Pharmacological treatment options for mast cell activation disease

Gerhard J. Molderings1, Britta Haenisch2, Stefan Brettner3, Jürgen Homann4, Markus Menzen4, Franz Ludwig Dumoulin4, Jens Panse5, Joseph Butterfield6, Lawrence B. Afrin7
1Institute of Human Genetics, University Hospital of Bonn, Bonn, Germany
2German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
3Department of Oncology, Hematology and Palliative Care, Kreiskrankenhaus Waldbröl, Waldbröl, Germany
4Allgemeine Innere Medizin, Gastroenterologie und Diabetologie, Gemeinschaftskrankenhaus, Bonn, Germany
5Department of Hematology, Oncology and Stem Cell Transplantation, Medical Faculty, RWTH Aachen University, Aachen, Germany
6Program for the Study of Mast Cell and Eosinophil Disorders, Mayo Clinic, Rochester, USA
7Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, USA

Tóm tắt

Mast cell activation disease (MCAD) is a term referring to a heterogeneous group of disorders characterized by aberrant release of variable subsets of mast cell (MC) mediators together with accumulation of either morphologically altered and immunohistochemically identifiable mutated MCs due to MC proliferation (systemic mastocytosis [SM] and MC leukemia [MCL]) or morphologically ordinary MCs due to decreased apoptosis (MC activation syndrome [MCAS] and well-differentiated SM). Clinical signs and symptoms in MCAD vary depending on disease subtype and result from excessive mediator release by MCs and, in aggressive forms, from organ failure related to MC infiltration. In most cases, treatment of MCAD is directed primarily at controlling the symptoms associated with MC mediator release. In advanced forms, such as aggressive SM and MCL, agents targeting MC proliferation such as kinase inhibitors may be provided. Targeted therapies aimed at blocking mutant protein variants and/or downstream signaling pathways are currently being developed. Other targets, such as specific surface antigens expressed on neoplastic MCs, might be considered for the development of future therapies. Since clinicians are often underprepared to evaluate, diagnose, and effectively treat this clinically heterogeneous disease, we seek to familiarize clinicians with MCAD and review current and future treatment approaches.

Tài liệu tham khảo

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