BackgroundSymptoms in patients with systemic mastocytosis (SM) are associated with an increase in mast cell burden and release of mast cell-derived mediators. The most frequent presentation of SM is indolent (ISM), with moderate symptoms and prognosis. Basophil numbers in these patients are generally normal. However, when examining basophil activation in patients with ISM, we noted an abnormal response to N-formylmethione-leucyl-phenylalanine (fMLP). ObjectiveTo compare basophil responsiveness to fMLP and anti-IgE in healthy volunteers and patients with ISM and relate findings to fMLP receptor (FPR) expression. MethodsBasophils isolated from peripheral blood of fifteen patients with ISM and fourteen healthy volunteers were stimulated with fMLP or anti-IgE. CD63 expression to assess basophil activation and expression of FPRs were assessed by flow cytometry. ResultsBaseline expression of CD63 on basophils was similar between healthy volunteers and patients with ISM. fMLP induced higher expression of CD63 on basophils from patients with ISM, while responses to anti-IgE were similar between groups. Basophils from patients with ISM also had higher fMLP1 receptor (FPR1) expression, while FPR2 and FPR3 were not detected. fMLP blocked the binding of anti-FPR1 antibody to FPR1, consistent with the conclusion that fMLP signals through FPR1. ConclusionsFMLP-induced basophil activation is higher in patients with ISM which is associated with an increase in FPR1 expression. Further investigation is needed to determine why FPR1 expression is elevated, whether such expression might serve as an additional surrogate marker in the diagnosis of ISM, and whether enhanced responses of basophils to fMPL might have some relationship to unexplained episodes of mediator release.
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