The mast cell/heparin paradox

Purified heparin extracted from tissues rich in mast cells remains the ideal rapid anticoagulant in clinical practice. Nevertheless, there are grounds for doubting that an injection of commercial heparin corresponds to the release of heparin-containing granules from the mast cells. The metachromatic granule contains much more than heparin--chondroitins, heparitins, histamine (in some species 5-hydroxytryptamine also), and a variety of enzymes. Shed granules, released by trauma of any kind, are ingested by connective-tissue phagocytes and are digested. Commercial heparin, on the other hand, is taken up by cells of the reticuloendothelial system and is stored there. This apparent paradox can be resolved by conceding that the mast cell is primarily concerned with the connective tissue, as Ehrlich saw it a century ago, and that, within these broad limits, it can express itself in a variety of ways.