Hyperosmolar conjunctival provocation for the evaluation of nonspecific hyperreactivity in healthy patients and patients with allergy

Sacchetti, Marta; Lambìase, Alessandro; Aronni, Silvia; Griggi, T.; Ribatti, Valentina; Bombardieri, Stefano; Bonini, Sergio

doi:10.1016/j.jaci.2006.06.022

Cited by 20 publications

(14 citation statements)

References 31 publications

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“…This nasal allergic reaction, leading to release of various mediators/factors and activation/inhibition of various cell types, may then induce a secondary AC form ( 28]. Additionally, the nonspecific hyperreactivity resulting from direct stimulation of mucosal, glandular, or neurogenic receptors by nonspecific agents might participate in the conjunctivitis complaints, although usually to an unimportant degree [5,28,32].…”

Section: Mechanism(s) Of Allergy Involvement In Allergic Conjunctivitismentioning

confidence: 99%

Allergic Conjunctivitis and Nasal Allergy

Pelikán¹

2010

Curr Allergy Asthma Rep

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Allergic conjunctivitis (AC) can be divided into the primary form (caused by an allergic reaction occurring primarily in the conjunctivae) and the secondary form (induced by allergic reaction originating primarily in the nasal mucosa, where the released mediators can reach conjunctiva through the lacrimal system, the blood, the lymphatic network, or the neurogenic network). Patients with primary AC develop an immediate, late, or delayed conjunctival response (CR) during conjunctival provocation tests. Patients with secondary AC develop an immediate, late, or delayed type of secondary CR, induced by the nasal allergic reaction, due to the nasal allergen challenge. Various hypersensitivity mechanisms may be involved in the particular CR types. The secondarily induced AC and CRs can only be confirmed by nasal provocations tests, performed by rhinomanometry combined with recording of conjunctival signs. The existence of the primary and secondarily induced AC has an impact on treatment of this disorder.

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Section: Mechanism(s) Of Allergy Involvement In Allergic Conjunctivitismentioning

confidence: 99%

Allergic Conjunctivitis and Nasal Allergy

Pelikán¹

2010

Curr Allergy Asthma Rep

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“…The normal tear film status in allergic patients outside the pollen season might be more vulnerable to allergens and non-specific irritants than in non-allergic patients [37]. In previous studies, a greater proportion of allergic patients in the asymptomatic phase showed non-specific conjunctival hyperreactivity after hyperosmolar conjunctival provocation test than non-allergic patients [38,39]. However, this conjunctival hyperreactivity is also detectable in a small proportion of normal patients, which suggests the possibility that the mechanism of this hypersensitivity is independent from the allergic inflammation [38].…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, a greater proportion of allergic patients in the asymptomatic phase showed non-specific conjunctival hyperreactivity after hyperosmolar conjunctival provocation test than non-allergic patients [38,39]. However, this conjunctival hyperreactivity is also detectable in a small proportion of normal patients, which suggests the possibility that the mechanism of this hypersensitivity is independent from the allergic inflammation [38]. Further investigation is required in which tear film function and tear cytology should be examined after conjunctival provocation test to detect the influence of potential subclinical inflammation on the ocular surface in SAC patients outside the pollen season.…”

Section: Discussionmentioning

confidence: 99%

Tear Film Function in Patients with Seasonal Allergic Conjunctivitis Outside the Pollen Season

Kosina-Hagyó

Veres

Fodor

et al. 2011

Int Arch Allergy Immunol

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Background: Seasonal allergic conjunctivitis can manifest itself through tear film instability and symptoms of eye discomfort during the pollen season. This study investigated whether seasonal allergic inflammation defines tear film instability outside the season. Methods: Twenty-three control subjects and 13 ragweed-allergic patients were involved (21 female, 15 male; mean age 26.6 ± 5.4 years). Outside the pollen season, subjective ocular symptoms, non-invasive tear film break-up time, lower tear meniscus height and the tear lipid layer’s interference pattern grade were recorded. C3a complement activation level was also measured in collected tear samples. Results: Non-invasive tear film break-up time, lower tear meniscus height, C3a complement activation level and the incidence of the different grades of tear lipid pattern did not differ significantly in the two examined groups (p ≧ 0.223). The mean eye symptom score outside the season was greater in the allergic group, but the difference was not significant (p = 0.062). The C3a complement activation level showed a significant and inverse correlation with the lipid layer grade (r = –0.343, p = 0.017). Among the participants with thinner tear lipid layers, the complement activation in the tear samples was higher than among those patients with normal tear lipid layers. Conclusion: Seasonal allergic inflammation did not cause permanent tear film instability and eye symptoms were not observed outside the pollen season.

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“…These have been used recently to detect nonspecific conjunctival hyperreactivity in patients with or without a history of allergy, suggesting that there is a mechanism of conjunctival hyperreactivity independent of allergic inflammation [21]. Differential cytokine levels in tear samples are good indicators of pathophysiologic mechanisms occurring in allergic conjunctivitis.…”

Section: Diagnosticsmentioning

confidence: 99%