Spring cystitis: the role of histamine

Every spring we usually read posts about cystitis that appear punctually with the arrival of good weather.

The first few times I did not pay much attention to it, but the redundancy of these posts over the years and the accumulation of knowledge about the (sometimes complex or subtle) underlying mechanisms of cystitis now allow all the pieces of this puzzle to be assembled.

If you suffer from “spring” cystitis, I hope this article provides you some elements to understand this atypical or more exactly atopic situation since in all this the culprit is histamine!

As seen in a previous article, histamine is one of the main mediators of inflammation, whose production is associated with the activation of mast cells (cells of the immune system) in response to stimuli perceived by the body as “dangerous”.

Among these causes of mast cell activation, we can mention mechanical or chemical irritation, infection by pathogens such as bacteria, viruses or yeasts or the presence of substances identified as foreign to the body (exogenous) such as allergens.

This last case is that of allergy, a kind of error of the organism that begins to treat a normally harmless substance as if it were dangerous for it and thus triggers an immune response directed against it.

Allergic and/or atopic subjects therefore differ from other people by a tendency to have higher levels of histamine with the consequence, when this level increases significantly, of visible manifestations of the immune response at dermatological, pulmonary, respiratory or even nervous/neuropathic level.

It is appropriate at this point to specify an important detail: not all atopic subjects are necessarily symptomatic. Indeed, it is sufficient that the histamine level, although increased by contact with the allergen(s), remains below the significant threshold for mast cell activation to remain silent.

In these conditions, therefore, there is a latent inflammatory “base” that, asks for nothing more than to burst at the slightest opportunity.

Spring cystitis: what is all about?

The “atopic base” defined above could be linked to spring cystitis in rare cases such as:

1) it may be a predisposing factor for cystitis

Indeed, when the histamine level is high (due to the subject’s sensitivity to certain allergens typical of spring such as pollen, for example), the urothelial mucosa can be considered “already stressed” by the latent chronic inflammation generated by histaminosis. In these conditions, the urinary tract is more weakened and more easily “attackable” since the immune defenses mobilized by the inflammatory response are unable to provide optimal preventive coverage against infections, particularly of the urinary tract.

2) it may be a precipitating factor for cystitis

And this is where uropathogenic bacteria come into play by colonizing the bladder even in small quantities, triggering cystitis. In fact, a low bacteria count that would normally be handled by the immune system  without causing cystitis, suddenly becomes a source of symptoms.

This is how subjects who, in fact, are regularly colonized by uropathogenic bacteria without even realizing it (largely thanks to the implementation of effective preventive measures such as a regular intake of D-Mannose) suddenly develop an acute episode  apparently “without a cause”.

Of course, these mechanisms are more plausible in multiallergic or highly atopic subjects because in these situations it is implied the existence, at the same time, of MCAS and histaminosis.

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