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Article Dans Une Revue Revue francaise d'allergologie Année : 2022

Tryptase in all its states: From allergy to mastocytosis

Michel Arock
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Résumé

In normal humans, tryptase, a serine protease with multiple biological activities, is synthesized nearly exclusively by mast cells (MCs). While immature forms of tryptase (␣-and ␤monomers) are constantly released by MCs and can be measured in the serum of normal individuals as the basal serum tryptase (BST) level, mature tryptases (mostly tetramers of ␤-tryptase) are retained in the secretory granules of MCs and are released only upon cell activation. Such MC activation occurs during IgE-mediated allergic reactions and increased levels of tryptase, which can be measured immediately after degranulation, are involved in the pathophysiology of immediate hypersensitivity. Interestingly, recent studies have reported that around 5% of the general population present with a genetic trait called hereditary alpha-tryptasemia (H␣T). In H␣T+ patients, the BST level is increased. Mastocytosis are a group of hematologic neoplasms characterized by an accumulation of atypical MCs in one or several organs/tissues, often accompanied by MC activation. Increased BST level is a hallmark of systemic mastocytosis (SM) and a diagnostic, prognostic and follow-up marker. Interestingly, the incidence of the H␣T trait has been found increased in SM patients (up to 18% of the cases) and H␣T+ SM patients are more prone to develop anaphylaxis, making H␣T a disease penetrance and phenotype modifier.
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hal-03706761 , version 1 (22-07-2024)

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Michel Arock. Tryptase in all its states: From allergy to mastocytosis. Revue francaise d'allergologie, 2022, 62, pp.207 - 210. ⟨10.1016/j.reval.2022.01.004⟩. ⟨hal-03706761⟩
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