Immune mechanisms in allergic eye diseases: what is new?

Abstract

The purpose of this review will be to focus on new findings that expand our understanding of the immune mechanisms occurring in the various forms of allergic eye disease and in experimental models, and some novel therapeutic approaches. The novel data encompass three main areas: effector mechanisms in allergic eye disease; cytokines and chemokines in conjunctival responses; combinations of drugs for improving treatment options for allergic eye disease. The term 'allergic eye disease' describes a spectrum of clinical conditions, ranging from the common, milder conditions of seasonal and perennial allergic conjunctivitis (SAC, PAC), to the rare and more severe diseases, vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). These latter two diseases can involve the cornea, leading to impaired vision. Although there is an underlying allergic mechanism, each of these ocular surface conditions involves different cellular responses and much effort has been made to identify the molecular pathways, which could be used as potential targets for therapeutic intervention. Currently available drugs, in particular for chronic forms of disease, are inadequate and there is an urgent need for safer, more localized and effective treatment.