Altered Expression of Neurotransmitter Receptors and Neuromediators in Vernal Keratoconjunctivitis

Motterle, Laura; Diebold, Yolanda; Salamanca, Andrés Bordalí; Saez, V.; Garcı́a-Vázquez, Carmen; Stern, Michael E.; Calonge, Margarita; Leonardi, Andrea

doi:10.1001/archopht.124.4.462

Cited by 60 publications

(36 citation statements)

References 32 publications

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“…In this way, both the organs can influence each other. 1,2,10,13,14,[22][23][24][25] Hypersensitivity reactions developed primarily in the nasal mucosa as a consequence of the intranasal exposure to external (inhalant) allergens may affect the conjunctiva and lacrimal ways and subsequently affect the cornea in various ways and upon involving of various mechanisms.…”

Section: Discussionmentioning

confidence: 99%

The possible involvement of nasal allergy in allergic keratoconjunctivitis

Pelikán¹

2008

Eye

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Purpose Allergic keratoconjunctivitis coexists regularly with allergic rhinitis. However, little is known about the relationship between these conditions. The purpose of this study was to investigate the possible involvement of nasal allergy in keratoconjunctivitis by means of nasal challenge with allergen (NPT), in combination with recording of the ocular symptoms. Methods In 26 patients suffering from atopic (n ¼ 15) or vernal (n ¼ 11) keratoconjunctivitis showing positive history and skin tests, but responding insufficiently to the local ophthalmologic therapy, 71 NPTs with inhalant allergens were performed and combined with the recording of the ocular response. In 11 control subjects with allergic rhinitis, but without ocular disease history, 11 positive NPTs were repeated and supplemented with the registration of the ocular features. Results Of the 26 patients, 24 developed 51 positive nasal responses (NRs; Po0.01), 43 of which were accompanied by significant ocular response (Po0.01). No ocular responses were measured during the 26 PBS control challenges (P40.05) or during 11 repeated NPTs in control subjects (P40.2). Conclusions These results give evidence for possible involvement of nasal allergy in some cases of keratoconjunctivitis. They also show diagnostic value of nasal challenges with allergen in combination with registration of the ocular symptoms in such patients, allowing then consideration of additional therapeutic measures concerning the nasal allergy.

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Section: Discussionmentioning

confidence: 99%

The possible involvement of nasal allergy in allergic keratoconjunctivitis

Pelikán¹

2008

Eye

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“…Recently we have shown increased and altered expression of muscarinic and adrenergic receptors and neurotransmitters in VKC tissues [31], explaining the mucus hypersecretion, goblet cells hyperplasia and conjunctival hyperreactivity typical of this disease.…”

Section: Vernal Keratoconjunctivitismentioning

confidence: 97%

Allergy and the eye

Leonardi

Motterle

Bortolotti

2008

Clinical and Experimental Immunology

126

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SummaryThe eye represents an ideal and frequent site for the allergic reactions. The term 'allergic conjunctivitis' refers to a collection of disorders that affect the lid, conjunctiva and/or cornea. Even though the diagnosis is essentially clinical, local tests such as cytology, conjunctival provocation and tear mediator analysis can be performed. The immunoglobulin E (IgE)-mediated mechanism does not explain completely the severity and the clinical course of chronic allergic ocular diseases such as vernal (VKC) and atopic keratoconjunctivitis (AKC), which are probably also related to T cell-mediated responses, massive eosinophil attraction and activation and non-specific hypersensitivity. An altered balance between T helper type 1 (Th1) and Th2 cells and between Th1-and Th2-types of cytokines is thought to be responsible of the development of ocular allergic disorders. New findings suggest that a wide range of cytokines, chemokines, proteases and growth factors are involved by complex interwoven interactions rather than distinct and parallel pathways. In addition, several non-specific enzymatic systems may be activated during acute and chronic allergic inflammation, thus contributing to the complex pathogenesis of the disease. Current drug treatment for ocular allergy targets the key mechanisms involved in the development of clinical disease: mast cells with mast cell stabilizers, histamine with histamine receptor antagonists and inflammation with corticosteroids, severe inflammation with immunomodulators. None of these agents lacks side effects and none abolishes signs and symptoms completely. New therapeutic strategies are still needed to respond to the complex pathogenesis of severe forms of ocular allergy such as VKC and AKC.

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“…In addition, Th2-type cytokines IL-4 and IL-13 stimulate the migration, proliferation, and collagen production from conjunctival fibroblasts and formation of giant papillae. Increased and altered expression of muscarinic and adrenergic receptors and neurotransmitters recently has been shown to occur in VKC tissues [17], thus explaining the mucus hypersecretion, goblet cells hyperplasia, and conjunctival hyperreactivity typical of this disease. There is a greater involvement of Th1 cells in AKC.…”

Section: Pathophysiology Of Ocular Allergic Diseasesmentioning

confidence: 99%