Tearfilm immunoglobulin E (IgE) level in vernal keratoconjunctivitis by ELISA

Abstract

Background: Vernal keratoconjunctivitis (VKC) is recurrent chronic allergic conjunctivitis occurring in the prepubertal age-group with secondary involvement of the cornea and is self-limiting in character. The disease is prevalent worldwide but it shows predominance in the areas with dry and warm climate including the South Asia. VKC represents about 3% of the serious ophthalmic disease in some parts of the world where the prevalence is rate is high.Type I hypersensitivity reaction which is IgE-dependent and type IV hypersensitivity reaction have been implicated for the pathogenesis VKC. Objective: To determine level of immunoglobulin E (IgE) in the tear ¿ lm of patients with Vernal Keratoconjunctivitis (VKC) attending outpatient department of BP Koirala Lions Centre for Ophthalmic Studies (BPKLCOS). Materials and methods: Thirty-four VKC patients and thirty-four controls were included in this study. Tear samples were collected using micro-capillary glass tube method and tear IgE levels were measured using an enzyme -linked immunosorbent assay (ELISA). Results: There was high concentration of tear IgE level in VKC (95.09IU/ml) than in controls (1.63IU/ml) though the difference was not statistically signi¿ cant (p=0.16). No statistically signi¿ cant difference was observed in male and female gender within VKC group and when compared with control group (in male group, p=0.21 and in female group, p=0.26). There was no statistically signi¿ cant difference observed in tear IgE level in different age groups within VKC group and when compared with control group (p=0.30). The result did not show any signi¿ cant difference in tear IgE level with respect to the duration of the disease (p=0.23).There was no statistically signi¿ cant difference in tear IgE level with different episodes of VKC (p=0.69). No statistically signi¿ cant difference of IgE concentration in tear was seen among different types of VKC (p=0.53) and grades of tarsal and limbal papillae (p= 0.72). Conclusion: There was high concentration of tear IgE level observed in VKC.Key words: Vernal keratoconjunctivitis, Tear¿ lm, IgE level, Type I hypersensitivity reaction, Type IV hupersensitivity reaction. T ype I hypersensitivity reaction which is IgEdependent and type IV hypersensitivity reaction have been implicated for the pathogenesis of Vernal Keratoconjunctivitis (VKC) 1,2,3 . However, IgEdependent hypersensitivity reaction has been observed as the important factor for the pathogenesis. IgE sensitizes cells like mast cells and basophils, resulting in degranulation and release of vasoactive amines which are responsible for clinical manifestations of VKC. In VKC, tear IgE level is signi¿ cantly high. In a study by Nomura K and Takamura E, tear IgE concentration was increased signi¿ cantly in the VKC (322.2 +/-45ng/ ml = 134.25 IU/ml), SAC (194.7+/-21.7 ng/ml) and PAC (134.8+/-23.1 ng/ml) than in controls (52.1+/-9.7 ng/ml=21.71 IU/ml) (p=0.1) 4 .In another study by Mathea R Allansmith, Hahn GS and Simon MA, the mean tear IgE concentration was high i...

Prevalence of allergic sensitization with vernal keratoconjunctivitis: A systematic review with meta‐analyses

“…Mumcuoglu et al ( 1988 ) sampled serum and tear for measuring total and specific IgE to 10 inhalant allergens and reported a positive test in 42% of patients and to house dust mites only. Pokharel et al ( 2009 ) reported that mean total tear IgE was higher in patients with VKC than in controls, but this difference did not reach statistical significance. Pucci et al ( 2003 ) reported that 45% of VKC patients had a positive skin prick test with house dust mites being the most prevalent allergen, and that patients had significantly higher serum total IgE and peripheral blood eosinophils compared to controls.…”

“…High levels of total IgE in tears are associated with allergic conjunctivitis (Monzón et al, 2009 ; Mumcuoglu et al, 1988 ; Pokharel et al, 2009 ). Patients with VKC are reported to have specific IgE in tears for dust mites, pollen (grass, tree), animal (cat), and food allergies (Leonardi et al, 2015 ; Mumcuoglu et al, 1988 ; Tuft et al, 1989 ).…”

“…To further add to the uncertainties surrounding this test, one should consider the risk of false-positive tests due to irritation of the conjunctiva (Leonardi et al, 2006). High levels of total IgE in tears are associated with allergic conjunctivitis (Monzón et al, 2009;Mumcuoglu et al, 1988;Pokharel et al, 2009). Patients with VKC are reported to have specific IgE in tears for dust mites, pollen (grass, tree), animal (cat), and food allergies (Leonardi et al, 2015;Mumcuoglu et al, 1988;Tuft et al, 1989).…”

Perbandingan Konsentrasi IgE Air Mata Penderita Alergi Okuli dengan Pemberian Pemirolast Potassium 0,1% dan Sodium Cromoglycate 4%

“…satu hal terpenting untuk mendiagnosa konjungtivitis alergi (6). Penelitian yang dilakukan oleh Nomura dan METODE Takamura menggunakan ELISA, menyebutkan bahwa Penelitian dilakukan dengan desain pre and post clinical didapatkan peningkatan kadar IgE air mata pada trial pada 32 penderita alergi okuli yang dibagi menjadi penderita VKC, SAC dan PAC (7,8).…”

Vernal Keratoconjunctivitis Clinical Features and Complications in 123 Patients in Gaza Strip

“…(4) The exact mechanism of vernal keratoconjunctivitis is not fully understood at the time being, (5) but there is a possibility of type I and IV hypersensitivity reactions involvement with vasoactive mediators release. (6)(7) There are three types of vernal keratoconjunctivitis, palpebral, limbal, and mixed, Fig. 1a, b, and c respectively.…”