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June 20, 2023

Mast Cell Activation

Mast Cell Activation


Does mast cell activation and release occur in non-atopic food intolerance? What is the evidence, for and against?


From the Editor: It appears that non IgE- mediated food mechanisms do not involve mast cell activation, except for the possibility in the spectrum of systemic mastocytosis.


By Dr. Iris E. Hidalgo Nicho

First, it is necessary to clarify that the diagnosis of “food intolerance” can include a wide spectrum of clinical manifestations related to food intake, from lactose intolerance due to lactase deficiency to gluten enteropathy due to a non-IgE mediated immune reaction...

Read the Full Answer here.

Iris E. Hidalgo Nicho, MD
Allergy and Immunology
Hospital Nacional Edgardo Rebagliati Martins
Lima, Peru


By Dr Lawrence Schwartz

I am not aware of foods triggering mast cell activation in a non-atopic or IgE-independent manner - unlike for certain drugs, such as vancomycin and morphine, which do directly activate mast cells in an IgE/FcERI-independent manner.

Lawrence B. Schwartz, MD, PhD
Charles & Evelyn Thomas Professor of Medicine
Chair, Division of Rheumatology, Allergy & Immunology
Richmond, Virginia, USA


By Dr Mariana Castells

There is indirect evidence through the measurement of mast cell mediators that GI mast cells can be activated by certain foods in patient with mastocytosis and MCAS. In non mastocytosis patients there is no evidence of mast cell activation in Food intolerance which has a wide definition: from lactose intolerance which does not involve mast cell activation and is the result of lactase deficiency to gluten enteropathy which is an IgG mediated immune reaction. 

Mariana C. Castells, MD, PhD
Associate Physician, Department of Medicine, Rheumatology and Immunology
Brigham and Women’s Hospital
Associate Professor of Medicine, Harvard Medical School
Boston, Massachusetts, USA

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