Mast cells in Abdominal Aortic Aneurysms
Mast cells are moving into the central field of attention for a variety of disorders. They have previously been seen as a kind of Cinderella cell, as professor Rita Levi Montalcini pointed out. This was shortly after her Nobel Prize for growth factors, but are in fact ‘prima dona’ cells. These cells might also participate in the pathogenesis of abdominal aortic aneurysm (AAA).
Mast cells are mentioned now related to the neovascularization of aortic wall and abdominal aneurysms. Mast cells also play a role in other vascular disorders.
For instance mast cells have been identified recetlt to also contribute to the pathogenesis of giant cell arthritis (GCA). Putatively by regulating the functions of other inflammatory cells and resident vessel wall cells.
These cells seem to promote neovascularization, which is one of the causal factors for the neointimal thickening in GCA.
Mast cells in giant cell arthritis
In 2011 mast cells (MC) are regarded as important players in the Orchestrated Pathogenesis of Abdominal Aortic Aneurysms (AAA) by researchers from the Karolinska Institute, in Sweden.
They focus on the fact that activated MCs synthesize and release eicosanoids and a large number of cytokines and chemokines. Experimentally induced AAA in MC-deficient animals. And animals treated with MC inhibitors demonstrate that MCs are involved in the pathogenesis of AAA via various mechanisms.
MC-dependent activation of metalloproteinases and the renin-angiotensin system, contribution to smooth muscle cell apoptosis, and release of proteolytic enzymes are some key examples.
Human studies indicate that MCs are the main source of cathepsin G in Abdominal Aortic Aneurysms. And they contribute to activation of the renin-angiotensin system via chymase and cathepsin G.
Activated MCs also contribute to neovascularization, inflammation, and atherosclerosis, all hallmarks of Abdominal Aortic Aneurysms.
The authors pointed out that new drugs with MC stabilizing properties, as well as leukotrine receptor antagonists and histamine receptor blockers, could also be tested for their efficacy in preventing development and growth of AAA 
Palmitoylethanolamide (PEA) as a classical and powerful mast cell degranulation inhibitor might also be such a candidate. This would also be interesting as a putative treatment option for giant cell arthritis.
Jan M. Keppel Hesselink, MD, PhD, January 2011
‘Mast cells in Abdominal Aortic Aneurysms’
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 Mäyränpää MI, Trosien JA, Fontaine V, Folkesson M, Kazi M, Eriksson P, Swedenborg J, Hedin U. | Mast cells associate with neovessels in the media and adventitia of abdominal aortic aneurysms. | J Vasc Surg. | 2009 Aug;50(2):388-95; discussion 395-6. Epub 2009 Jun 10.
 Mäyränpää MI, Trosien JA, Nikkari ST, Kovanen PT. | Mast cells associate with T-cells and neointimal microvessels in giant cell arteritis. | Clin Exp Rheumatol. | 2008 May-Jun;26(3 Suppl 49):S63-6.
 Swedenborg J, Mäyränpää MI, Kovanen PT. | Mast cells: important players in the orchestrated pathogenesis of abdominal aortic aneurysms. | Arterioscler Thromb Vasc Biol. | 2011 Apr;31(4):734-40. Epub 2011 Jan 4.