Are mast cells all bad?

Abstract

Over the past ten years there have been considerable advances in our understanding of the pathogenesis of asthma. This understanding has been accompanied by the introduction and increased usage of a whole range of new therapies for the treatment of asthma. Unfortunately he increased understanding and available therapy has done very little to prevent asthma from being considered the only 'preventable' disease whose morbidity and mortality are still on the increase in most parts of the world. Why does this paradox occur? I will try to put forward a plausible scientific explanation for this paradox. I fell that this is to be found in a long recognised but little publicised pharmacological effect of beta 2 agonists, a widely prescribed drug class in the treatment of bronchial asthma, that is the ability of these drugs to inhibit mast cell degranulation. Through this mechanism beta 2 agonists may be inhibiting a natural anti-inflammatory mechanism mediated by mast cell products and thus be contributing to the worldwide increase in asthma morbidity and mortality.