Mast cells and immunological skin diseases

Mast cells play an important role in both adaptive and innate immunity, and a large body of literature demonstrates their functions in skin immunity. This article reviews the literature on the role of this cell type in the pathogenesis of a number of immunological skin diseases, including contact dermatitis, atopic dermatitis, immunobullous disease, scleroderma, and chronic graft-vs.-host disease. In all these diseases, mast cells are noted to increase in number and undergo degranulation in the affected skin, and in some cases, their specific mediators are detected. Elucidation of the contribution of mast cells to the pathogenesis of these diseases has been aided significantly by the use of animal models, especially mouse models. The studies of mast cell-deficient mice in conjunction with normal congenic mice have been particularly fruitful, although in some cases, such as contact dermatitis, a definitive conclusion has not been achieved despite extensive efforts. The role of mast cells in atopic dermatitis has also been suggested by studies of gene polymorphism, which have linked some of the mast cell-related genes to the disease. In the case of scleroderma and chronic graft-vs.-host disease, the function of mast cells in fibrosis is further supported by the ability of these cells and their mediators to induce activation and proliferation of fibroblasts. Therapies targeting mast cells may prove beneficial for treatment of these inflammatory and autoimmune diseases.