Role of cardiac mast cells in cardiovascular diseases: a review

Mast cells are multifunctional immune cells that play complex roles in maintaining tissue homeostasis and disease pathogenesis. They are also involved in inflammation, lymphangiogenesis, and tissue remodeling by releasing several inflammatory mediators. Recent preclinical studies highlighting the heterogeneity of cardiac mast cells (CMCs) have intensified the focus on elucidating their functional diversity in both tissue homeostasis and disease pathogenesis. Notably, CMCs can exhibit distinct or even opposite functions to adapt to the dynamic tissue environment. Although the precise mechanisms remains unclear, evidence from animal studies suggests that mast cells participate in human diseases in ways similar to macrophages and other inflammatory cells, either directly or indirectly. In this review, we provide a concise overview of the origin of mast cells and their distribution within cardiac tissue. We also discuss the critical role of activated mast cells in inflammation regression and tissue remodeling following cardiac injury. Furthermore, we highlight the dual roles of CMCs in cardiovascular disease development and their potential implications. Finally, we address future perspectives and directions in basic research, as well as the potential clinical applications of CMCs.