tetano
Editor, Senior Moderator
Inflamm Res
. 2025 Apr 29;74(1):71.
doi: 10.1007/s00011-025-02032-5. COVID-19 mRNA-1273 vaccination induced mast cell activation with strongly elevated Th[SUB]2[/SUB] cytokines in a systemic mastocytosis patient
Matthias Weiss-Tessbach[SUP] #[/SUP][SUP] 1 [/SUP], Teresa Haider[SUP] #[/SUP][SUP] 2 [/SUP], Aoife Gowran[SUP] 1 [/SUP], Lorenz Schubert[SUP] 3 [/SUP], Jakob Mühlbacher[SUP] 4 [/SUP], Jelena Brankovic[SUP] 1 [/SUP], Markus Wahrmann[SUP] 5 [/SUP], Bernd Jilma[SUP] 1 [/SUP], Thomas Boehm[SUP] 6 [/SUP]
Affiliations
Objective and design: SARS-CoV-2 vaccines are recommended for mastocytosis patients. We describe clinical symptoms, chemokine, cytokine, metabolomic and lipidomic derangements in a systemic mastocytosis patient following mRNA-1273 booster vaccination.
Methods: Twenty-eight chemokines and cytokines, 41 amino acids and 16 lipid classes were quantified with state-of-the-art methods.
Results: Mast cell activation (MCA) symptoms started 24 h after the mRNA-1273 booster vaccination with significant metabolic, lipidomic and cytokine derangements. Histamine concentrations peaked at life-threatening 18 ng/ml concomitant with high tryptase. Peak plasma IL-1Ra, IL-5, IL-6, IL-10, IL-11, CXCL10 and GM-CSF concentrations were elevated 54-, 4.9-, 85-, 54-, 6.1-, 19- and 6.4-fold respectively. Tocilizumab, an IL-6 receptor antagonist, was administered 6 h after admission, because of the highly elevated IL-6 concentrations. More than one year later IL-6 was highly elevated during another MCA attack likely caused by a PCR-proven SARS-CoV-2 infection and tocilizumab was again used. Clinical symptoms improved during the following 12 h similar to the vaccine booster MCA attack.
Conclusions: A mRNA-1273 first booster vaccination likely caused a delayed severe MCA attack with highly elevated Th[SUB]2[/SUB]-biased cytokines with metabolic and lipidomic derangements. Administration of an IL-6 receptor blocker during both MCA attacks might have shortened the duration of clinical symptoms.
Keywords: Histamine; SARS-Cov-2; Systemic mastocytosis; Th2-biased cytokines; Tocilizumab; mRNA-1273 vaccination.
. 2025 Apr 29;74(1):71.
doi: 10.1007/s00011-025-02032-5. COVID-19 mRNA-1273 vaccination induced mast cell activation with strongly elevated Th[SUB]2[/SUB] cytokines in a systemic mastocytosis patient
Matthias Weiss-Tessbach[SUP] #[/SUP][SUP] 1 [/SUP], Teresa Haider[SUP] #[/SUP][SUP] 2 [/SUP], Aoife Gowran[SUP] 1 [/SUP], Lorenz Schubert[SUP] 3 [/SUP], Jakob Mühlbacher[SUP] 4 [/SUP], Jelena Brankovic[SUP] 1 [/SUP], Markus Wahrmann[SUP] 5 [/SUP], Bernd Jilma[SUP] 1 [/SUP], Thomas Boehm[SUP] 6 [/SUP]
Affiliations
- PMID: 40299000
- PMCID: PMC12041034
- DOI: 10.1007/s00011-025-02032-5
Objective and design: SARS-CoV-2 vaccines are recommended for mastocytosis patients. We describe clinical symptoms, chemokine, cytokine, metabolomic and lipidomic derangements in a systemic mastocytosis patient following mRNA-1273 booster vaccination.
Methods: Twenty-eight chemokines and cytokines, 41 amino acids and 16 lipid classes were quantified with state-of-the-art methods.
Results: Mast cell activation (MCA) symptoms started 24 h after the mRNA-1273 booster vaccination with significant metabolic, lipidomic and cytokine derangements. Histamine concentrations peaked at life-threatening 18 ng/ml concomitant with high tryptase. Peak plasma IL-1Ra, IL-5, IL-6, IL-10, IL-11, CXCL10 and GM-CSF concentrations were elevated 54-, 4.9-, 85-, 54-, 6.1-, 19- and 6.4-fold respectively. Tocilizumab, an IL-6 receptor antagonist, was administered 6 h after admission, because of the highly elevated IL-6 concentrations. More than one year later IL-6 was highly elevated during another MCA attack likely caused by a PCR-proven SARS-CoV-2 infection and tocilizumab was again used. Clinical symptoms improved during the following 12 h similar to the vaccine booster MCA attack.
Conclusions: A mRNA-1273 first booster vaccination likely caused a delayed severe MCA attack with highly elevated Th[SUB]2[/SUB]-biased cytokines with metabolic and lipidomic derangements. Administration of an IL-6 receptor blocker during both MCA attacks might have shortened the duration of clinical symptoms.
Keywords: Histamine; SARS-Cov-2; Systemic mastocytosis; Th2-biased cytokines; Tocilizumab; mRNA-1273 vaccination.