The impact of psychological stress on mast cells

Ann Allergy Asthma Immunol. 2020 Oct;125(4):388-392. doi: 10.1016/j.anai.2020.07.007. Epub 2020 Jul 17.


Objective: Atopic diseases worsen with psychological stress, but how stress contributes to their pathogenesis is still not clear. We review the evidence supporting the premise that stress contributes to allergic and inflammatory processes through stimulation of mast cells (MCs) by neuroimmune stimuli.

Data sources: PubMed was searched between 1950 and 2019 using the following terms: allergies, atopic diseases, corticotropin-releasing hormone, inflammation, hypothalamic-pituitary-adrenal axis, mast cells, mastocytosis, neuropeptides, psychological stress, neurotensin, and substance P.

Study selections: Only articles published in English were selected based on their relevance to stress and MCs, especially those that discussed potential mechanisms of action.

Results: Psychological stress worsens many diseases, especially asthma, atopic dermatitis, and mastocytosis. This effect is mediated through MCs stimulated by neuropeptides, especially corticotropin-releasing hormone, neurotensin, and substance P, a process augmented by interleukin-33.

Conclusion: Understanding how stress stimulates MCs to release proinflammatory mediators is important in advancing treatments for diseases that worsen with stress.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Hypersensitivity / immunology*
  • Hypersensitivity / psychology*
  • Mast Cells / immunology*
  • Stress, Psychological / immunology*