title: Mastocytosis: molecular mechanisms and clinical disease heterogeneity.
abstract: Systemic mastocytosis has one unifying feature: an unexplained and pathologic increase in mast cells in specific tissues. This observation, along with clinical disease heterogeneity has long suggested that mastocytosis is a disease of complex etiology. At the same time, the last decade has witnessed significant progress in identifying the critical elements that regulate mast cell growth and development. Human mast cells are now known to arise from CD34(+) progenitors, particularly under the influence of stem cell factor (SCF). This information in turn led to the critical observation that a substantial number of patients with mastocytosis exhibit activating mutations in c-kit, the receptor for SCF. And while this observation may well be key in understanding mastocytosis, this mutation alone does not explain all heterogeneity. It now appears that other influences such as genetic polymorphisms within the host may influence the course of disease in those with KIT mutations; and that the search for additional molecular events capable of creating disease diversity must continue.
authors.affiliation: Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bldg. 10, Rm. 11C205, 10 Center Drive MSC 1881, Bethesda, MD 20892-1881, USA.
authors.forename: D D
authors.initials: DD
authors.lastname: Metcalfe
authors.forename: C
authors.initials: C
authors.lastname: Akin
mesh_terms: D000328:Adult; D017668:Age of Onset; D019943:Amino Acid Substitution; D000818:Animals; D002454:Cell Differentiation; D002648:Child; D018450:Disease Progression; D018740:Genetic Heterogeneity; D006801:Humans; D008407:Mast Cells / Q000473:pathology*; D008415:Mastocytosis / Q000145:classification / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D051379:Mice; D008817:Mice, Mutant Strains; D020125:Mutation, Missense; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000235:genetics; D010024:Osteoporosis / Q000209:etiology; D019009:Proto-Oncogene Proteins c-kit / Q000235:genetics / Q000502:physiology; D012333:RNA, Messenger / Q000032:analysis; D012867:Skin / Q000473:pathology; D019089:Stem Cell Factor / Q000502:physiology; D014781:Viscera / Q000473:pathology
chemical_list: D012333:RNA, Messenger; D019089:Stem Cell Factor; D019009:Proto-Oncogene Proteins c-kit