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In a sensitized system especially with mast cell instability or a history of Mast Cell Activation Syndrome these same pathways can shift: Increased histamine release Neurogenic inflammation Vascular reactivity Delayed hypersensitivity-type responses What was meant to heal can present as: flushing, burning, swelling, or persistent erythema

doi: 10.1523/JNEUROSCI.2184-09.2009 81

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