The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Time course of appearance and disappearance of human mast cell tryptase in the circulation after anaphylaxis.
Open accessAbstract
Tryptase, a neutral protease of human mast cells, is a potentially important indicator of mast cell involvement in various clinical conditions. The current study examined the time course of appearance and disappearance of tryptase in the circulation after an anaphylactic event and the stability of both endogenous and exogenous tryptase in terms of freeze-thawing and temperature. The peak level of tryptase after an experimentally induced systemic anaphylactic reaction occurred 1-2 h after the initiating bee sting in each of three subjects, in contrast to histamine levels which peaked at 5-10 min. In some cases elevated levels of tryptase may not be detected during the initial 15-30 min. Tryptase levels then declined under apparent first order kinetics with a t1/2 of approximately 2h. Similar disappearance kinetics were observed for two subjects presenting in the emergency room with immediate type reactions, one with severe asthma after indomethacin ingestion, the other with systemic anaphylaxis after a bee sting. Histamine levels declined rapidly and were back to baseline by 15-60 min. Measured levels of tryptase in serum or plasma were not diminished by up to four freeze-thaw cycles. Incubation of serum samples taken from subjects with elevated levels of tryptase at 22 and 37 degrees C indicated that greater than 50% of endogenous tryptase was still detected after 4 d. Purified tryptase added to serum or plasma and incubated as above was less stable: approximately 50% of exogenous tryptase in serum and approximately 15% in plasma was detected after 2d of incubation. Therefore, optimally samples should be stored frozen, but even those stored at room temperature for up to 4 d should be satisfactory. The best time to obtain samples for tryptase determinations is 1-2 h after the precipitating event, but depending on the magnitude of the initial response elevated levels of tryptase may be present in the circulation for several hours.
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“the most specific and reliable marker of systemic MC activation is an acute and substantial event-related (transient) increase in the serum tryptase level over the individual’s baseline value.”
From Why the 20% + 2 Tryptase Formula Is a Diagnostic Gold Standard for Severe Systemic Mast Cell Activation and Mast Cell Activation Syndrome (2019) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“although it was clear that tryptase is the biomarker of choice to define anaphylaxis and thus MCAS based on previous literature data and experience in specialized centers [12–18], a diagnostic threshold was missing.”
From Why the 20% + 2 Tryptase Formula Is a Diagnostic Gold Standard for Severe Systemic Mast Cell Activation and Mast Cell Activation Syndrome (2019) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“tryptase has been repeatedly described as the most specific and reliable biomarker of severe systemic MC activation in daily practice [12–18].”
From Why the 20% + 2 Tryptase Formula Is a Diagnostic Gold Standard for Severe Systemic Mast Cell Activation and Mast Cell Activation Syndrome (2019) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In the work-up of anaphylaxis, BST levels raise significantly after the episode due to the considerable release by MC and is expected to turn to the baseline value at least after 24 h (28, 29).”
From Defining “Normal” basal serum tryptase levels: a context-dependent approach to improve diagnostics in systemic mastocytosis (2025) · cites this paper as [29]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“during and shortly after a severe anaphylactic event where MC release large amounts of tryptase, the serum tryptase level increases substantially over the individual’s baseline (Fig. 1) [12–17].”
From Why the 20% + 2 Tryptase Formula Is a Diagnostic Gold Standard for Severe Systemic Mast Cell Activation and Mast Cell Activation Syndrome (2019) · cites this paper as [16]
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Citations
Cites
Two types of human mast cells that have distinct neutral protease compositions.
Irani, A.-M. A., Schechter, N. M., Craig, S. S., DeBlois, G., & Schwartz, L. B. (1986) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.83.12.4464 · Cited by 1,007
Self-citationTryptase levels as an indicator of mast-cell activation in systemic anaphylaxis and mastocytosis
Schwartz, L. B., Metcalfe, D. D., Miller, J. S., Earl, H., & Sullivan, T. (1987) · New England Journal of Medicine · doi:10.1056/nejm198706253162603 · Cited by 784
Self-citationQuantitation of histamine, tryptase, and chymase in dispersed human T and TC mast cells.
Schwartz, L. B., Irani, A. M., Roller, K., Castells, M., & Schechter, N. M. (1987) · The Journal of Immunology · doi:10.4049/jimmunol.138.8.2611 · Cited by 500
Self-citationTryptase from human pulmonary mast cells. Purification and characterization
Schwartz, L. B., Lewis, R. A., & Austen, K. F. (1981) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(19)68496-6 · Cited by 419
Self-citationPhysiologic manifestations of human anaphylaxis.
Smith, P. L., Kagey‐Sobotka, A., Bleecker, E. R., Traystman, R. J., Kaplan, A., Gralnick, H. R., Valentine, M. D., Permutt, S., & Lichtenstein, L. M. (1980) · Journal of Clinical Investigation · doi:10.1172/jci109936 · Cited by 380
Regulation of tryptase from human lung mast cells by heparin. Stabilization of the active tetramer.
Schwartz, L. B., & Bradford, T. R. (1986) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(17)38401-6 · Cited by 343
Self-citationAcid hydrolases and tryptase from secretory granules of dispersed human lung mast cells.
Schwartz, L. B., Lewis, R. A., Seldin, D. C., & Austen, K. F. (1981) · The Journal of Immunology · doi:10.4049/jimmunol.126.4.1290 · Cited by 328
Self-citationEvaluation of human peripheral blood leukocytes for mast cell tryptase
Castells, M. C., Irani, A. M., & Schwartz, L. B. (1987) · The Journal of Immunology · doi:10.4049/jimmunol.138.7.2184 · Cited by 278
Self-citationHuman lung tryptase. Purification and characterization.
Smith, T. J., Hougland, M. W., & Johnson, D. A. (1984) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)90620-4 · Cited by 168
Exercise-induced anaphylaxis: a distinct form of physical allergy
Sheffer, A. L., Soter, N. A., McFadden, E. R., & Austen, K. F. (1983) · Journal of Allergy and Clinical Immunology · doi:10.1016/0091-6749(83)90085-4 · Cited by 137
Cited by
Sorted by citations
Fatal and Near-Fatal Anaphylactic Reactions to Food in Children and Adolescents
Sampson, H. A., Mendelson, L., & Rosen, J. P. (1992) · New England Journal of Medicine · doi:10.1056/nejm199208063270603 · Cited by 1,609
Allergy Diagnostic Testing: An Updated Practice Parameter
Bernstein, I. L., Li, J. T., Bernstein, D. I., Hamilton, R., Spector, S. L., Tan, R., Sicherer, S., Golden, D. B. K., Khan, D. A., Nicklas, R. A., et al. (2008) · Annals of Allergy, Asthma & Immunology · doi:10.1016/s1081-1206(10)60305-5 · Cited by 723
The diagnosis and management of anaphylaxis
Lieberman, P., Kemp, S., Oppenheimer, J., Lang, D., Bernstein, I., Nicklas, R., Anderson, J. A., Bernstein, D., Bernstein, J., Fink, J., et al. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.01.010 · Cited by 296
“Plasma histamine levels begin to increase within 5 to 10 minutes of the onset of symptoms of anaphylaxis and remain increased for 30 to 60 minutes.(24,25) Therefore they are not of help if the patient is seen as long as an hour or more after the onset of the event.”
BackgroundAnaphylaxis and Emergency Treatment
Sampson, H. A. (2003) · PEDIATRICS · doi:10.1542/peds.111.s3.1601 · Cited by 610
T Cells Expressing Chimeric Antigen Receptors Can Cause Anaphylaxis in Humans
Maus, M. V., Haas, A. R., Beatty, G. L., Albelda, S. Μ., Levine, B. L., Liu, X., Zhao, Y., Kalos, M. D., & June, C. H. (2013) · Cancer Immunology Research · doi:10.1158/2326-6066.cir-13-0006 · Cited by 596
“Serum tryptase is the best clinically measurable indicator of recent mast cell degranulation, with levels typically peaking 15 to 60 minutes after symptom onset and declining with a half-life of about 2 hours (19).”
Background
Metadata
- Authors
- Schwartz, L. B., Yunginger, J. W., Miller, J., Bokhari, R., & Dull, D.
- Affiliations
- Virginia Commonwealth University Medical Center (US)
- Mayo Clinic (US)
- Venue
- Journal of Clinical Investigation
- Published
- 1989-05-01
- Volume
- 83
- Issue
- 5
- Pages
- 1551-1555
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC303860
- OpenAlex
- W2024275029
- Cited by
- 456
- References
- 18
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 6 · 2023: 9 · 2022: 6 · 2021: 14 · 2020: 6 · 2019: 16 · 2018: 8 · 2017: 10 · 2016: 11 · 2015: 12 · 2014: 20 · 2013: 9 · 2012: 4
- FWCI
- 6.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (AI20487, AI-72621)
- 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 › Pharmacology (medical) › Drug-Induced Adverse Reactions
- Keywords
- tryptase, mast cells, anaphylaxis, bee stings, histamine, freeze-thaw cycles, sample storage, immediate hypersensitivity, serum biomarkers
- MeSH terms
- Adult, Anaphylaxis, Body Temperature, Child, Preschool, Female, Freezing, Histamine Release, Humans, Kinetics, Mast Cells, Peptide Hydrolases, Temperature
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