Saisonale allergische Konjunktivitis

Abstract

Seasonal allergic conjunctivitis (SAC) is a frequent disease, which is often associated with allergic rhinitis and subsequently manifested as allergic rhinoconjunctivitis. In contrast to other types of chronic allergic conjunctivitis, the course of SAC is not sight-threatening. Pathogenetically, the underlying cause of SAC is an immunoglobulin E (IgE) mediated, Th2-driven type 1 hypersensitivity reaction. Clinically it presents with itching, light-red conjunctival injection as well as chemosis that exceeds the extent of conjunctival injection. The goals of treatment are relief of acute signs and symptoms, control of the underlying inflammatory process and utilization of preventive options. Dually effective local therapeutics combine the advantages of rapid action with a relatively long-lasting effect by a two-fold active approach. Specific immunotherapy is useful in selected patients.

Mevsimsel Alerjik Konjonktivitli Çocuklarda Sistemik İnflamasyon Biyobelirteçlerinin İncelenmesi

“…Alerjenlere duyarlı kişilerde maruziyet sonrası akut ya da subakut olarak ortaya çıkan bu reaksiyonda konjonktivadaki mast hücrelerinin degranülasyonu ile histamin ve diğer inflamatuar mediyatörler açığa çıkar. Doku içine ve gözyaşına dağılan mediyatörler lokal inflamatuar yanıtı tetikleyerek konjonktiva damarlarında dilatasyon (konjonktival hiperemi, kırmızı göz), kan damarlarında geçirgenlik artışı (konjonktiva ödemi, kemozis) ve kaşıntıya neden olurlar (7,8). Daha çok hastalığın lokal inflamatuar temeline yönelmiş birçok araştırmacı oküler yüzeyde ve gözyaşında yaptıkları araştırmalar ile etyopatojenezi aydınlatmaya çalışmışlardır.…”

Discovery to Launch of Anti-allergy (Emadine; Patanol/Pataday/Pazeo) and Anti-glaucoma (Travatan; Simbrinza) Ocular Drugs, and Generation of Novel Pharmacological Tools Such as AL-8810

“…Over the next few minutes to hours, the mast cells release newly generated prostaglandins (PGs; mainly PGD 2 ), leukotrienes and cytokines (e.g., interleukin-3 [IL-3], IL-6, IL-8, and tumor neurosis factor-α [TNF-α]) as part of a delayed late-phase secondary response to the allergen. 2,3,21,24 The cytokines in turn induce IgE synthesis/ release by B-cells and cause inflammatory white blood cells (e.g., eosinophils) to infiltrate the conjunctiva, and to cause leukocyte adhesion, migration, and activation, thereby amplifying and exacerbating the situation. 2,23−25 By now the clinical manifestation of the allergic inflammation in the eye is readily observable and the patient feels the swollen eyelids that are itchy, red, and increasingly becoming painful and further irritated.…”

“…Added to this complexity was the uncertainty of translating results obtained from one organ to the next, and the known significant heterogeneity among mast cells and epithelial cells, 22,47 and of the many species differences in disease pathology and known differences in compound affinities and potencies across mammalian species. [1][2][3]47 Since PAF exhibited potent chemotactic and chemokinetic activity for eosinophils and PAF receptor antagonists were showing promise as antiasthmatic drugs, 48 and a dual PAF/histamine receptor antagonist (SCH-37370) had recently been reported, 49 our interest in PAF began to grow. However, since SCH-37370 exhibited a relatively low antagonist affinity/potency at PAF and H 1 -histamine receptors (IC 50 = 0.6 and 1.2 μM, respectively), we decided not to pursue PAF antagonists for AC.…”

“…It was a humbling but exalting feeling to be invited to chart the journey of my colleagues and I in the processes of establishing, validating, and implementing a few drug discovery/development platforms and projects that eventually yielded drugs to treat two different types of eye diseases. The first of these was allergic conjunctivitis (AC), and in particular seasonal AC (SAC), a bothersome ocular disorder, the hallmark signs and symptoms of which are undeniable (intense ocular itching, hyperemia (redness), tearing and swelling of the eyelids with possible pain that people of all ages suffer from every few months, some even more frequently. − The second disease was ocular hypertension (OHT)/primary open-angle glaucoma (POAG), − that involves a slowly progressing, symptomless but unrelenting demise of retinal ganglion cells (RGCs) and their axons that connect the eye to the brain. The net result of OHT/POAG is loss of peripheral vision that eventually leads to pan-visual impairment culminating in blindness if the patient remains undiagnosed and untreated.…”

“…With an aging world population, the number of people afflicted with AMD is projected to rise to 243 million, and for glaucoma is expected to increase to greater than 95 million by 2030. Others estimate that by 2040, there may be as many as 112 million patients with glaucoma, with the highest prevalence in Asia and Africa. ,, As for allergic conjunctivitis (AC), as much as 40% of the population is affected by some symptoms of AC, with the majority of the cases (up to 95%) ascribed to SAC or perennial AC (PAC). − ,, Therefore, ophthalmic disorders and diseases represent a significant healthcare issue since our society, communities, education systems, economies, sports, media, and every facet of our waking lives are incredibly reliant on the ability to see. Sight is important from infant to mother bonding, to continued learning/educational achievements over the course of life, development of social skills/personality and character, and is critical for physical development and health, and for mental health and self-esteem development and maintenance.…”