Low Expression of IL-10 in Circulating Bregs and Inverted IL-10/TNF-α Ratio in Tears of Patients with Perennial Allergic Conjunctivitis: A Preliminary Study.

Allergic conjunctivitis (AC) is one of the most common ophthalmological disorders seen in clinical practice. Growing evidence from recent years suggests that a subset of IL-10-expressing B cells is involved in inflammatory allergic diseases. In this study, we aimed to evaluate the potential involvement of blood Bregs cells in perennial allergic conjunctivitis (PAC), and interleukins (IL)-1ß, IL-6, IL-8, IL-10, and IL-12, and tumor necrosis factor (TNF)-α, were measured in tear samples and compared with healthy controls (HC) using flow cytometry. Non-significant differences in CD19⁺IL-10⁺ cell frequency between PAC patients and healthy controls (HC) were observed. Nevertheless, when we analyzed the mean fluorescence intensity (MFI) of IL-10 on CD19⁺CD38Lo/Med/Hi-gated cells, we observed a significant decrease in MFI in all Bregs subsets in PAC patients. Additionally, tear cytokines showed 2.8 times lower levels of IL-10 than TNF-α in PAC patients when compared to HC. Our findings demonstrate an immunological dysregulation in patients with allergic conjunctivitis, characterized by the low expression of IL-10 in circulating CD19⁺CD38⁺ Bregs subsets and an inverted tear IL-10/TNF-α ratio, promoting a local pro-inflammatory microenvironment. These findings highlight the novel pathologic changes involved in ocular allergic diseases. Understanding systemic and local mechanisms will aid the design of immunomodulating therapeutics at different levels.

Intracellular IL-4, IL-5, and IFN-γ as the main characteristic of CD4+CD30+ T cells after allergen stimulation in patients with vernal keratoconjunctivitis.

BACKGROUND: Vernal keratoconjunctivitis (VKC) is a severe form of allergic conjunctivitis, in which inflammatory infiltrates of the conjunctiva are characterized by CD3+ and CD30+ cells. Until today, the functional involvement of CD30+ T cells in VKC was unclear. Our aim was to evaluate the functional characteristics of CD30+ T cells after allergen stimulation in peripheral blood mononuclear cells obtained from patients with VKC. METHODS: Seventeen consecutive patients at the Institute of Ophthalmology with active forms of VKC were included. RESULTS: After allergen stimulation, we observed the frequency of CD30+ T cells increased compared with non-stimulated cells (p<0.0001). The CD30+ T cells responded to the specific allergen-inducing expression of intracellular interleukin-4 (IL-4), IL-5, and interferon-gamma (IFN-γ) compared with the CD30- T cells (p<0.0001). Increased early secretion of soluble CD30 was observed in the supernatant of the cultured cells from patients with keratoconjunctivitis, compared with healthy controls (p=0.03). Blockage with IL-4 significantly diminished CD30 frequency in the allergen-stimulated cells. CONCLUSIONS: Our results suggest that after allergenic stimulation, CD4+CD30+ cells are the most important source of IL-4, IL-5, and IFN-γ. IL-4 acts as an activation loop that increases CD30 expression on T cells after specific stimulation. These findings suggest that CD4+CD30+ T cells are effector cells and play a significant role in the immune pathogenic response in patients with vernal keratoconjunctivitis.

[Skin tests, serum specific IgE and total IgE in the diagnosis of patients with perennial allergic rhinitis]. / Pruebas cutáneas, IgE sérica específica e IgE total en el diagnóstico de pacientes con rinitis alérgica perenne.

BACKGROUND: Skin tests are the most used diagnostic method of allergic rhinitis, which, in addition to identify specific allergen, can determine the relative sensitivity of one patient to the allergen. OBJECTIVE: To assess the association between skin test reactivity and total and specific serum IgE levels on the diagnosis of patients with perennial allergic rhinitis. MATERIAL AND METHODS: We measured the response to skin test reactivity and total and specific serum IgE levels in 69 patients with perennial allergic rhinitis. RESULTS: The skin test reactivity showed responses to: Dermatophagoides pt in 62 patients (90%), house dust in 57 (83%), cat in 41 (59%), dog in 23 (33%), and Lolium p in 16 (23%). The mean level of total IgE was of 378 UI (19 to 4,036) and that of specific IgE was of 39.2 UI (0.2 to 98.6). Total IgE > 200 UI was observed in fifty two patients (75%), which was significantly lesser than the frequency of specific IgE > 0.35 UI (at least for an allergen), which was 94% (p < 0.05, Z). At least two tests of skin reactivity were positive for 90% of the patients. This frequency was similar to the 95% for the specific IgE but different to the 75% for the total IgE (p < 0.05, X2). The correlation between the results of the skin test reactivity and the specific seric IgE showed Spearman r from 0.23 to 0.35 (p < 0.05). The correlation between the total IgE and the specific IgE showed a Spearman r of 0.08 (p < 0.05) and between the total IgE and the skin test reactivity an r of 0.15 (p < 0.05). CONCLUSION: In the diagnosis of perennial allergic rhinitis, the results of the skin test reactivity and the specific serum IgE are correlated but these two results are non consistent with the results of the total serum IgE.

[Allergic dermatitis: new concepts for old diseases]. / Dermatitis alérgicas: nuevos conceptos para viejas enfermedades.

The skin is the largest body's organ, with a well defined functional lymphoid tissue. This organ can be the target of several hypersensitivity-mediated diseases, that are both, genetically determined and influenced by environmental factors. In this paper the main clinical features and the current treatment modalities for the most frequent allergic cutaneous diseases are reviewed.