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Abstract
Cytokines are key cell signalling proteins in a number of immune and homeostatic pathways of the human body. In particular, they mediate intracellular mechanisms of allergy on the ocular surface by triggering cellular responses that result in typical physiological ocular allergy symptoms, such as itchiness, watery eyes, irritation, and swelling. Given the recent research focus in optometry on the aetiology of corneal ectasia subtypes like keratoconus, there is an increasing need for the development of new clinical diagnostic methods. An increasing trend is evident among recent publications in cytokine studies, whereby the concentrations of cytokines in healthy and disease states are compared to derive a specific cytokine profile for that disease referred to as ‘biosignatures’. Biosignatures have diagnostic applications in ocular allergy as a cheap, non-invasive alternative to current techniques like IgE antibody testing and skin prick tests. Cytokine detection from tear samples collected via microcapillary flow can be analysed either by enzyme-linked immunosorbent assays (ELISA), multiplex magnetic bead assays, or immunoblot assays. Characterising patient hypersensitivities through diagnostic tests is the first step to managing exposure to triggers. Investigating cytokine biosignatures in ocular allergy and their links to physiology are imperative and will be the focus of this systematic review article.
Highlights
The global impact of allergy is on the rise, with over 40% of the population currently suffering from some level of hypersensitivity [1]
This review focuses on deviant levels of regulatory cytokines in ocular allergy and their theoretical
This review focuses on deviant levels of regulatory cytokines in ocular allergy and their clinical applications in diagnosis and in the rationalisation of ocular allergy symptoms
Summary
The global impact of allergy is on the rise, with over 40% of the population currently suffering from some level of hypersensitivity [1]. IgE level is used as an estimate, there is a clinical gap in the development of an alternative objective, non-invasive diagnostic test. Attempting to relieve symptoms by rubbing the eyes exacerbates inflammation and itchiness by triggering mechanical stress responses [12]. To decrease the prevalence of corneal ectasia among ocular allergy sufferers, early diagnosis and patient education regarding eye-rubbing is important [12]. This review will investigate significance of cytokines in tears to help drive further research on the various types of ocular allergy, treatments, and management options. PAC is an easier subtype to assess as tear samples can be collected during an active year-round flare-up, and not just in peak allergy seasons.
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