Direct In Vivo Monitoring of Acute Allergic Reactions in Human Conjunctiva

Abstract

Immediate allergic reactions are initiated by allergen-induced, specific IgE-mediated mast cell degranulation and involve leukocyte recruitment into the inflamed site. We compared conjunctival signs, symptoms, and in vivo leukocyte rolling and extravasation into sites of inflammation in five patients allergic to birch pollen and in 10 nonallergic controls who received a challenge to birch allergen or histamine. Both the specific allergen in allergic patients and histamine, both in patients and in healthy controls, induced symptoms and signs of an immediate allergic reaction together with leukocyte rolling within the conjunctival blood vessels. However, only allergen, not histamine, caused leukocyte extravasation into the site of inflammation in the allergic patients. Allergen also increased expression of endothelial P-selectin in conjunctival vessels and slowed the rolling of leukocytes which is required for their extravasation from blood circulation into the target tissue. Finally, i.v. heparin strongly reduced the number of slowly rolling cells during allergen- or histamine-induced reactions and this can probably hinder the leukocyte extravasation after allergen exposure. These findings suggest that slow rolling is required for leukocyte extravasation in acute allergic reactions, and it can be inhibited by heparin in vivo in therapeutically relevant conditions.

Caveolar transport through nasal epithelium of birch pollen allergen Bet v 1 in allergic patients

“…We have already demonstrated the early in vivo leukocyte response after Bet v 1 pollen allergen challenge in human subjects. [10][11][12] The aim of our systems-level analyses is to begin to explore the role of epithelial cells in the early pathogenesis of type I allergic reactions.…”

Leukotriene Antagonist Drugs as Treatment of Allergic Conjunctivitis and Comorbidities in Children

“…facialis, plexus pterygoideus) (Dua et al, 1995;Pelikan, 1996;Bielory, 2000;; (iii) allergic reactions in the nasal mucosa can stimulate the local neurogenic network and released neuropeptides may reach conjunctiva along and/or through the appropriate nerves (n. trigemini, n. nasociliaris, pterygopalatine ganglion) (Pelikan, 1995;Fujishima et al, 1997;Calonge et al, 2005;Zoukhri, 2006;Motterle et al, 2006;; and (iv) this reaction and released factors can stimulate the local nasal mucosal lymphatic system, 'nose-associated lymphatic tissue' (NALT), which is able to communicate with the lymphatic tissue of the lacrimal system, 'tear duct-associated lymphatic tissue' (TALT), 'lacrimal drainageassociated lymphoid tissue' (LDALT), 'eye-associated lymphatic tissue' (EALT) and that of the conjunctiva, called 'conjunctiva-associated lymphatic tissue' (CALT) (Pelikan, 1996;Sirigu et al, 2000;Knop & Knop, 2000;Knop & Knop, 2001, Paulsen et al, 2002Paulsen et al, 2003;Zoukhri et al, 2006;. In this way not only transmission of certain signals but also cellular traffic of various cell types, for example, T lymphocytes (Th1 and Th2) and B cells (plasma cells), can also be realized (Dua et al, 1995;Pelikan, 1996;Calder et al, 1999;Bacon, 2000;Magone et al, 2000.;Pelikan, 2002;Helintö, 2004;Ono & Abelson, 2005;Baudouin et al, 2005;Stern et al, 2005;Bielory, 2008;. An additional mechanism that could also play a role in the cellular traffic among the particular organ-associated lymphatic tissues is the 'defective homing' of the B lymphocytes (Pelikan, 1996;Mikulowska-Mennis et al, 2001;.…”

Cellular changes in tears associated with keratoconjunctival responses induced by nasal allergy

“…11,16,20,25,36,43 There is a dearth of data documenting the dynamic course of the cytologic changes in tears during particular types of the primary keratoconjunctival response to CPT with allergens. 2,3,10,11,16,20,25,34,36,44 Moreover, no Keratoconjunctival response-cytologic changes in tears Z Pelikan…”

“…These tests, performed on a certain organ, may definitely (1) confirm the existence of an allergic component in the particular and/or related organ(s); (2) demonstrate that a certain allergen causes indeed a certain response type in the particular organ, which can be measured quantitatively in its dynamic course; (3) to confirm the causal role of an allergic reaction occurring initially in one organ, in the secondarily induced response of another organ 7,9,10,26,[38][39][40][41] The conjunctival provocation tests with allergens are a suitable technique to demonstrate the primary conjunctival/keratoconjunctival responses resulting from direct exposure of the ocular tissue to an external allergen. 4,11,16,17,20,25,33,35,36,38,[42][43][44] However, they are unable to detect conjunctival/keratoconjunctival responses induced secondarily by an allergic reaction occurring initially in the nasal mucosa. These responses can only be detected by the NPT with allergens, in combination with registration of ocular features.…”

“…3,4,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][28][29][30][31]34,37,43,44 This is also an exfoliative process leading to release of various cells into the particular media, such as tears or nasal secretions. [1][2][3][4][5][6][7][8][9][10][11]13,[16][17][18][19][20][21][22]25,26,[28][29][30]34,…”