Cytokine Profiles in Tears Accompanying the Secondary Conjunctival Responses Induced by Nasal Allergy

Abstract

Purpose/aim: Allergic conjunctivitis (AC) occurs either in a primary form, due to the allergic reaction localized in the conjunctivae or in a secondary form, induced by an allergic reaction initiated primarily in the nasal mucosa. The purpose of this study was to investigate the cytokine profiles in tears associated with the secondary conjunctival response (SCR) types.

Materials and methods: In 47 AC patients developing 16 immediate (SICR; p < 0.01), 20 late (SLCR; p < 0.001) and 11 delayed (SDYCR; p < 0.05) responses to nasal provocation tests (NPTs) with allergens, the NPTs were repeated and combined with recording of cytokine concentrations in the tears.

Results: The SCRs were associated with significant concentration changes of particular cytokines in tears (p < 0.05) as follows: (1): SICRs: interleukin (IL)-3, IL-4, IL-10 and granulocyte macrophage colony-stimulating factor (GM-CSF); (2) SLCRs: IL-3, IL-4, IL-5, IL-8, IL-10, IL-12p40, GM-CSF and granulocyte colony-stimulating factor (G-CSF); and (3) SDYCRs: IL-2, IL-8, IL-10, interferon gamma, G-CSF and tumor necrosis factor alpha. No significant cytokine changes were recorded in tears during the phosphate-buffered saline controls or negative SCRs.

Conclusions: Different cytokine profiles in the tears accompanying the immediate, late and delayed types of SCR, induced by nasal allergy, would indicate involvement of different hypersensitivity mechanisms in the particular SCR types. The low cytokine concentrations in tears recorded during the SCRs may suggest their origin from the nasal mucosa. These results emphasize the diagnostic value of NPTs with allergens combined with monitoring of various ocular features in patients suffering from the secondary form of AC. These results may also have an impact on the therapeutical approach to this clinical entity.

• Allergic conjunctivitis
• cytokines in tears
• nasal allergy
• nasal provocation tests with allergens
• secondarily induced conjunctival responses

Notes

*Parts of the results reported in this article were presented as a preliminary communication at the XXI Congress of the European Academy of Allergology and Clinical immunology, Naples, 1–5 June 2002.²⁹