Basal serum tryptase: A critical reconsideration of reference values
Open accessAbstract
Basal serum tryptase in 681 healthy adults. Mathematical analysis reveals a double population of low (2–8 μg/L) or high producers (8–11.4 μg/L) with a threshold at 8 μg/L.
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BST normal values have been established in the range of 1 to 11.5 ng/ml.
“BST normal values have been established in the range of 1 to 11.5 ng/ml (20, 24)”
From Defining “Normal” basal serum tryptase levels: a context-dependent approach to improve diagnostics in systemic mastocytosis (2025) · cites this paper as [24]
The opening section reports a manufacturer-defined 95th-percentile reference level of 11.4 µg/L, close to the claimed upper bound. The Table 1 note identifies 1 µg/L as the assay’s detection limit, not an established lower bound of normal; the paper also says the reference level remains controversial and proposes a lower threshold. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe majority of individuals with HαT are healthy and will not develop any MC-related conditions.
“The majority are healthy individuals and will not develop any MC-related conditions [41].”
From Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders (2023) · cites this paper as [41]
The Additional information section reports that some healthy donors had elevated tryptase and might have HαT, but says genetic confirmation is needed. Our copy does not establish what proportion of people with HαT are healthy or whether they will develop mast-cell-related conditions; searches for those clinical outcomes found no such passage. (LLM, conf=0.75)
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Cites
Lyons, J. J. (2018) · Immunology and Allergy Clinics of North America · doi:10.1016/j.iac.2018.04.003 · Cited by 179 · see citing works
The Genetic Basis and Clinical Impact of Hereditary Alpha-Tryptasemia
Luskin, K. T., White, A. A., & Lyons, J. J. (2021) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2021.03.005 · Cited by 67 · see citing works
Elevated Basal Serum Tryptase: Disease Distribution and Variability in a Regional Health System
Waters, A. M., Park, H. J., Weskamp, A. L., Mateja, A., Kachur, M. E., Lyons, J. J., Rosen, B. J., & Boggs, N. A. (2022) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2021.12.031 · Cited by 46 · see citing works
Serum tryptase levels in atopic and nonatopic children
Komarow, H. D., Hu, Z., Brittain, E., Uzzaman, A., Gaskins, D., & Metcalfe, D. D. (2009) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2009.06.040 · Cited by 42 · see citing works
Serum Baseline Tryptase Level as a Marker for the Severity of Anaphylaxis
Aniceto, V., Dias, M. M., Melo, J. M. L., Neto, O. T., Aragon, D. C., Maia, L. S. M., Moreno, A. S., & Arruda, L. K. (2019) · International Archives of Allergy and Immunology · doi:10.1159/000497235 · Cited by 35 · see citing works
Mast cell activation in the context of elevated basal serum tryptase: genetics and presentations
Khoury, P., & Lyons, J. J. (2019) · Current Allergy and Asthma Reports · doi:10.1007/s11882-019-0887-x · Cited by 30 · see citing works
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Niedoszytko, M., Górska, A., Brockow, K., Bonadonna, P., Lange, M., Kluin‐Nelemans, H. C., Oude‐Elberink, H., Sabato, V., Shoumariyeh, K., von Bubnoff, D., et al. (2024) · Allergy · doi:10.1111/all.16132 · Cited by 23 · see citing works
Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders
Beyens, M., Toscano, A., Ebo, D., Gülen, T., & Sabato, V. (2023) · Diagnostics · doi:10.3390/diagnostics13243662 · Cited by 22 · see citing works
“The majority are healthy individuals and will not develop any MC-related conditions [41].”
BackgroundWhat the clinician should know when ordering a mast cell tryptase test
Michel, M., Giusti, D., Klingebiel, C., Pham, B., & Vitte, J. (2025) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2025.03.003 · Cited by 8 · see citing works
Worm, M., Cichocka‐Jarosz, E., Ruëff, F., Spindler, T., Köhli, A., Trück, J., Lange, L., Hartmann, K., Hawranek, T., Nemat, K., et al. (2024) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2024.08.036 · Cited by 4 · see citing works
Crupi, F., Caroprese, J., & Mannelli, F. (2025) · Frontiers in Allergy · doi:10.3389/falgy.2025.1592001 · Cited by 2 · see citing works
“BST normal values have been established in the range of 1 to 11.5 ng/ml (20, 24), maintaining a consistent level in healthy individuals due to the balance between storage and release from MCs (25, 26).”
InfluentialShean, R. C., Spies, N. C., & Saadalla, A. M. (2026) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2025.12.1002 · Cited by 2 · see citing works
Tryptase in drug-induced anaphylaxis: the need for acute and baseline values
Michel, M., Giusti, D., Klingebiel, C., & Vitte, J. (2024) · Current Opinion in Allergy and Clinical Immunology · doi:10.1097/aci.0000000000001012 · Cited by 2 · see citing works
TauroSept-Induced Anaphylaxis: A Pediatric Case Report
Mank, E., Broos, N., Terreehorst, I., Liem, O., Nusman, C. M., Gerards, A. E., Derikx, J. P. M., & Tabbers, M. M. (2025) · Pediatric Allergy Immunology and Pulmonology · doi:10.1177/2151321x251379008 · Cited by 2 · see citing works
Pediatric anaphylaxis in the emergency department: Performances of dynamic tryptase measurement
Gonzalez, C., Sun, M., Morand, A., Minodier, P., Léone, M., Dubus, J. ‐., Vitte, J., & Michel, M. (2025) · Journal of Allergy and Clinical Immunology Global · doi:10.1016/j.jacig.2025.100524 · Cited by 1 · see citing works
Chantran, Y., Novakowski, H., Vial‐Dupuy, A., Bouz, C., Apoil, P. A., Choi, S., Fromentin, E., Goret, J., Mathieu, P., Michel, M., et al. (2025) · Allergy · doi:10.1111/all.70069 · Cited by 1 · see citing works
Near-Fatal Mastocytosis Mimicking as Malignant Vasovagal Syncope
Estublier, B., Martin‐Blondel, A., Berthomieux, L., Severino‐Freire, M., Beneyto, M. M., Rieu, J., Voisin, S., & Maury, P. (2025) · JACC Case Reports · doi:10.1016/j.jaccas.2025.106290 · Cited by 1 · see citing works
New basal serum tryptase measurement on Noveos™ system:Preprint
Lambert, C., Waeckel, L., & BERGER, A.-E. (2023) · doi:10.22541/au.169137003.35859683/v1
Self-citationNouveaux critères diagnostiques des mastocytoses : des progrès mais encore des interrogations
Arock, M. (2024) · Bulletin de l Académie Nationale de Médecine · doi:10.1016/j.banm.2024.03.009
The value of serum triptase in hymenoptera venom allergy
Popa, M. D., Muntean, A. M., & Deleanu, D. M. (2024) · Alergologia · doi:10.26416/aler.8.3.2024.10137
Sarrat, A., Vitte, J., Chantran, Y., Beauvillain, C., Alyanakian, M., Apoil, P. A., Chollet, L., Cirée, A., Amiot, C., Dumontet, E., et al. (2025) · Journal of Allergy and Hypersensitivity Diseases · doi:10.1016/j.jahd.2025.100037
Self-citation
- Authors
- Francois, F., Mauff, B. L., Waeckel, L., de Chaisemartin, L., Tabary, T., Dumontet, E., Lecron, J. C., Delamare, B., Boumediene, A., Chauvineau‐Grenier, A., Pescarmona, R., Garnier, L., Lambert, C., & French Network of Hospital Biologist in Allergology (AllergoBioNet)
- Affiliations
- Centre Hospitalier Universitaire de Saint-Étienne (FR)
- Centre Hospitalier Universitaire de Caen Normandie (FR)
- APHP, Laboratoire d'Immunologie, Hôpital Bichat Paris France
- Centre Hospitalier Universitaire de Reims (FR)
- Hôpital Pontchaillou (FR)
- Centre Hospitalier Universitaire de Poitiers (FR)
- Centre hospitalier universitaire d'Orléans (FR)
- Laboratoire Immunologie CHU Limoges Limoges France
- Centre hospitalier Robert-Ballanger (FR)
- Laboratoire Immunologie CH Lyon Sud Lyon France
- Hôpital Lyon Sud (FR)
- Corresponding author
- Lambert, Claude
- ORCID
- Venue
- Allergy
- Publisher
- Wiley
- Published
- 2023-06-26
- Volume
- 78
- Issue
- 11
- Pages
- 3003-3006
- ISSN
- 0105-4538 (ISSN-L)
- 1398-9995
- OpenAlex
- W4382010868
- Cited by
- 15
- References
- 6
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 5 · 2023: 2
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Allergy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- HAL (submittedVersion, cc-by-nc-nd)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Mast cells and histamine
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- reference values, healthy adults, bimodal distribution, threshold
- MeSH terms
- Anaphylaxis, Humans, Mast Cells, Mastocytosis, Reference Values, Tryptases
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