Histamine can be released from mast cell granules in two ways, both of which have pharmacological impor-
tance. Endogenous or exogenous compounds can promote an exocytotic release of histamine without cell destruction or lysis. Alternatively, histamine can be released from mast cells by a variety of nonexocytotic processes, including mast cell lysis, modification of mast cell membranes, and physical displacement of histamine.
Both exocytotic and nonexocytotic mechanisms can contribute to adverse drug reactions that involve hista-mine release. Histamine is only one of several potent physiological mediators that are released from mast cells; the other substances can also contribute to the overall immediate hypersensitivity reaction.
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