Conjunctival provocation with airborne allergen in patients with atopic keratoconjunctivitis

Nivenius, Emma; Ploeg, I.C. Van der; Gafvelin, Guro; Hage, Marianne van; Montan, Per

doi:10.1111/j.1365-2222.2011.03858.x

Cited by 17 publications

(19 citation statements)

References 27 publications

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“…Flow cytometry analysis of the tear fluid collected from the individuals with atopic keratoconjunctivitis after a conjunctival allergen provocation test presented higher levels of interferon-gamma, IL-6, and a borderline increase in IL-10 after 48 hours. There was a significant difference between provoked and unprovoked eye for the same cytokines: IL-6, IFNγ, and IL-10 (86) . We speculate that individuals exposed to air pollution or other hazardous stimuli can elicit the similar inflammatory cascade during acute phase and lead to EDED clinical presentation, similar to other ocular surface inflammatory diseases, such as AKC (78) .…”

Section: Epidemiology Of Dry Eye Related To Environmental Factorsmentioning

confidence: 88%

Is dry eye an environmental disease?

Alves¹,

Novaes²,

Morraye³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Previous studies have revealed that eye contact with either air pollutants or adverse indoor and/or outdoor environmental conditions can affect tear film composition and ocular surface components. These effects are mediated by selective binding of the environmental agents to ocular surface membrane receptors, leading to activation of pro inflammatory signaling pathways. The aim of the current review was to examine the published evidence associated with environmental factors and ocular surface disease and dry eye. Specifically, the reader will appreciate why it is possible to refer to them as mediators of Environmental Dry Eye Disease (EDED), a singular clinical entity inside DED context, directly caused by pollutants and/ or adverse climatic conditions. The indicators and clinical findings are described along with EDE differential diagnosis in its acute and the chronic phases. Based on strong existing evidence of clinical reports and epidemiological observations regarding DED and environmental factors we conclude that there is a straight cause-and-effect relationship between ambient stresses and DED. International standards and web-based tools are described for monitoring worldwide environmental conditions referring localities and populations susceptible to EDED. This information is beneficial to health providers to pinpoint the individuals and predisposed groups afflicted with DED. Such insights may not only improve the understanding and treatment of DED but also help to identify the contributing factors and lower the frequency and progression of EDED. of DED has been studied and confirmed in animal models of human DED (13)(14)(15) . KeywordsAs indicated, a healthy and pain-free ocular surface depends on identifying and eliminating factors that cause ambient humidity, airflow and purity, and temperature to intolerable levels. Such an undertaking is needed to preserve tear film qualities commensurate with ocular surface health. This is essential to sustain sufficient corneal refractive power, visual acuity, and ocular comfort (5,16,17) . A desiccating environment can lead to increase in tear film evaporation and/or decline in its turn over and clearance. These initial events lead to exposure of the ocular surface to hazardous environmental elements that trigger or exacerbate EDED symptoms. Clinical findings have shown that increased numbers of people are affected by EDED because of exposure to environmental factors ( Figure 2).Our purpose herein is to provide a critical appraisal of the clinical and epidemiological evidence indicating that DED is influenced by environmental factors. Secondly, we delineate EDED as a single clinical entity with a unique set of symptoms and clinical findings different from that of either DED or other diseases, such as Sjögren's syndrome, diabetes mellitus or drug induced, allergic conjunctivitis, toxic or irritative conjunctivitis, and actinic keratitis. Moreover, we will describe standard tools used to monitor environmental conditions and discuss their relevance in EDED ep...

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Section: Epidemiology Of Dry Eye Related To Environmental Factorsmentioning

confidence: 88%

Is dry eye an environmental disease?

Alves¹,

Novaes²,

Morraye³

et al. 2014

Arquivos Brasileiros De Oftalmologia

View full text Add to dashboard Cite

show abstract

“…The conjunctival provocation tests with allergens, performed directly on the conjunctiva, confirm the role of an allergic reaction occurring in the conjunctiva due to a direct exposure of conjunctival tissue to an inhalant allergen [3,8,12,15,16,17,21,38,42]. …”

Section: Discussionmentioning

confidence: 99%

“…The appearance of a cytokine in the tears of the patients suffering from the primary form of allergic keratoconjunctivitis has already been investigated [9,10,11,12,13,20,37,38,39,40,41,43]. In most of these studies the cytokines, such as IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IFN-γ and TNF-α, have been detected by means of a single, patient-related determination in the tears [3,9,10,11,12,13,20,37,38,39,40,41,42,43]. No data concerning the concentration changes of cytokines in tears during the particular types of the primary KCR to the conjunctival provocation tests with allergens, thus response-related data, are available in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Different hypersensitivity mechanisms activated by direct exposure of the conjunctiva to external allergens result then in the development of different types of primary KCR, such as an IKCR, LKCR or DYKCR [1,2,3,4,8,9,10,11,12,13,14,15,16,17,38,41,42,43]. Similarly, different hypersensitivity mechanisms taking place in the nasal mucosa leading to the development of different types of nasal response can then, under certain circumstances, induce different types of the SKCR, such as an SIKCR, SLKCR or SDYKCR [7,8,9,10,11,12,38].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there is a dearth of data related to the course of the cytokine changes in tears during the individual KCR types of the primary KC form [1,2,3,9,10,11,12,13,15,17,19,20,37,38,39,40,41,42,43]. Moreover, no data are available to illustrate the concentration changes of the cytokines in tears accompanying the particular SKCR types [14].…”

Section: Introductionmentioning

confidence: 99%

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Cytokines in Tears during the Secondary Keratoconjunctival Responses Induced by Allergic Reaction in the Nasal Mucosa

Pelikán¹

2014

Ophthalmic Res

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Background: Allergic keratoconjunctivitis (KC) can occur in a primary form due to an allergic reaction taking place in the conjunctivae or in a secondary form induced by nasal allergy. Objectives: To search for the cytokine changes in tears accompanying the secondary keratoconjunctival response types (SKCR), caused by the nasal allergy. Methods: In 43 KC patients developing 15 immediate (SIKCR), 16 late (SLKCR) and 12 delayed (SDYKCR) responses to nasal provocation tests with allergens (NPT), the NPTs were repeated with subsequent recording of cytokine concentrations in tears up to 72 h. Results: The SIKCRs (p < 0.001), occurring 10-120 min after the NPT, were accompanied by significant changes (p < 0.05) of interleukin (IL)-4, IL-6, IL-10, IL-12p70 and granulocyte-macrophage colony-stimulating factor (GM-CSF). The SLKCRs (p < 0.01), appearing 5-12 h after the NPT, were associated with significant changes (p < 0.05) of IL-3, IL-4, IL-5, IL-8, IL-10, tumor necrosis factor (TNF)-α, GM-CSF and granulocyte colony-stimulating factor. The SDYKCRs (p < 0.01), occurring 24-48 h after the NPT, were accompanied by significant changes (p < 0.05) of IL-2, IL-8, IL-10, interferon-γ, transforming growth factor-β and TNF-α. Conclusions: The particular SKCR types, induced by an allergic reaction in the nasal mucosa, were accompanied by different cytokine profiles in the tears, suggesting involvement of different hypersensitivity mechanisms. These results also stress the diagnostic usefulness of NPTs combined with monitoring of ocular features in KC patients who did not respond satisfactorily to the topical ophthalmological treatment.

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