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1.
Am Fam Physician ; 110(2): 134-144, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39172671

ABSTRACT

Conjunctivitis caused by viruses, bacteria, or allergies is one of the most common eye conditions in primary care. There is no single sign or symptom that accurately differentiates viral from bacterial conjunctivitis. A comprehensive history and physical examination can guide diagnosis. Viral and allergic conjunctivitis are more common in adults and typically present with watery discharge. Supportive care options for viral conjunctivitis include artificial tears, cold compresses, and antihistamine eye drops. Strict personal hygiene, including frequent handwashing, is essential to decrease the risk of transmission. Topical antihistamines with mast cell-stabilizing activity are the treatment of choice for allergic conjunctivitis. Bacterial conjunctivitis is more common in children and typically presents as mucopurulent discharge with the eyelids matted shut. Delayed antibiotic prescribing has been found to have similar symptom control as immediate prescribing. Ophthalmology referral is indicated for conjunctivitis in a neonate or patients with severe pain, decreased vision, recent ocular surgery, vesicular rash on the eyelids or nose, history of rheumatologic disease, or immunocompromised state.


Subject(s)
Conjunctivitis , Humans , Conjunctivitis/diagnosis , Conjunctivitis/therapy , Diagnosis, Differential , Conjunctivitis, Bacterial/diagnosis , Conjunctivitis, Bacterial/therapy , Conjunctivitis, Bacterial/drug therapy , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/therapy , Conjunctivitis, Viral/drug therapy , Anti-Bacterial Agents/therapeutic use , Conjunctivitis, Allergic/diagnosis , Conjunctivitis, Allergic/therapy
2.
Med J Malaysia ; 79(4): 375-379, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39086332

ABSTRACT

INTRODUCTION: Vernal keratoconjunctivitis (VKC) is a chronic allergic disease characterised by intense ocular surface symptoms and corneal involvement. There is limited data about the corneal changes in children with VKC based on severity of the disease. We aimed to compare the central corneal thickness (CCT) and corneal topographic indices in Malaysian children with VKC, as well as among the varying grades of VKC severity. MATERIALS AND METHODS: This study is a comparative, crosssectional and hospital-based study. We recruited 83 children with VKC and 83 healthy children as controls. All children underwent complete ocular examinations, CCT measurement using an ultrasound pachymeter and corneal topography using a Placido disc corneal analyser. RESULTS: There was a statistically significant difference of means CCT and topographic indices in children with VKC compared to controls (p<0.05). The probability keratoconus reached 18% in children with VKC. The mean CCT was observed to be thinnest in the severe-to-very severe groups of VKC compared to the mild-to-moderate (p<0.05). The means simulated-K1 and -K2, apical keratometry, apical gradient curvature, superior-inferior index and keratoconus prediction index were significantly different in severe-tovery severe VKC compared to mild-to-moderate VKC and controls (p<0.05). However, there was no significant difference in mean cylinder value and percent probability keratoconus when comparing different groups of severity of VKC (p=0.912 and 0.070 respectively). CONCLUSION: Children with VKC have thinner CCT and topographic indices changes compared to healthy children. Similar pattern was observed between groups with VKC. Degree of astigmatism and probability of keratoconus were similar in mild-to-moderate and severe-to-very severe groups.


Subject(s)
Conjunctivitis, Allergic , Cornea , Corneal Topography , Humans , Conjunctivitis, Allergic/diagnostic imaging , Conjunctivitis, Allergic/pathology , Child , Male , Female , Malaysia , Cornea/pathology , Cornea/diagnostic imaging , Cross-Sectional Studies , Adolescent , Case-Control Studies , Severity of Illness Index , Keratoconus/diagnostic imaging , Keratoconus/pathology
3.
Sci Rep ; 14(1): 16235, 2024 07 14.
Article in English | MEDLINE | ID: mdl-39004666

ABSTRACT

We investigated the relationship between subjective symptoms and objective findings in patients with allergic conjunctival diseases (ACD) and test results for tear total IgE (t-tIgE), conjunctival eosinophils (c-Eo), serum total IgE (s-tIgE), serum-antigen specific IgE (s-sIgE), and serum eosinophils (s-Eo). Subjective symptoms and objective findings of patients with ACD were evaluated using Japanese Allergic Conjunctival Disease Quality of Life Questionnaire (JACQLQ), which described disability score and emotional score written by patient and clinical findings score written by ophthalmologist. We investigated the relationship between questionnaire scores and laboratory data for t-tIgE, c-Eo, s-tIgE, s-sIgE, and s-Eo. Scores of impediments to life and of moods were highest in vernal keratoconjunctivitis among ACD. Cases with positive pollen-sIgE showed significantly more nasal symptom score than those with negative pollen-sIgE (P < 0.05). Cases with positive t-tIgE or c-Eo showed significantly more objective symptoms' JACQLQ score than those with negative t-tIgE or c-Eo (P < 0.05), respectively. Cases positive for house dust/mite-sIgE, showed significantly more objective symptoms' JACQLQ score than those without for house dust/mite-sIgE (P < 0.05). These results indicate that ACD could be analyzed more accurately by the combination of JACQLQ and laboratory data.


Subject(s)
Conjunctivitis, Allergic , Immunoglobulin E , Quality of Life , Humans , Female , Male , Surveys and Questionnaires , Adult , Immunoglobulin E/blood , Immunoglobulin E/immunology , Conjunctivitis, Allergic/immunology , Conjunctivitis, Allergic/diagnosis , Middle Aged , Young Adult , Adolescent , Eosinophils/immunology , Tears , Conjunctiva/pathology , Aged
4.
Curr Allergy Asthma Rep ; 24(7): 347-360, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38869807

ABSTRACT

PURPOSE OF REVIEW: The aim of this review, is to present an updated revision of topical management of SAC and PAC, based on the available scientific evidence and focused on the impact of ophthalmic solution formulations on eye surface. RECENT FINDINGS: Physicians treating ocular allergy should be aware of tear film and tear film disruption in SAC and PAC, and how eye drop composition and additives affect the physiology of the allergic eye. Seasonal and perennial allergic conjunctivitis (SAC and PAC) are the most frequent causes of ocular allergy (OA), and both conditions are underdiagnosed and undertreated. SAC and PAC are immunoglobulin E (IgE)-mediated hypersensitivity reactions. The additional tear film disruption caused by the release of inflammatory mediators increases and exacerbates the impact of signs and symptoms and may trigger damage of the ocular surface. Comorbidities are frequent, and dry eye disease in particular must be considered. Clinical guidelines for the management of SAC and PAC recommend topical therapy with antihistamines, mast cells stabilizers or dualaction agents as first-line treatment, but care should be taken, as many medications contain other compounds that may contribute to ocular surface damage.


Subject(s)
Conjunctivitis, Allergic , Ophthalmic Solutions , Humans , Conjunctivitis, Allergic/drug therapy , Conjunctivitis, Allergic/immunology , Ophthalmic Solutions/therapeutic use , Histamine Antagonists/therapeutic use , Tears
5.
Front Immunol ; 15: 1386344, 2024.
Article in English | MEDLINE | ID: mdl-38855108

ABSTRACT

Background: Ocular allergy (OA) is a localized subset of allergy characterized by ocular surface itchiness, redness and inflammation. Inflammation and eye-rubbing, due to allergy-associated itch, are common in OA sufferers and may trigger changes to the ocular surface biochemistry. The primary aim of this study is to assess the differences in the human tear proteome between OA sufferers and Healthy Controls (HCs) across peak allergy season and off-peak season in Victoria, Australia. Methods: 19 participants (14 OA sufferers, 5 HCs) aged 18-45 were recruited for this study. Participants were grouped based on allergy symptom assessment questionnaire scoring. Proteins were extracted from human tear samples and were run on an Orbitrap Mass Spectrometer. Peaks were matched to a DIA library. Data was analyzed using the software MaxQuant, Perseus and IBM SPSS. Results: 1267 proteins were identified in tear samples of OA sufferers and HCs. 23 proteins were differentially expressed between peak allergy season OA suffers vs HCs, and 21 were differentially expressed in off-peak season. Decreased proteins in OA sufferers related to cell structure regulation, inflammatory regulation and antimicrobial regulation. In both seasons, OA sufferers were shown to have increased expression of proteins relating to inflammation, immune responses and cellular development. Conclusion: Tear protein identification showed dysregulation of proteins involved in inflammation, immunity and cellular structures. Proteins relating to cellular structure may suggest a possible link between OA-associated itch and the subsequent ocular surface damage via eye-rubbing, while inflammatory and immune protein changes highlight potential diagnostic and therapeutic biomarkers of OA.


Subject(s)
Proteome , Proteomics , Seasons , Tears , Humans , Tears/metabolism , Tears/chemistry , Tears/immunology , Adult , Male , Female , Proteomics/methods , Middle Aged , Victoria , Young Adult , Adolescent , Eye Proteins/metabolism , Conjunctivitis, Allergic/metabolism , Conjunctivitis, Allergic/immunology , Inflammation/metabolism , Biomarkers , Hypersensitivity/metabolism , Hypersensitivity/immunology
6.
J Pharmacol Toxicol Methods ; 128: 107520, 2024.
Article in English | MEDLINE | ID: mdl-38830514

ABSTRACT

Allergic conjunctival disease is an immune-mediated inflammatory disease of the conjunctiva. To develop clinically useful drugs, it is necessary to develop quantitative evaluation methods that reflect the clinical symptoms in experimental animal models. Allergic conjunctivitis model mice were systemically sensitised with ovalbumin (OVA) administered intraperitoneally and locally sensitised with OVA eye drops between day 14-28. Next, conjunctivitis induced by ocular administration of OVA solution to sensitised mice was evaluated based on tear volume. Additionally, we evaluated increase in tear volume induced by direct ocular instillation of histamine, compound 48/80, and carrageenan. An increase in antigen-induced tear volume was observed in the mice model. Additionally, direct instillation of histamine, compound 48/80, and carrageenan increased tear volume. Furthermore, levocabastine inhibited the increase in tear volume in antigen-induced allergic conjunctivitis and histamine- and compound 48/80-induced conjunctivitis models. In contrast, betamethasone suppressed carrageenan-induced tear volume but not histamine- or compound 48/80-induced tear volume. Histamine may be involved in increased tear volume in allergic conjunctivitis. Betamethasone is not directly involved in the action of histamine and is thought to suppress increase in tear volume. Evaluation of tear volume in a conjunctivitis mice model is highly quantitative; therefore, it is possible to evaluate drug efficacy. This is considered a useful index compared with conventional methods.


Subject(s)
Carrageenan , Conjunctivitis, Allergic , Disease Models, Animal , Histamine , Ovalbumin , Tears , Animals , Tears/drug effects , Tears/metabolism , Conjunctivitis, Allergic/drug therapy , Conjunctivitis, Allergic/immunology , Conjunctivitis, Allergic/chemically induced , Mice , Female , p-Methoxy-N-methylphenethylamine/pharmacology , Ophthalmic Solutions , Betamethasone/pharmacology , Mice, Inbred BALB C , Male
7.
Allergy Asthma Proc ; 45(4): 232-239, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38760164

ABSTRACT

Background: The clinical development program of the SQ grass, ragweed, tree, and house dust mite (HDM) sublingual immunotherapy (SLIT)-tablets for allergic rhinitis/conjunctivitis (AR/C) included clinical trials conducted in North America, Europe, and Japan. Objective: Data from these trials were analyzed to assess efficacy, immunologic mechanisms, and safety outcomes across allergens and geographic regions. Methods: Thirteen phase III, double-blind, placebo controlled trials in the subjects with AR/C were conducted in North America, Europe (including Russia), and Japan (N = 7763 analyzed). Trials were generally similar with respect to medical practice, target population, eligibility criteria, and efficacy and safety monitoring. Data were analyzed for the approved doses in North America and Europe. Four statistical models were used to enhance comparison of the efficacy end points among the trials. Results: The SLIT-tablets demonstrated consistent efficacy across allergens and regions, regardless of the statistical analysis used. Relative improvement in the primary efficacy end point compared with placebo by using the predefined protocol analysis ranged from 17.9% to 32.8%, 17.5% to 19.3%, 20.6% to 38.3%, and 39.6% with the grass, HDM, ragweed, and tree SLIT-tablets, respectively. The kinetics of specific immunoglobulin E (IgE) and IgG4 responses were similar among the allergens and regions. Local application-site reactions were the most common adverse events for all allergens and in all regions. Most treatment-related adverse events for all allergens and in all regions were mild in severity. The rate of systemic allergic reactions was similar across regions (0%-0.54%). Conclusion: Confirmatory phase III trials for SLIT-tablets in the treatment of AR/C showed consistent efficacy, immunologic, and safety outcomes across allergens and geographic regions.


Subject(s)
Allergens , Sublingual Immunotherapy , Humans , Sublingual Immunotherapy/methods , Sublingual Immunotherapy/adverse effects , Allergens/immunology , Allergens/administration & dosage , Treatment Outcome , Rhinitis, Allergic/therapy , Rhinitis, Allergic/immunology , Conjunctivitis, Allergic/therapy , Conjunctivitis, Allergic/immunology , Tablets , Europe , Double-Blind Method , Animals , North America , Adult , Male , Female , Japan , Clinical Trials, Phase III as Topic , Child , Adolescent
8.
JAMA Ophthalmol ; 142(7): 680-681, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38753324

ABSTRACT

This case report presents a case of improvement of vernal keratoconjunctivitis associated with initiation of an oral Janus kinase inhibitor upadacitinib.


Subject(s)
Conjunctivitis, Allergic , Heterocyclic Compounds, 3-Ring , Humans , Conjunctivitis, Allergic/drug therapy , Conjunctivitis, Allergic/diagnosis , Heterocyclic Compounds, 3-Ring/therapeutic use , Male , Female , Child
10.
Mol Immunol ; 171: 47-55, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38795684

ABSTRACT

Myopia is regarded as a worldwide epidemic ocular disease, has been proved related to inflammation. CD55, also known as decay-accelerating factor (DAF) can modulate the activation of complement through inhibiting the formation of complement 3 convertase and its dysregulation is involved in various inflammatory diseases. To investigate the association between CD55 and myopia, and to test whether CD55 can inhibit myopia development by suppressing inflammation in the eye, we use three different animal models including monocular form-deprivation myopia, myopia induced by TNF-α administration and allergic conjunctivitis animal model to reveal the CD55 in myopia development. The tears of thirty-eight participants with different spherical equivalents were collected and CD55 in the tears were also analyzed. Complement 3 and complement 5 levels increased while CD55 levels decreased in allergic conjunctivitis and myopic eyes. After anti-inflammatory drugs administration, CD55 expression was increased in monocular form-deprivation myopia model. We also found inflammatory cytokines TGF-ß, IL-6, TNF-α, and IL-1ß may enhance complement 3 and complement 5 activation while CD55 level was suppressed contrary. Moreover, lower CD55 levels were found in the tears of patients with myopia with decreased diopter values. Finally, CD55-Fc administration on the eyelids can inhibit the elongation of axial length and change of refractive error. CD55-Fc application also suppress myopia development subsequent to complement 3 and complement 5 reduction and can lower myopia-specific (MMP-2 and TGF-ß) cytokine expression in TNF-α induced myopia animal model. This suggests that CD55 can inhibit myopia development by suppression of complement activation and eventual down-regulation of inflammation.


Subject(s)
CD55 Antigens , Disease Models, Animal , Inflammation , Myopia , Adolescent , Animals , Female , Humans , Male , Young Adult , CD55 Antigens/metabolism , Complement Activation/drug effects , Complement C3/metabolism , Conjunctivitis, Allergic/immunology , Conjunctivitis, Allergic/metabolism , Cytokines/metabolism , Myopia/metabolism , Tears/metabolism , Tumor Necrosis Factor-alpha/metabolism , Complement C5/metabolism
11.
Indian J Ophthalmol ; 72(Suppl 4): S634-S638, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38770629

ABSTRACT

BACKGROUND: To study the levels of vitamin D serum levels in children with vernal keratoconjuctivits (VKC) and comparing vitamin D levels in after giving vitamin D supplements between intervention and control group. METHODS: The study was conducted in population between 1 to 12 years in tertiary care hospital in North India. Amongst children with VKC, full ocular examination along with Boninis clinical grading of VKC and serum vitamin D levels were assessed. Whole study group was randomly divided into two groups. Intervention group had received vitamin D powder while control group kept under observation. RESULTS: A total of 88 children received vitamin D supplementation and 39 kept in control group. CONCLUSION: Our study suggests that children in intervention group showed improvement in serum vitamin D levels with the clinical improvement in VKC grading too.


Subject(s)
Conjunctivitis, Allergic , Tertiary Care Centers , Vitamin D , Humans , Child , India/epidemiology , Male , Female , Vitamin D/blood , Child, Preschool , Conjunctivitis, Allergic/blood , Conjunctivitis, Allergic/epidemiology , Tertiary Care Centers/statistics & numerical data , Infant , Vitamins/blood , Vitamins/administration & dosage , Hospitals, Pediatric , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/blood , Vitamin D Deficiency/diagnosis , Follow-Up Studies , Dietary Supplements , Tertiary Healthcare
12.
Arq Bras Oftalmol ; 87(4): e2023, 2024.
Article in English | MEDLINE | ID: mdl-38656024

ABSTRACT

PURPOSE: The prevalence of ocular allergy varies according to the population and location of the study. Severe forms of ocular allergy are associated with compromised quality of life. In this study, we aimed to evaluate the application of the Brazilian-Portuguese version of the Quality of Life in Children with Keratoconjunctivitis questionnaire to children and adolescents with different subtypes of allergic conjunctivitis. METHOD: A total of 48 patients (aged 5-12 years) with allergic conjunctivitis were included in this study. They were enrolled and monitored at a specialized center. After the clinical appointment, the children responded to the questionnaire on two occasions at an interval of 30 days. Individual scores (ranging from 0 to 3) of the 16 items were added. RESULTS: The Brazilian-Portuguese version of the Quality of Life in Children with Keratoconjunctivitis questionnaire demonstrated good translation, adaptation, and intellectual properties, with substantial internal consistency (Cronbach's α coefficient = 0.702). There was no significant difference between the responses of the two interviews, revealing good reproducibility. The moderate/severe forms of allergic conjunctivitis had significantly higher quality of life scores (indicating a poorer quality of life) than the mild forms. CONCLUSIONS: The Brazilian-Portuguese version of the Quality of Life in Children with Keratoconjunctivitis proved to be quick, reliable, and reproducible for assessing the quality of life in children with allergic conjunctivitis. However, its ability to detect changes resulting from symptom aggravation or treatment needs to be further evaluated.


Subject(s)
Conjunctivitis, Allergic , Psychometrics , Quality of Life , Translations , Humans , Child , Conjunctivitis, Allergic/psychology , Brazil/epidemiology , Surveys and Questionnaires/standards , Male , Female , Child, Preschool , Reproducibility of Results , Language , Cultural Characteristics , Severity of Illness Index
13.
Sci Rep ; 14(1): 9598, 2024 04 26.
Article in English | MEDLINE | ID: mdl-38671063

ABSTRACT

Allergic conjunctivitis (AC) is the most common form of allergic eye disease and an increasingly prevalent condition. Topical eye drop treatments are the usual approach for managing AC, although their impact on the ocular surface is not frequently investigated. The aim of this study was to perform a comparative physicochemical characterization, and in vitro biological evaluations in primary conjunctival and corneal epithelial cells of the new multidose preservative-free bilastine 0.6% and main commercially available eye drops. MTT assay was used to measure cell viability; oxidative stress was analyzed with a ROS-sensitive probe; and apoptosis was evaluated monitoring caspase 3/7 activation. Differences in pH value, osmolarity, viscosity and phosphate levels were identified. Among all formulations, bilastine exhibited pH, osmolarity and viscosity values closer to tear film (7.4, 300 mOsm/l and ~ 1.5-10 mPa·s, respectively), and was the only phosphates-free solution. Single-dose ketotifen did not induce ROS production, and single-dose azelastine and bilastine only induced a mild increase. Bilastine and single-dose ketotifen and azelastine showed high survival rates attributable to the absence of preservative in its formulation, not inducing caspase-3/7-mediated apoptosis after 24 h. Our findings support the use of the new bilastine 0.6% for treating patients with AC to preserve and maintain the integrity of the ocular surface.


Subject(s)
Apoptosis , Benzimidazoles , Caspase 3 , Cell Survival , Ophthalmic Solutions , Preservatives, Pharmaceutical , Ophthalmic Solutions/pharmacology , Humans , Preservatives, Pharmaceutical/pharmacology , Cell Survival/drug effects , Benzimidazoles/pharmacology , Benzimidazoles/chemistry , Caspase 3/metabolism , Apoptosis/drug effects , Piperidines/pharmacology , Oxidative Stress/drug effects , Epithelial Cells/drug effects , Epithelial Cells/metabolism , Conjunctiva/drug effects , Conjunctiva/metabolism , Conjunctiva/pathology , Caspase 7/metabolism , Reactive Oxygen Species/metabolism , Conjunctivitis, Allergic/drug therapy , Conjunctivitis, Allergic/pathology , Conjunctivitis, Allergic/metabolism , Phthalazines/pharmacology , Osmolar Concentration , Epithelium, Corneal/drug effects , Epithelium, Corneal/metabolism , Cells, Cultured , Viscosity
14.
J Allergy Clin Immunol Pract ; 12(6): 1415-1427, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38685477

ABSTRACT

Allergen immunotherapy (AIT) is a recognized key therapeutic modality for the treatment of allergic respiratory disease. Definitive studies have provided evidence-based data to demonstrate its effectiveness in allergic rhinitis and asthma due to the inhalation of proteinaceous allergic substances from specific seasonal pollens, dust mites, animal allergens, and certain mold spores. Over the ensuing decades, laboratory investigations have provided objective evidence to demonstrate immunologic changes, including production of protective IgG antibody, suppression of IgE antibody, upregulation of regulatory T cells, and induction of a state of immune tolerance to the offending allergen(s). Tangential to this work were carefully designed clinical studies that defined allergen dose and duration of treatment, established the importance of preparing extracts with standardized allergens (or well-defined extracts) based on major protein moieties, and used allergen provocation models to demonstrate efficacy superior to placebo. In the United States, the use of subcutaneous immunotherapy extracts for AIT was grandfathered in by the Food and Drug Administration based on expert literature review. In contrast, sublingual tablet immunotherapy underwent formal clinical development programs (phase I-III clinical trials) that provided the necessary clinical evidence for safety and efficacy that led to regulatory agency approvals for the treatment of allergic rhinitis in properly characterized patients with allergy. The allergy specialist's treatment options currently include traditional subcutaneous AIT and specific sublingual tablets approved for grass, ragweed, house dust mites, trees belonging to the birch-homologous group, and Japanese cedar. Tangential to this are sublingual drops that are increasingly being used off-label (albeit not approved by the Food and Drug Administration) in the United States. This article will review the evidence-based literature supporting the use of these forms of AIT, as well as focus on several current controversies and gaps in our knowledge base that have relevance for the appropriate selection of patients for treatment with specific AIT.


Subject(s)
Allergens , Asthma , Desensitization, Immunologic , Rhinitis, Allergic , Humans , Desensitization, Immunologic/methods , Rhinitis, Allergic/therapy , Rhinitis, Allergic/immunology , Injections, Subcutaneous , Animals , Asthma/therapy , Asthma/immunology , Allergens/immunology , Allergens/therapeutic use , Conjunctivitis, Allergic/therapy , Conjunctivitis, Allergic/immunology , Sublingual Immunotherapy/methods , Sublingual Immunotherapy/adverse effects , Administration, Sublingual
15.
Klin Monbl Augenheilkd ; 241(5): 607-618, 2024 May.
Article in English, German | MEDLINE | ID: mdl-38604222

ABSTRACT

Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease with a bipolar age distribution in childhood, adolescence and middle adulthood. Up to 50% of AD patients show ocular involvement, which can be potentially sight threatening. Clinically, the majority of cases present with atopic blepharo(kerato)conjunctivitis or atopic keratoconjunctivitis (AKC); other clinical variants from this group of inflammatory ocular surface diseases are keratoconjunctivitis vernalis in childhood and adolescence and allergic conjunctivitis. In addition to the aforementioned blepharitis, keratitis and conjunctivitis, AD is also associated with eyelid involvement with subsequent eyelid malposition, limbal insufficiency with the development of pseudopterygia, (chronic) cicatrizing conjunctivitis with symblephara formation and fornix shortening, as well as ocular surface malignancies such as conjunctival intraepithelial neoplasia (CIN) and squamous cell carcinoma. In addition, an association with AD or AKC has been described for keratoconus. Whereas the therapy of AD in dermatology has made revolutionary advances in recent years through the use of biologicals, the primary use of these biologicals in ophthalmological complications is still very hesitant. Treatment here is often provided using topical steroids and calcineurin inhibitors. The following article summarises recent developments in basic and clinical dermatological research and discusses them in the context of current concepts for ophthalmological therapy.


Subject(s)
Dermatitis, Atopic , Keratoconjunctivitis , Humans , Keratoconjunctivitis/therapy , Keratoconjunctivitis/physiopathology , Keratoconjunctivitis/diagnosis , Dermatitis, Atopic/therapy , Dermatitis, Atopic/physiopathology , Dermatitis, Atopic/diagnosis , Treatment Outcome , Evidence-Based Medicine , Calcineurin Inhibitors/therapeutic use , Biological Products/therapeutic use , Conjunctivitis, Allergic/physiopathology , Conjunctivitis, Allergic/therapy , Conjunctivitis, Allergic/diagnosis
16.
Invest Ophthalmol Vis Sci ; 65(4): 23, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38597723

ABSTRACT

Purpose: Vernal keratoconjunctivitis (VKC) is an ocular allergic disease characterized by a type 2 inflammation, tissue remodeling, and low quality of life for the affected patients. We investigated the involvement of endoplasmic reticulum (ER) stress and unfolded protein response in VKC. Methods: Conjunctival imprints from VKC patients and normal subjects (CTs) were collected, and RNA was isolated, reverse transcribed, and analyzed with the Affymetrix microarray. Differentially expressed genes between VKC patients and CTs were evaluated. Genes related to ER stress, apoptosis, and autophagy were further considered. VKC and CT conjunctival biopsies were analyzed by immunohistochemistry (IHC) with specific antibodies against unfolded protein response (UPR), apoptosis, and inflammation. Conjunctival fibroblast and epithelial cell cultures were exposed to the conditioned medium of activated U937 monocytes and analyzed by quantitative PCR for the expression of UPR, apoptosis, autophagy, and inflammatory markers. Results: ER chaperones HSPA5 (GRP78/BiP) and HYOU1 (GRP170) were upregulated in VKC patients compared to CTs. Genes encoding for ER transmembrane proteins, PKR-like ER kinase (PERK), activating transcription factor 6 (ATF6), ER-associated degradation (ERAD), and autophagy were upregulated, but not those related to apoptosis. Increased positive reactivity of BiP and ATF6 and unchanged expression of apoptosis markers were confirmed by IHC. Cell cultures in stress conditions showed an overexpression of UPR, proinflammatory, apoptosis, and autophagy markers. Conclusions: A significant overexpression of genes encoding for ER stress, UPR, and pro-inflammatory pathway components was reported for VKC. Even though these pathways may lead to ER homeostasis, apoptosis, or inflammation, ER stress in VKC may predominantly contribute to promote inflammation.


Subject(s)
Conjunctivitis, Allergic , Humans , Conjunctivitis, Allergic/genetics , Quality of Life , Unfolded Protein Response , Endoplasmic Reticulum Stress/genetics , Inflammation , Conjunctiva , Endoplasmic Reticulum Chaperone BiP
17.
Clin Exp Allergy ; 54(8): 596-606, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38660824

ABSTRACT

BACKGROUND: The impact of allergic rhinoconjunctivitis on the early (EAR) and late asthmatic response (LAR) has yet to be assessed during optimal allergen exposure conditions. OBJECTIVE: We aimed to assess predictive factors of the EAR and LAR and to evaluate the relation between rhinitis, conjunctivitis and asthma induced by cat allergen exposure in an environmental exposure chamber (EEC). METHODS: Data from two cohort studies involving asthmatic patients with cat allergy who performed a cat allergen exposure challenge in ALYATEC EEC were analysed. Spirometry, visual analogue scale (VAS) for asthma, VAS for rhinitis, Total Nasal Symptoms Score, Total Ocular Symptoms Score (TOSS), Rhinoconjunctivitis Total Symptoms Score and Abelson score were used to assess asthma, rhinitis and conjunctivitis during and after exposure. RESULTS: An EAR occurred in 65.1% of patients, 32.1% of whom had a LAR. The diameter of the prick test to cat allergens and non-specific bronchial hypersensitivity level were independent risk factors for EAR (p < .05). No independent risk factors for LAR were identified. Rhinoconjunctivitis severity during exposure correlated with the asthma VAS during EAR and LAR (p < .05). Allergen exposure time needed to trigger an EAR correlated with the Abelson score during exposure (p < .05). The asthma VAS and TOSS during exposure correlated with faster LAR occurrence (p < .05). CONCLUSION: Prick test size and non-specific bronchial hypersensitivity level were confirmed as independent predictive factors of EAR during allergen exposure in an EEC. This study demonstrated the relation between the severity of rhinitis, conjunctivitis and asthma induced by allergen exposure for both EAR and LAR.


Subject(s)
Allergens , Asthma , Conjunctivitis, Allergic , Environmental Exposure , Severity of Illness Index , Cats , Humans , Asthma/immunology , Asthma/etiology , Asthma/diagnosis , Female , Male , Adult , Environmental Exposure/adverse effects , Conjunctivitis, Allergic/immunology , Conjunctivitis, Allergic/etiology , Conjunctivitis, Allergic/diagnosis , Animals , Allergens/immunology , Middle Aged , Skin Tests , Adolescent , Rhinitis, Allergic/immunology , Rhinitis, Allergic/etiology , Rhinitis, Allergic/diagnosis , Risk Factors , Young Adult
18.
Sci Rep ; 14(1): 6725, 2024 03 20.
Article in English | MEDLINE | ID: mdl-38509142

ABSTRACT

Globally, there has been a dramatic increase in the geriatric population. Sadly, this populace is highly prone to develop various ocular morbidities putting pressure on the strained eye care delivery system especially in low-income countries. Hence, the aim of this study was to determine the distribution of ocular morbidities among elderly. The study was a retrospective cross-sectional study conducted at Mzuzu Central Hospital in Malawi. We retrieved data from the hospital's Ophthalmology out-patient registry from January 2021 to December 2021. We recruited all 970 elderly patients who visited the clinic during the period of study. Data entry and analysis was done employing SPSS (v.26). More males than females had ocular morbidities. Cataract 400 (41.2%) was the most prevalent ocular morbidity followed by glaucoma 189 (19.5%), pinguecula 48 (4.9%) and allergic conjunctivitis 43 (4.4%). Anterior segment eye diseases were common 714 (73.6%). The prevalence of cataract, glaucoma, refractive error and allergic conjunctivitis was significantly associated with sex (p < 0.05). Age association was found with the prevalence of cataract, glaucoma, pinguecula, allergic conjunctivitis and corneal scar (p < 0.05). The pattern of eye diseases is endemic to the country. More resources should be targeting cataract and glaucoma among the age group.


Subject(s)
Cataract , Conjunctivitis, Allergic , Eye Diseases , Glaucoma , Pinguecula , Male , Female , Humans , Aged , Tertiary Care Centers , Cross-Sectional Studies , Retrospective Studies , Malawi/epidemiology , Eye Diseases/epidemiology , Glaucoma/epidemiology , Cataract/epidemiology , Prevalence , Outpatients
19.
Int J Pediatr Otorhinolaryngol ; 179: 111906, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38492328

ABSTRACT

BACKGROUND: Previous studies have reported an increasing prevalence of childhood allergic rhinitis in developing countries. There is still a lack of the recent epidemiology of allergic rhinitis among Chinese preschool children. Therefore, this study explored the prevalence of rhinitis symptoms and identified their associations with potential risk factors among children at the age of 3-6 in Shanghai, China. METHODS: Validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was adopted to collect information about rhinitis symptoms and potential risk factors. Univariate and multivariate logistic regression analyses were used to assess associations between risk factors and allergic rhinitis and rhinoconjunctivitis. RESULTS: A total of 6183 questionnaires were included in our study. The prevalence of rhinitis ever, current rhinitis, and physician-diagnosed rhinitis were 32.6%, 29.2%, and 14.3%, respectively, while the prevalence of current rhinoconjunctivitis was 11.3%. The higher prevalence was observed in boys than in girls in terms of rhinitis ever, current rhinitis, current rhinoconjunctivitis and doctor-diagnosed rhinitis. Autumn had the highest prevalence among four seasons. In our multivariate logistic regression analyses, history of allergic diseases and paracetamol use in the last year showed positive associations with the increased risk of both current rhinitis and rhinoconjunctivitis, and antibiotic use was an independent significant risk factor only for current rhinitis. Genetic factors, including maternal and paternal rhinitis, asthma, and eczema, were significantly associated with the prevalence of current rhinitis. Similar associations were seen between these factors and current rhinoconjunctivitis, except for paternal eczema. Among environmental factors, smoking exposure at home, heavy truck traffic in home's street, floor heating system were independent risk factors for both current rhinitis and rhinoconjunctivitis in the adjusted model, while cleaning the house less than once a week was only associated with current rhinitis. CONCLUSION: The prevalence of current rhinitis was 29.2% among children aged 3-6 in Shanghai, China. Sex differences and seasonal variations were observed in the prevalence of rhinitis symptoms. The identified risk factors would provide a basis for policy makers and medical experts to take intervention measures to prevent allergic rhinitis and rhinoconjunctivitis.


Subject(s)
Asthma , Conjunctivitis, Allergic , Eczema , Rhinitis, Allergic , Rhinitis , Humans , Female , Child, Preschool , Male , Conjunctivitis, Allergic/epidemiology , Conjunctivitis, Allergic/etiology , China/epidemiology , Rhinitis/complications , Risk Factors , Eczema/epidemiology , Rhinitis, Allergic/epidemiology , Rhinitis, Allergic/complications , Asthma/complications , Surveys and Questionnaires , Prevalence
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