{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T09:27:08Z","timestamp":1769074028495,"version":"3.49.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Laboratory evidence supporting diagnosis of the prevalent condition of mast cell activation syndrome (MCAS) currently includes elevated levels in blood or urine of mediators relatively specific to mast cells (MCs) and\/or increased numbers of MCs in luminal gastrointestinal (GI) tract tissues.  However, identification of elevated mediators is technically challenging and expensive, and controversy persists regarding the normal ranges of numbers\/counts of MCs in various GI tract segments, let alone challenges in determining how many of the visualized MCs are activated.  To aid diagnosis of MCAS, we developed a potential new approach for the pathologist to identify the extent of GI tract MC activation easily and inexpensively.<\/jats:p>\n                  <jats:p>Participants and Methods Visualization of MCs in gastrointestinal biopsies from 251 patients vs. 95 controls using antibodies against CD117 and tryptase; MC counting per mm2; calculation of the difference between the CD117-positive MCs (identifying all MCs) vs. tryptase-positive MCs (identifying non-activated tryptase-containing MCs), which we define as the tryptase depletion index (TDI).<\/jats:p>\n                  <jats:p>Results Mean total MC counts did not differ significantly between patients and controls, but mean TDIs differed significantly. Non-overlapping confidence intervals at the 99.9% level identified cut-offs of TDIs between patients vs. controls of 26, 45 and 32 MCs\/mm2 in gastric antrum, duodenum, and colon, respectively.<\/jats:p>\n                  <jats:p>Conclusions The TDI may discriminate between MCAS patients vs. controls.  If this preliminary work can be independently confirmed, the TDI may become a useful additional minor diagnostic criterion for MCAS.<\/jats:p>","DOI":"10.1055\/a-1833-9226","type":"journal-article","created":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T19:06:59Z","timestamp":1652728019000},"page":"268-274","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of a tryptase depletion index for better pathologic identification of mast cell activation syndrome"],"prefix":"10.1055","volume":"61","author":[{"given":"Tomasz","family":"Zienkiewicz","sequence":"additional","affiliation":[{"name":"Institute of Pathology Bonn-Duisdorf, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Homann","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Gemeinschaftskrankenhaus Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"M\u00fccke","sequence":"additional","affiliation":[{"name":"Institute for Digitalization in General Practice and Center for Rare Diseases Aachen (ZSEA), University Hospital Aachen, Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger","family":"Seidel","sequence":"additional","affiliation":[{"name":"Center for Bleeding Disorders and Transfusion Medicine (CBT), Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-J\u00f6rg","family":"Hertfelder","sequence":"additional","affiliation":[{"name":"Center for Bleeding Disorders and Transfusion Medicine (CBT), Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard B.","family":"Weinstock","sequence":"additional","affiliation":[{"name":"Departments of Medicine, Missouri Baptist Medical Center and Washington University School of Medicine, St. Louis, MO, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence B.","family":"Afrin","sequence":"additional","affiliation":[{"name":"AIM Center for Personalized Medicine, Purchase, NY, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9005-2749","authenticated-orcid":false,"given":"Gerhard J.","family":"Molderings","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics, University of Bonn, Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,5,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1007\/s10620-020-06264-9","article-title":"Mast cell activation syndrome: a primer for the gastroenterologist","volume":"66","author":"LB Weinstock","year":"2021","journal-title":"Dig Dis Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"190","DOI":"10.3109\/07853890.2016.1161231","article-title":"Often seen, rarely recognized: mast cell activation disease \u2013 a guide to diagnosis and therapeutic options","volume":"48","author":"LB Afrin","year":"2016","journal-title":"Ann Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e76241","DOI":"10.1371\/journal.pone.0076241","article-title":"Familial occurrence of systemic mast cell activation disease","volume":"8","author":"GJ Molderings","year":"2013","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1515\/dx-2020-0005","article-title":"Diagnosis of mast cell activation syndrome: a global \"consensus-2\"","volume":"8","author":"LB Afrin","year":"2020","journal-title":"Diagnosis (Berl)"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"362","DOI":"10.5858\/2006-130-362-MEIMMC","article-title":"Mastocytic enterocolitis: increased mucosal mast cells in chronic intractable diarrhea","volume":"130","author":"S Jakate","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1097\/PAS.0000000000000190","article-title":"A clinicopathologic study of 24 cases of systemic mastocytosis involving the gastrointestinal tract and assessment of mucosal mast cell density in irritable bowel syndrome and asymptomatic patients","volume":"38","author":"LA Doyle","year":"2014","journal-title":"Am J Surg Pathol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/j.1600-065X.2007.00519.x","article-title":"Differential release of mast cell mediators and the pathogenesis of inflammation","volume":"217","author":"TC Theoharides","year":"2007","journal-title":"Immunol Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"11939","DOI":"10.1016\/S0021-9258(19)68496-6","article-title":"Tryptase from human pulmonary mast cells. 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