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with elevated BST levels absent HaT or clonal mast cell disease (Fig 1, C). Thus, although Chollet and Akin address an important question, their study cannot clarify phenotypic associations with HaT. Furthermore, conclusions regarding potential impacts of b-tryptase copy number on BST level are not justified. The clinical impact of HaT will certainly be refined by large well-designed studies in the future. However, we are still only beginning to perceive the full implications of tryptase genetic variability with regard to human health and disease.

[1]  J. Lyons.  On the complexities of tryptase genetics and impact on clinical phenotypes. , 2021, The Journal of allergy and clinical immunology.

[2]  P. Korošec,et al.  Clinical relevance of inherited genetic differences in human tryptases: Hereditary alpha-tryptasemia and beyond. , 2021, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[3]  C. Akin,et al.  Hereditary alpha tryptasemia is not associated with specific clinical phenotypes. , 2021, The Journal of allergy and clinical immunology.

[4]  Jenny Huang,et al.  The Prevalence of Hereditary Alpha-Tryptasemia in Patients Diagnosed With POTS via Tilt Table Testing , 2021 .

[5]  C. Akin,et al.  A novel case of beta-tryptase/TPSB2 allele duplication , 2021 .

[6]  K. Schmetterer,et al.  Hereditary alpha tryptasemia is a valid genetic biomarker for severe mediator-related symptoms in mastocytosis. , 2020, Blood.

[7]  T. Briggs,et al.  Hereditary Alpha-Tryptasemia: UK Prevalence and variability in disease expression. , 2020, The journal of allergy and clinical immunology. In practice.

[8]  B. Yaspan,et al.  An Allosteric Anti-tryptase Antibody for the Treatment of Mast Cell-Mediated Severe Asthma , 2019, Cell.

[9]  W. El-Haig,et al.  Secondary Intraocular Lens Implantation After Simultaneous Penetrating Keratoplasty and Cataract Extraction for Coexisting Corneal and Lens Opacities , 2019, Cornea.

[10]  Andrew J. Oler,et al.  Elevated basal serum tryptase identifies a multisystem disorder associated with increased TPSAB1 copy number , 2016, Nature Genetics.

[11]  D. Lockington,et al.  Effectiveness of cataract phacoemulsification with toric intraocular lenses in addressing astigmatism after keratoplasty , 2014, Journal of cataract and refractive surgery.

[12]  R. Steinert,et al.  Results of toric intraocular lenses for post-penetrating keratoplasty astigmatism. , 2014, Ophthalmology.

[13]  H. Dua,et al.  Fine needle diathermy occlusion of corneal vessels , 2014, British Journal of Ophthalmology.

[14]  S. Masket,et al.  Complications of sulcus placement of single‐piece acrylic intraocular lenses: Recommendations for backup IOL implantation following posterior capsule rupture , 2009, Journal of cataract and refractive surgery.

[15]  D. Metcalfe,et al.  Tryptase haplotype in mastocytosis: relationship to disease variant and diagnostic utility of total tryptase levels. , 2007, Clinical immunology.

[16]  S. Cook,et al.  Proposed classification for topographic patterns seen after penetrating keratoplasty , 1999, The British journal of ophthalmology.