The mastcell, director of chronic pelvic pain orchestra: implications for the gynaecologist

Increasing evidence supports the prominent role of up-regulated mastcells (MC's) in the maintenance of chronic inflammation and in the shifting from nociceptive to neuropathic pain in the affected tissues, contributing to chronic pelvic pain (CPP).
New therapeutic lines consider reduction of agonists and/or using drugs (“antagonists”) that can down-regulated the release of pro-inflammatory, angiogenic and neurotrophic factors from the mastcells.
Gynaecologist’ may improve CPP by understanding the pathophysiology of MCs in chronic inflammation and addressing it in a multimodal therapeutic process.