Sex hormones in allergic conjunctivitis: altered levels of circulating androgens and estrogens in children and adolescents with vernal keratoconjunctivitis.

Marta Sacchetti,Flavio Mantelli,Stefano Bonini,Alessandro Lambiase,Costanzo Moretti

doi:10.1155/2015/945317

Abstract

Purpose. Vernal keratoconjunctivitis (VKC) is a chronic allergic disease mainly affecting boys in prepubertal age and usually recovering after puberty. To evaluate a possible role of sex hormones in VKC, serum levels of sex hormones in children and adolescents with VKC were assessed. Methods. 12 prepubertal and 7 early pubertal boys with active VKC and 6 male patients with VKC in remission phase at late pubertal age and 48 healthy age and sex-matched subjects were included. Serum concentration of estrone, 17 beta-estradiol, dehydroepiandrosterone-sulfate, total testosterone and free testosterone, dihydrotestosterone (DHT), cortisol, delta-4-androstenedione, follicle-stimulating hormone, luteinizing hormone, and sex-hormones binding globuline (SHBG) were evaluated. Results. Serum levels of Estrone were significantly increased in all groups of patients with VKC when compared to healthy controls (P < 0.001). Prepubertal and early pubertal VKC showed a significant decrease in DHT (P = 0.007 and P = 0.028, resp.) and SHBG (P = 0.01 and P = 0.002, resp.) when compared to controls and serum levels of SHBG were increased in late pubertal VKC in remission phase (P = 0.007). Conclusions and Relevance. VKC patients have different circulating sex hormone levels in different phases of the disease and when compared to nonallergic subjects. These findings suggest a role played by sex hormones in the pathogenesis and/or activity of VKC.

Highlights

Vernal keratoconjunctivitis (VKC) is an ocular allergic disease mainly affecting the paediatric population, as it usually recovers spontaneously after puberty [1]
In this study we demonstrated that boys with active VKC have different circulating sex hormone levels as compared to healthy subjects
VKC is a chronic allergic disease, and as in other atopic conditions such as atopic eczema and asthma, boys are more frequently affected compared to girls, with this ratio becoming almost equal after puberty due to a spontaneous remission in the late puberty

Summary

Introduction

Vernal keratoconjunctivitis (VKC) is an ocular allergic disease mainly affecting the paediatric population, as it usually recovers spontaneously after puberty [1]. To other atopic conditions, VKC has a different prevalence between males and females. Boys are two to four times more likely to develop VKC [1,2,3,4]. We previously described a significant increase of conjunctival estrogen and progesterone receptors in children with VKC as compared to healthy subjects. These findings, together with the higher disease prevalence in boys, suggest an influence of sex hormones on VKC development and/or activity [5]. In line with this, increasing evidence demonstrates a close relationship between sex hormones and ocular surface conditions such as dry eye, autoimmune diseases, contact lens intolerance, corneal angiogenesis, and wound healing [6]

Methods

Results

Conclusion