The Normal Range of Baseline Tryptase Should Be 1 to 15 ng/mL and Covers Healthy Individuals With HαT
Year: 2023
Type: article
Abstract: Physiological levels of basal serum tryptase vary among healthy individuals, depending on the numbers of mast cells, basal secretion rate, copy numbers of the TPSAB1 gene encoding alpha tryptase, and renal function. Recently, there has been a growing debate about the normal range of tryptase because individuals with the hereditary alpha tryptasemia (HαT) trait may or may not be symptomatic, and if symptomatic, uncertainty exists as to whether this trait directly causes clinical phenotypes or aggravates certain conditions. In fact, most HαT-positive cases are regarded as asymptomatic concerning mast cell activation. To address this point, experts of the European Competence Network on Mastocytosis (ECNM) and the American Initiative in Mast Cell Diseases met at the 2022 Annual ECNM meeting and discussed the physiological tryptase range. Based on this discussion, our faculty concluded that the normal serum tryptase range should be defined in asymptomatic controls, inclusive of individuals with HαT, and based on 2 SDs covering the 95% confidence interval. By applying this definition in a literature screen, the normal basal tryptase in asymptomatic controls (HαT-positive persons included) ranges between 1 and 15 ng/mL. This definition should avoid overinterpretation, unnecessary referrals, and unnecessary anxiety or anticipatory fear of illness in healthy individuals.
Authors: Peter Valent, Gregor Hoermann, Patrizia Bonadonna, Karin Hartmann, Wolfgang R. Sperr, Sigurd Broesby-Olsen, Knut Brockow, Marek Niedoszytko, Olivier Hermine, Yannick Chantran, Joseph H. Butterfield, Georg Greiner, Melody C. Carter, Vito Sabato, Deepti H. Radia, Frank Siebenhaar, Massimo Triggiani, Theo Gülen, Ivan Alvarez-Twose, Thomas Staudinger, Ludwig Traby, Karl Sotlar, Andreas Reiter, Hans-Peter Horny, Alberto Orfao, Stephen J. Galli, Lawrence B. Schwartz, Jonathan J. Lyons, Jason Gotlib, Dean D. Metcalfe, Michel Arock, Cem Akin
Institutions: Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Munich Leukemia Laboratory (Germany), Azienda Ospedaliera Universitaria Integrata Verona, University of Basel, University Hospital of Basel, Odense University Hospital, Technical University of Munich, Gdańsk Medical University, Hôpital Necker-Enfants Malades, Université Paris Cité, Assistance Publique – Hôpitaux de Paris, Institut des Maladies Génétiques Imagine, Hôpital Saint-Antoine, Paris-Sorbonne University, Mayo Clinic, National Institutes of Health, National Institute of Allergy and Infectious Diseases, University of Antwerp, Antwerp University Hospital, National Health Service, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, Humboldt-Universität zu Berlin, Fraunhofer Institute for Translational Medicine and Pharmacology, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, University of Salerno, Karolinska University Hospital, Karolinska Institutet, Hospital Virgen del Valle, Centro de Investigación Biomédica en Red de Cáncer, Paracelsus Medical University, University Medical Centre Mannheim, Pathologisches Institut, Ludwig-Maximilians-Universität München, Universidad de Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cáncer, Stanford Medicine, Stanford University, Virginia Commonwealth University, Virginia Commonwealth University Medical Center, Stanford Cancer Institute, Pitié-Salpêtrière Hospital, University of Michigan
Language: English
Topic: Mast cells and histamine
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,000
Funders: National Science Foundation, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, Austrian Science Fund, Fonds Wetenschappelijk Onderzoek, Stockholms Läns Landsting, Svenska Läkaresällskapet, National Institutes of Health, National Institute of Allergy and Infectious Diseases, NHLBI Division of Intramural Research
Awards: G2724286588, G3560809795, Novel Diagnostic Markers and Targets in Activated Mast Cells, G6550947869, Primary mast cell disorders with and without anaphylaxis: a search for specific biomarkers., G8690818240, Identification of novel therapeutic targets in oncogenic signaling pathways in mastocytosis, G8838525055, G9000155121, G9000231743, Integrated Genomic and Functional Studies of Immunotherapy for Multi-Food Allergy
OpenAlex ID: W4385737169