In addition to extensive degranulation of mast cells, chymase is also rapidly inactivated after the allergen challenge, possibly by pre-existing chymase inhibitors in the mast cells. This inactivation is associated with the release of histamine.
Other mediators as well as histamine can contribute to the allergic wheal reaction. In this study, the microdialysis technique was used to monitor the release of histamine, leukotriene C4 (LTC4) and prostaglandin D2 (PGD2) in prick-test wheal reactions induced by cow dander allergen. Of 31 atopic subjects, 25 showed detectable histamine release that correlated significantly with the number of tryptase-positive mast cells and serum cow-specific IgE but not with the wheal size. Detectable LTC4 release was shown by 16 of 18 subjects, but PGD2 release was shown by only 7 of 17 subjects, and neither mediator was associated with tryptase-positive mast cells, IgE levels or wheal size. An inverse association between histamine release and LTC4 release in these 18 subjects was found rather than a direct correlation. With advancing age of the subject histamine release (n = 31) tended to decrease, although insignificantly, but LTC4 release (n = 18) and sensitivity to histamine prick increased significantly, which seemed to parallel the changes in the wheal size induced by cow allergen. In conclusion, the results showed that the release of histamine, LTC4 or PGD2 alone cannot explain the extent of the wheal reaction. In addition, the amount of histamine released was not related to the amount of LTC4 released, but rather an inverse association existed between these mediators.
The novel finding was that IL-4-positive, but not tryptase- and chymase-positive, mast cells are intimately associated with the extent of the prick-test wheal.
(Pro)filaggrin expression is decreased in AD and is reversely associated with MC tryptase and IL-6. However, it does not associate with disease severity, and it was also decreased in psoriasis.
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