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February 16, 1990

Mast Cells and Scleroderma-Reply

JAMA. 1990;263(7):949. doi:10.1001/jama.1990.03440070035024

In Reply.—  Chanez and colleagues studied the lungs of patients with scleroderma. They found increased mast cell numbers in bronchoalveolar lavage fluid, but this finding did not correlate with the presence or absence of interstitial lung disease. Bronchoalveolar lavage histamine levels and mast cell numbers in bronchial biopsy specimens were not elevated in patients with scleroderma.Taken together, these results do not seem to support the hypothesis that mast cell activity is important in the fibrosis of scleroderma and other fibrotic processes. There are some points that need to be considered, and these concern the activity of the disease process. The patients of Chanez et al had been sick for 15 to 29 years, and one cannot tell if they are in the active, the quiescent, or the resolving stage of the disease. If their disease is quiescent, the hypothesis would not predict any increase in mast cell numbers