Original Articles
Tear and serum soluble leukocyte activation markers in conjunctival allergic diseases

https://doi.org/10.1016/S0002-9394(99)00295-0Get rights and content

Abstract

PURPOSE:

To measure markers of leukocyte activation in patients with an exclusively ocular inflammatory or bacterial disease.

METHODS:

Neutrophil myeloperoxidase, eosinophil cationic protein, eosinophil neurotoxin, and soluble interleukin-2 receptor were measured in serum and tears of 17 patients with allergic vernal keratoconjunctivitis, seven with atopic keratoconjunctivitis, 11 with seasonal allergic conjunctivitis, seven with giant papillary conjunctivitis, 13 with rosacea blepharokeratoconjunctivitis, seven with bacterial conjunctivitis, and 13 normal subjects as controls.

RESULTS:

In serum of patients with vernal and atopic keratoconjunctivitis, levels of eosinophil cationic protein, eosinophil neurotoxin, and interleukin-2 receptor were significantly increased compared with control subjects but were not correlated with the severity of ocular symptoms. In tears of patients with vernal and atopic keratoconjunctivitis and seasonal allergic conjunctivitis, as well as in the nonallergic diseases, rosacea blepharokeratoconjunctivitis and bacterial conjunctivitis, levels of eosinophil cationic protein, neurotoxin, and interleukin-2 receptor were significantly increased compared with control subjects. The highest values of these markers were found in vernal keratoconjunctivitis samples. Neutrophil myeloperoxidase was significantly increased in vernal and atopic keratoconjunctivitis, rosacea blepharokeratoconjunctivitis, and bacterial conjunctivitis. In vernal keratoconjunctivitis, tear markers were correlated to the clinical score of the disease, but not with cytology.

CONCLUSIONS:

Tear histamine was measured in 10 allergic patients after allergen challenge. Although none of the above markers can be considered specific to a single disease, their measurement may still be useful for the quantification of local cell activation in ocular inflammatory diseases.

Section snippets

Patients and methods

Written informed consent was obtained from all patients or, in the case of minors, from their parents. Peripheral-blood and tear samples were collected from 13 normal volunteers (mean age, 21 ± 8 years; seven males, six females) and 62 patients affected by active inflammatory eye diseases: 11 with seasonal allergic conjunctivitis (mean age, 24 ± 7 years; six males, five females), 17 with vernal keratoconjunctivitis (mean age, 14.0 ± 6.1 years; 15 males, two females), seven with atopic

Results

Serum levels of eosinophil cationic protein and eosinophil neurotoxin were significantly higher compared with those in control subjects in seasonal allergic conjunctivitis, vernal keratoconjunctivitis, and atopic keratoconjunctivitis but not in giant papillary conjunctivitis (Table 1). Myeloperoxidase serum levels were not increased in any allergic condition. Soluble interleukin-2 receptor serum levels were significantly increased in both vernal and atopic keratoconjunctivitis. Serum values of

Discussion

Ocular allergic disorders can be differentiated by the severity of the patient’s signs and symptoms. The degree of local involvement of the inflammatory cells associated with these conditions—eosinophils, neutrophils and lymphocytes—may be evaluated by the assaying in biologic fluids of specific proteins released when these cells are activated. In this study, leukocyte activation markers were studied in tears and serum of allergic and nonallergic patients to establish the concentrations of

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