear to stimulate the formation of fibrosis after a cardiac infarction. In this review, the available data on the role of mast cells in cardiovascular disease are summarized, containing both in vitro research and animal studies, followed by a discussion of human data on the association between cardiovascular morbidity and diseases in which mast cells are important: Kounis syndrome, mastocytosis and allergy.
Highlights
Mast cells (MC) are long-lived cells that reside in the connective tissue
MCT are typically found in the mucosa, whereas MCTC are more prominent in the connective tissue
While MC are important in the induction of pro-fibrotic processes, they can vice versa be activated by the mechanical stress that results from fibrosis of the tissue
Summary
Mast cells (MC) are long-lived cells that reside in the connective tissue They are part of the innate immune system and have pleiotropic functions and phenotypes. MC rely on their c-KIT receptor for proliferation and survival This c-KIT is activated by its ligand stem cell factor (SCF) [3]. A unique receptor to MC is the Mas-related G-protein receptor X2 (MRGPRX2) This receptor can be activated by many different ligands such as substance P, different small molecule drugs including neuromuscular blockers and antibiotics, and the components of snake and wasp venom [7]. The proteases that they release upon activation can degrade the toxic components of those venoms of snakes and insects [10] To these useful features of MC, they are most infamous for their role in allergic diseases. We will summarize the current knowledge regarding mast cell effects on atherosclerosis and heart diseases
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