Conditions, Interstitial Cystitis

Interstitial Cystitis and Mast Cells

Mast cells have long been reported to be raised in patients suffering from interstitial cystitis. Mast cells are a type of cell that are usually associated with allergies. Today I’m going to take a look at the relationship between interstitial cystitis and mast cells.




What is a Mast Cell?

A mast cell is a type of white blood cell that is a part of the immune system. Mast cells are most abundant in tissue that is in contact with the outside world such as skin, lungs, digestive system and eyes. But they can also be found in diseased bladder tissue.

Mast cells contain granules that are rich in the compounds histamine and heparin. These compounds are usually secreted as part of the defence mechanism of the immune system.

Normally, mast cells play an important role in the defence against pathogens, wound healing, formation of new blood vessels, immune tolerance and blood-brain barrier function.

On the other hand, they are best known for their role in allergies as they play a big role in causing the unpleasant side-effects of an allergic attack.

During an allergic response, mast cells release histamine and other pro-inflammatory compounds. These compounds are responsible for much of the allergic symptoms (such as itching and swelling). That is why antihistamine drugs can reduce allergic symptoms.

Mast cells also play a big role in anaphylactic shocks.

Mast Cells in Interstitial Cystitis

Mast cells have been found to be raised in patients suffering from IC [1].

Although mast cells are usually present in the lamina propria (the connective tissue just under the urothelium) of healthy bladders, they are found in increased numbers in the submucosal layer of the bladder wall and especially in the muscle layer (detrusor muscle) surrounding the bladder in interstitial cystitis sufferers [1].

Mast cells are especially rich in IC bladders with ulcers [1].

As a result, interstitial cystitis bladders also contain about double as much histamine as healthy bladders. Histamine plays a role in inflammation.

Increased numbers of activated mast cells are also referred to as mastocystosis.

Mastocytosis is a mast cell activation disorder caused by the presence of high numbers of mast cells, leading to a high level of mast cell degranulation (inflammatory compounds are released from mast cell granules, including histamine).

Apart from histamine, mast cells can also release the inflammatory chemical Interleukin-6 (IL-6). IL-6 release can be triggered by bacterial lipopolysaccharide (LPS), a toxin released by pathogenic bacteria [2].

Interestingly, IL-6 has also been found to be raised in IC bladders [2], raising the question whether IC is in fact a bacterial infection (see ‘intracelullar bacteria’).

What about mast cells and regular cystitis?

There is also evidence that at least in mice mast cells play a role in the lower urinary tract symptoms experienced in a bout of cystitis (urinary tract infection) [3].

Mast cells and other diseases

As mentioned above, mast cells are highly implicated in allergic conditions and autoimmune diseases.

People with increased mast cell can be prone to skin conditions, swelling and itchiness.

Increased mast cell counts can also be present in conditions such as irritable bowel syndrome (IBS) [4].

This explains a possible connection between IC and other conditions.

What activates Mast Cells?

Many patients will find that one or more of the following aggravates their symptoms. This is because they activate mast cells:

  • Estrogen [1]: Estrogen levels rise in the first half of the female cycle, just after the period. Hormonal birth control also usually contains estrogens. This could explain flares of symptoms at certain times of the cycle.
  • A damaged urothelium (bladder lining) [2]: a damaged or dysfunctional urothelium produces certain chemicals that can activate mast cells.
  • Stress: Hormones that are released in response to physiological or emotional stress destabilize mast cells and cause them to release their inflammatory chemicals [5].
  • Coli: Pathogenic e. coli that have adhered to the bladder wall have the ability to activate mast cells [2].
  • Bacterial, Fungal, Viral and Parasitic Infections: All types of infections and pathogenic overgrowth can activate mast cells in the body [6].
  • Heavy Metal Toxicity: Heavy metals such as mercury, aluminium, lead, cadmium and bismuth can activate mast cells [7].

Natural Ways of Reducing Mast Cell Activation

Ultimately, the root cause of increased mast cells would have to be found and addressed. In the meantime, the following measures may help provide some relief:

  • Low Histamine-Diet: For those with high levels of mast cells histamine from food could exacerbate symptoms, as the body is most likely already high in histamine. A low histamine diet is part of my customization plan for a healing diet (read more about diet here and here).
  • Nutrients/Herbs that may help stabilize mast cells: Selenium, Vitamin C, holy basil, peppermint, ginger, thyme, turmeric, quercetin, bromelain, nigella sativa, nettle and butterbur.
  • Chondroitin Sulfate and Quercetin: Synergistically help to inhibit mast cell activation [2].
  • Stress reduction techniques: meditation, deep breathing exercises, yoga, Mindfulness Based Stress Reduction (MBSR), Tai Chi, walks in nature, massage, acupuncture, flotation tanks, reflexology, sauna etc.

Now I’d like to hear from you: Do you think your mast cell levels are raised? Have you done anything to deal with it? Let me know in the comments.



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Sources

 

  1. Theoharides, Theoharis C et al. Mast cell involvement in interstitial cystitis: a review of human and experimental evidence Urology June 2001 [Volume 57 , Issue 6 , 47 – 55] http://www.goldjournal.net/article/S0090-4295(01)01129-3/abstract
  2. Sant, Grannum R. et al. The Mast Cell in Interstitial Cystitis: Role in Pathophysiology and Pathogenesis Urology 2007 [Volume 69 , Issue 4 , S34 – S40] http://www.goldjournal.net/article/S0090-4295(06)02239-4/fulltext
  3. Xu Wang et al Evidence for the Role of Mast Cells in Cystitis-Associated Lower Urinary Tract Dysfunction: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Animal Model Study Plos One December 21, 2016 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0168772
  4. Pang et al Mast cell and substance p-positive nerve involvement in a patient with both irritable bowel syndrome and interstitial cystitis Urology [Volume 47, Issue 3, March 1996, Pages 436-438] http://www.sciencedirect.com/science/article/pii/S0090429599804695
  5. Spanos, Constantine et al. Stress-Induced Bladder Mast Cell Activation: Implications for Interstitial Cystitis The Journal of Urology 1997 [Volume 157 , Issue 2 , 669 – 672] http://www.jurology.com/article/S0022-5347(01)65247-9/fulltext
  6. Saluja R, Metz M, Maurer M. Role and Relevance of Mast Cells in Fungal Infections. Frontiers in Immunology. 2012 [3:146.] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374363/
  7. Bent, S., Göttsch, C., Braam, U. et al. The effects of heavy metal ions (Cd2+, Hg2+, Pb2+, Bi3+) on histamine release from human adenoidal and cutaneous mast cells Agents and Actions (1992) [36(Suppl 2): C321.] https://link.springer.com/article/10.1007/BF01997363

4 Comments

  • Reply

    Sheryl Chan

    May 17, 2017

    Fascinating research, articulated so simply and covered so thouroughly as always! Very interesting piece, never thought about mast cells connection. I do get a lot of random outbreak of hives. My bladder irritation is quiet for now, but nobody even knows what the cause was. Now I’m wondering if mast cells have to do with anything else 😉 Thanks for the insight!

    • Reply

      Layla

      May 18, 2017

      Thanks, Sheryl! Some researchers believe that mast cell activation disorders could be at the root of many conditions, I believe the book ‘never bet against Occam’ that has been recently reviewed on the CIB network deals with this topic (although I haven’t read it myself).

  • Reply

    Kelley PALOMINO

    September 11, 2017

    How would one test for Mast cells in the urine?

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