The MastAttack 107: The Layperson’s Guide to Understanding Mast Cell Diseases, Part 65

79. Do probiotics help GI symptoms from mast cell disease?

  • Some people may not be aware of this, but my first science love was microbiology. I love bacteria. They are my teeny little super guys. Mostly because they make the world go round. <3
  • Yes, probiotics help symptoms from mast cell disease.
  • Your body is populated with millions and millions of microbes in just about every place where your body comes into contact with the outside world. This is mostly skin, GI tract, GU tract, and upper respiratory tract.
  • This is an example of symbiosis: the science term for “everybody wins.” Microbes get a steady source of food and protection from the outside world by living attached to some part of us. In return, they help us to break down molecules, make vitamins for us, and help protect us from infections by taking up all the available microbe real estate. If there’s already friendly bacteria (or yeast) living in every available place where microbes could attach to us, that helps to protect us from not so friendly microbes who need a place to latch on.
  • Antibiotics and antimicrobials are in tons of over the counter of products. We are in an age where antibiotics and antimycotics are being used more than ever, often in situations where they can’t even provide benefit.
  • These have the effect of killing off all the helpful microbes, leaving us in a situation where the ones that are left are the most resistant to treatment. This is a huge problem for a number of reasons, the biggest one being the genesis of super bugs, antibiotic resistant organisms that we can’t kill.
  • But there’s another big reason: when you kill off helpful bacteria, it affects our day to day bodily functions. Our bodies have evolved to have this symbiotic relationship with these organisms for millennia. When we kill all those little super guys off, our body is open to infections and situations that cause inflammation.
  • The population of microbes that normally lives happily inside our healthy bodies is called our commensal. If it’s in the GI tract, it’s called the GI commensal.
  • We know for sure that food allergies is related at least partially to changes in the GI commensal.
  • There are a number of experiments that show that if you take the GI commensal out of a healthy mouse and transplant it into a food allergic mouse, that mouse is no longer food allergic. We also know that if you take the GI commensal out of a food allergic mouse and transplant it into a healthy mouse, now you have two food allergic mice.
  • Probiotics contain microbes that you can use to replace the good ones that have been killed off. Mast cell patients, and patients with other inflammatory GI diseases, report a lot of benefit with using probiotics. Mast cell patients have to be careful and need to be sure to look up the ingredients of every probiotic they try, as many of them contain triggers, like lactose. VSL3 often works pretty well in people who are reactive. Culturelle is used by lots of patients. It depends on a lot. Your mileage may vary.
  • People with central lines should use caution and always be sure to wash hands and sterilize surfaces between taking probiotics and using their lines. These organisms are not supposed to be introduced to the bloodstream and could potentially cause infections, especially in people with depressed immunity.
  • I would to give a shout out to MastAttack admin, Pari, who is the most relentless advocate for probiotics I have ever seen. She cares more about your use of probiotics than I care about most things.

Mast cell inhibitory effects of some microorganisms

We have talked recently about how infections can activate mast cells and result in worsening of symptoms in mast cell patients. However, some organisms are actually able to decrease mast cell degranulation and secretion of mediators. Some of these organisms are highly pathogenic with dangerous infectious capabilities, but some are commensal bacteria that can be found in probiotics. These findings support a growing body of evidence that indicates that the changes in our commensal organisms in the last thirty years have contributed to the increased frequency of atopic disease in developed countries. Additionally, improved hygiene and public health have decreased the frequency of some infections, which may also contribute to allergic conditions.

Lactobacillus and Bifidobacteria have been found to directly inhibit mast cell degranulation. Lactobacillus reduces both mast cell degranulation and cytokine secretion by reducing the number of IgE receptors on mast cell surface. Expression of IL-8 and TNF-a are actively decreased, while expression of the anti-inflammatory IL-10 is increased. Bifidobacterium bifidum inhibit IgE activation of mast cells in similar ways.

Salmonella typhimurium is a frequent cause of foodborne illness. In the US, it is estimated to cause 1,000,000 illness events annually, resulting in 19,000 hospitalizations and 380 deaths. It causes diarrhea, fever and severe abdominal cramping that can last several days. A 2001 study found that Salmonella are able to avoid detection by neutrophils through inactivation of local mast cells. Specifically, Salmonella inject a protein known as SptP into the fluid inside mast cells. Following exposure to Salmonella, mast cells lost their ability to degranulate, even when exposed to IgE or strong antigens.

Yersinia pestis, which causes plague, can also suppress mast cell degranulation by injecting a similar protein called YopH. Several forms of commensal E. coli (which do not cause infection) have been found to exhibit similar suppression.

Some organisms can cause mast cells to lyse (burst) and thus die. Pseudomonas aeruginosa releases exotoxin A, which causes lysis of mast cells.

Infectious fungi, such as Aspergillus fumigatus, release a gliotoxin that suppresses mast cell degranulation as well as mediator secretion. Other fungal products that decrease mast cell activity include FK-506 from Streptomyces tsukubaensis and cyclosporine A from Tolypocladium inflatum. Cyclosporine A is often used as an immunosuppressive after organ transplant and also sees some use in treating inflammatory disorders.

Some nematodes (roundworms) are also able to block mast cell degranulation. Filarial nematodes release a molecule, ES-62, that blocks IgE activation of mast cells as well as inhibiting secretion of allergic inflammatory factors. This finding is notable as it provides a possible reason why allergic diseases occur less frequently in developing countries. Toxoplasma gondii, a parasitic protozoan that causes toxoplasmosis, also prevented mast cell degranulation.



Choi, H.W., Brooking-Dixon, R., Neupane, S., Lee, C.-J., Miao, E.A., Staats, H.F., Abraham, S.N., 2013. Salmonella typhimurium impedes innate immunity with a mast-cell-suppressing protein tyrosine phosphatase, SptP. Immunity 39,1108–1120.

Cornelis, G.R., 2002. Yersinia type III secretion: send in the effectors. J. Cell Biol. 158, 401–408.

Magerl, M., Lammel, V., Siebenhaar, F., Zuberbier, T., Metz, M., Maurer, M., 2008. Non-pathogenic commensal Escherichia coli bacteria can inhibit degranulation of mast cells. Exp. Dermatol. 17, 427–435.

Harata, G., He, F., Takahashi, K., Hosono, A., Kawase, M., Kubota, A., Hiramatsu, M.,Kaminogawa, S., 2010. Bifidobacterium suppresses IgE-mediated degranulationof rat basophilic leukemia (RBL-2H3) cells. Microbiol. Immunol. 54, 54–57.

Forsythe, P., Wang, B., Khambati, I., Kunze, W.A., 2012. Systemic effects of ingested Lactobacillus rhamnosus: inhibition of mast cell membrane potassium (IKCa)current and degranulation. PLoS One 7, e41234.

Oksaharju, A., Kankainen, M., Kekkonen, R.A., Lindstedt, K.A., Kovanen, P.T., Korpela,R., Miettinen, M., 2011. Probiotic Lactobacillus rhamnosus downregulates FCER1and HRH4 expression in human mast cells. World J. Gastroenterol. 17, 750–759.

Wesolowski, J., Paumet, F., 2011. The impact of bacterial infection on mast celldegranulation. Immunol. Res. 51, 215–226.

Niide, O., Suzuki, Y., Yoshimaru, T., Inoue, T., Takayama, T., Ra, C., 2006. Fungal metabolite gliotoxin blocks mast cell activation by a calcium- and superoxide-dependent mechanism: implications for immunosuppressive activities. Clin.Immunol. 118, 108–116.

Melendez, A.J., Harnett, M.M., Pushparaj, P.N., Wong, W.S., Tay, H.K., McSharry, C.P.,Harnett, W., 2007. Inhibition of Fc epsilon RI-mediated mast cell responses by ES-62, a product of parasitic filarial nematodes. Nat. Med. 13, 1375–1381.

Hae Woong Choi, Soman N. Abraham. Mast cell mediator responses and their suppression by pathogenic and commensal microorganisms. Molecular Immunology 63 (2015) 74–79.