COVID-19 mRNA-1273 vaccination induced mast cell activation with strongly elevated Th2 cytokines in a systemic mastocytosis patient

• DOI: 10.1007/s00011-025-02032-5
• Publication Date: 2025-04-29T09:47:19Z
• Authors: Matthias Weiss-Te...; Teresa Haider; Aoife Gowran; Lorenz Schubert; Jakob Mühlbacher; Jelena Brankovic; Markus Wahrmann; Bernd Jilma; Thomas Boehm
• Keywords: Booster dose; Tryptase

Abstract Objective and design SARS-CoV-2 vaccines are recommended for mastocytosis patients. We describe clinical symptoms, chemokine, cytokine, metabolomic lipidomic derangements in a systemic patient following mRNA-1273 booster vaccination. Methods Twenty-eight chemokines cytokines, 41 amino acids 16 lipid classes were quantified with state-of-the-art methods. Results Mast cell activation (MCA) symptoms started 24 h after the vaccination significant metabolic, cytokine derangements. Histamine concentrations peaked at life-threatening 18 ng/ml concomitant high tryptase. Peak plasma IL-1Ra, IL-5, IL-6, IL-10, IL-11, CXCL10 GM-CSF elevated 54-, 4.9-, 85-, 6.1-, 19- 6.4-fold respectively. Tocilizumab, an IL-6 receptor antagonist, was administered 6 admission, because of highly concentrations. More than one year later during another MCA attack likely caused by PCR-proven infection tocilizumab again used. Clinical improved 12 similar to vaccine attack. Conclusions A first delayed severe Th 2 -biased cytokines metabolic Administration blocker both attacks might have shortened duration symptoms.