Dynamic Changes in Mast Cell-Derived Histamine and Tryptase Following Reperfusion Therapy in Acute Ischemic Stroke

Ischemic stroke (IS) is characterized by complex inflammatory mechanisms that contribute to both primary injury and reperfusion-related damage. Among inflammatory mediators, mast cell–derived histamine and tryptase have been implicated in blood–brain barrier disruption and neuroinflammation, yet their dynamics following thrombolysis remain unclear. This study investigated plasma histamine and tryptase levels in patients with acute IS before and after intravenous thrombolytic therapy and examined their association with clinical and laboratory parameters. At admission, both mediators were significantly elevated. Following thrombolytic therapy, histamine and tryptase decreased significantly, corresponding to an approximately 1.5-fold decrease. Correlation analysis revealed positive associations between both mediators and triglycerides, hemoglobin, and bleeding time, while post-thrombolysis tryptase levels are additionally associated with clotting time. Although mean neurological improvement was not significant, 45% of patients showed clinical improvement following treatment. In conclusion, our findings suggest that thrombolysis may modulate mast cell-related inflammatory activity, metabolic pathways, and coagulation processes in acute IS.