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When I see patients with concerns for mast cell activation syndrome (MCAS), I often emphasize that this is a neuroimmune condition, meaning the immune system and nervous system are in constant communication. Mast cells sit very close to nerves and can be directly activated by stress signals like norepinephrine and CRH (corticotropin-releasing hormone). During a flare, the body often shifts toward a more sympathetic (“fight or flight”) state, which can further dysregulate mast cells and amplify s
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