{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:59:34Z","timestamp":1794362374230,"version":"4.9.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Allergy"],"abstract":"<jats:p>Since its initial description ten years ago, numerous studies have contributed to a better understanding of the role of hereditary alpha-tryptasemia (H\u03b1T) in the diagnosis and management of patients with clonal mast cell activation disorders (cMCADs). These studies have highlighted the high prevalence of H\u03b1T among cMCADs patients, the associated elevation in baseline serum tryptase levels\u2014which can influence both diagnosis and disease monitoring\u2014and distinct clinical features, notably an increased risk of severe anaphylaxis. As a result, screening for H\u03b1T has become an integral part of the diagnostic work-up in patients with cMCADs. However, several key questions remain unresolved: Why is H\u03b1T more prevalent among cMCADs patients? How can we accurately distinguish between H\u03b1T and cMCADs during the diagnostic process? And how does the presence of this genetic trait influence the clinical management of cMCADs? In this article, we present the position and clinical approach of the French National Reference Center for Mastocytosis (CEREMAST).<\/jats:p>","DOI":"10.3389\/falgy.2025.1674609","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T05:10:35Z","timestamp":1762837835000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From mechanism to management: CEREMAST perspectives on the intersection of H\u03b1T and clonal mast cell disorders"],"prefix":"10.3389","volume":"6","author":[{"given":"Laura","family":"Polivka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Hermine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Rossignol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1002\/ajh.26962","article-title":"Systemic mastocytosis in adults: 2023 update on diagnosis, risk stratification and management","volume":"98","author":"Pardanani","year":"2023","journal-title":"Am J Hematol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1941","DOI":"10.1016\/j.jaip.2022.05.007","article-title":"Global classification of mast cell activation disorders: an ICD-10-CM\u2013adjusted 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