Why Does MCAS Not Respond to Standard Treatment? The Four Mechanistically Distinct Patterns — thesis

Treatment-resistant MCAS is usually a stratification problem, not a stabilization problem. Four mechanistically distinct patterns produce the MCAS phenotype — barrier-driven, neuroimmune/vagal, chemical/toxicant, and clonal/KIT-driven — and they require different upstream interventions. A Host Capacity Model reading of why cromolyn, ketotifen, and the standard stack fail, and what stratification-anchored care looks like.