|Budget Amount *help
¥2,500,000 (Direct Cost : ¥2,500,000)
Fiscal Year 2000 : ¥900,000 (Direct Cost : ¥900,000)
Fiscal Year 1999 : ¥700,000 (Direct Cost : ¥700,000)
Fiscal Year 1998 : ¥900,000 (Direct Cost : ¥900,000)
To discover the mechanism of severe corneal damage such as erosions or ulcers in patients with severe ocular allergy, we analyzed 1) presence of cytokines in the tears, 2) correlation of chemokines and inflammatory cells in the conjunctival epithelium by brush cytology, 3) expression of cytokine mRNA using reverse-transcripts polymerase chain reaction (RTPCR) in the conjunctiva, 4) presence of eotaxin and eosinophiles in the tear after ocular allergen challenge test with cedar pollen allergen.
1) We examined the presence of RANTES, IL-4 and eotaxin in the tears using ELISA.RANTES, IL-4 and eotaxin were detectable in the diluted tears of patients with severe allergic conjunctivitis, while no these cytokines presence in the tears of normal controls was observed. Eotaxin tear levels in patients with severe atopic keratoconjunctivitis(AKC) with corneal ulcer were significantly higher than those with superficial punctate keratopathy(SPK).
2) In the upper tarsal conjunctiva in patients with
AKC with cornal erosion or SPK, the IL-8 concentration in the conjunctiva correlated with the number of not only neutrrophils but also eosinophils and the eotaxin concentration correlated with the number of eosinophils. However, RANTES and MCP-1 concentration did not correlate with both inflammatory cells.
3) The eotaxin expression was found in giant papilla of the upper tarsal conjunctival specimen from vernal keratoconjunctivitis (VKC) , although it was not found in the conjunctival epithelium from AKC obtained using with brush cytology.
4) In seasonal allergic conjunctivitis patients, six cases had eosinophils and two of them had eotaxin in the tears, although all of them had symptorns ten minutes after ocular allergen challenge
These results suggest eotaxin and inflammatory cytokines are expressed in elevated levels in the conjunctival epithelia of VKC and AKC.Local inflammatory processes in the conjunctiva may play an important role in the epithelial damage of severe ocular allergy.