Allergic Conjunctiva Research Articles

EFFICACY OF ASCHYOTANA IN THE MANAGEMENT OF VATAJA ABHISHYANDA (ALLERGIC CONJUNCTIVITIS): AN OBSERVATIONAL STUDY

Background: Inflammation of the conjunctiva due to allergy is known as allergic conjunctiva. It is also seen in the people suffering from allergic rhinitis and is affected by all age groups at least once in their lifetime. But older population and children are more prone for allergic conjunctivitis.
 Objectives: To evaluate the effect of Aschyotana karma or the therapy with Bilvadi eye drops in the management of Vataja abhishyanda (allergic conjunctivitis). Design: This was an observational study with random sampling. Forty subjects who fulfilled the eligibility criteria were included for the study. Patients with complaints of Allergic Conjunctivitis were selected from OPD of Department of Shalakya Tantra (Netra-Roga), R.G.G.P.G. Ayu. Hospital Paprola, Himachal Pradesh. These patients were administered Bilvadi aschyotana 2 eye drops 4to 5 times for 15 days and were assessed for itching, redness, burning sensation and photophobia before the treatment, on the 3rd day, once in a week and after the treatment. 
 Results: Aschyotana with Bilvadi eye drops in Vataja abhishyanda provided significant relief in itching 70.09%, redness 41.7%, burning sensation 47.6% and photophobia 53.3%.

Characterisation of the phenotype and function of monocyte-derived dendritic cells in allergic conjunctiva

BackgroundDendritic cells (DCs) are the most potent antigen-presenting cells involved in initiating the immune response, presenting antigens to T cells and leading to T cell proliferation. In an immature state,...

Characterization of dendritic cell phenotype in allergic conjunctiva: increased expression of FcɛRI, the high-affinity receptor for immunoglobulin E

Dendritic cells (DCs) express the high-affinity receptor for IgE (Fc(epsilon)RI) on their surface, which may enhance their ability to capture and internalize antigens for presentation to T-lymphocytes. The aim of this study was to determine if expression of Fc(epsilon)RI(+) DCs is increased in the conjunctivae of vernal keratoconjunctivitis (VKC) patients compared with those of normal controls. Conjunctival biopsies were obtained from non-atopic and VKC patients. Double immunohistochemical staining was carried out using antibodies against Fc(epsilon)RI and the CD1a antigen, a DC marker. The double-positive cells were counted in five representative fields of view for each conjunctival sample. Fc(epsilon)RI(+) CD1a(+) cells were present in significantly higher numbers in VKC conjunctivae compared with normal controls (mean cell count of 21.3 in VKC vs5.0 in controls, P<0.005). In normal patients the Fc(epsilon)RI-expressing DCs tended to be confined to the epithelial layer or the superficial substantia propria, but in the VKC samples these Fc(epsilon)RI(+) cells were mainly concentrated in the deeper substantia propria. Fc(epsilon)RI(+) DC numbers are elevated in the conjunctivae of VKC patients, a finding consistent with the results of other studies focusing on atopic conditions. Elevated expression of Fc(epsilon)RI on DCs would facilitate antigen presentation and enhance T-cell priming, thereby contributing to ocular symptoms.

Expression of Toll-like Receptors in Healthy and Allergic Conjunctiva: Discussion

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Expression of Toll-like Receptors in Healthy and Allergic Conjunctiva

To investigate the expression of toll-like receptors (TLRs) in healthy and active vernal keratoconjunctivitis (VKC) conjunctiva. Comparative nonrandomized interventional study. Nine patients with vernal keratoconjunctivitis and 10 healthy subjects. Normal and VKC conjunctiva were evaluated for TLR-2, TLR-4, and TLR-9 mRNA and proteins by relative real-time polymerase chain reaction and immunohistochemistry. Colocalization of TLRs was further evaluated by confocal microscopy and double-labeled immunofluorescence in T cells (CD4), mast cells (AA1), and eosinophils (EG2). Identification of TLRs at molecular and biochemical levels and identification of inflammatory cells that coexpress these receptors. Toll-like receptor 2, TLR-4, and TLR-9 were expressed in normal and VKC conjunctival epithelium and stroma, both with a more intense immunoreactivity in the stroma. In VKC tissues, TLR-4 was upregulated, TLR-9 was downregulated, and TLR-2 was slightly decreased relative to normal tissues. Toll-like receptor 4 was localized on CD4+ lymphocytes, eosinophils, and mast cells, whereas lymphocytes and eosinophils, but not mast cells, expressed TLR-9. Toll-like receptors are expressed in healthy and allergic conjunctiva. The upregulation or downregulation of these receptors and their presence on inflammatory cells suggest a role of TLRs in VKC.

Toll-like receptors expression in the healthy and allergic conjunctiva

RATIONALE: Toll-like receptors (TLRs) represent a family of transmembrane glycoproteins with a major role in recognition and innate immunity to various microbial antigens. Recently, increasing attention had been devoted to the role of TLRs in linking innate and adaptive immunity in infections and allergy. The aim was to investigate the expression of TLRs in the healthy human conjunctiva and in the conjunctiva of patients with Vernal Keratoconjunctivitis (VKC), a chronic inflammatory Th2-driven disorder of the ocular surface METHODS: Expression of TLR-2, -4 and -9 in conjunctival biopsies from healthy subjects and VKC patients was investigated at both molecular (relative real-time PCR) and biochemical (Western Blotting/confocal analysis/immunohistochemistry) level. TLRs expression (mRNA and protein) was also studied in normal and VKC conjunctival derived fibroblasts expanded in vitro. RESULTS: Human healthy conjunctiva expresses TLR-2, -4 and -9 mRNA's and proteins. VKC conjunctiva expresses significant higher amounts of TLR-4mRNA/protein, and a significant decrease of TLR-9mRNA/protein. TLR-4 mRNA and protein was also found to be over-expressed in VKC-derived fibroblasts, while TLR-2 and -9mRNAs and proteins were slightly down-regulated. CONCLUSIONS: This is the first report of TLR-2, -4 and -9 expression in the human healthy conjunctiva. The up-regulation of TLR-4 and down-regulation of TLR-9, in VKC both at molecular and biochemical level, might suggest a role of the innate and adaptive response to microbial antigens in modulating the ocular allergic inflammatory response.

Nerve Growth Factor: An Important Molecule in Allergic Inflammation and Tissue Remodelling

Background: Several studies provide evidence that nerve growth factor (NGF) has an expanding role in neuroimmune interactions. Methods: We review our data on circulation levels of NGF in allergic diseases as well as on the relationships between this neurotrophin and primary and secondary effector cells of allergic inflammation. Results: In vernal keratoconjunctivitis, a close relationship exists between the increased NGF plasma values and the number of mast cells infiltrating the conjunctiva. NGF serum values are also increased in other allergic diseases and asthma, and are related to the severity of the inflammatory process and disease. Human CD4+ T cell clones (preferentially of activated Th2 type) produce and release NGF, and express high–affinity NGF receptors. NGF is preformed in and can act on human peripheral blood eosinophils to preferentially release inflammatory mediators. Immunoreactivity for high affinity NGF receptors is present both in basal epithelial cells and in the inflamed stroma of the allergic conjunctiva. Topical administration of NGF results in a complete healing of neurotophic corneal ulcers in man, thus suggesting a profound effect of NGF on human fibroblasts and extracellular matrix. Conclusion: Data presented suggest that NGF is an important molecule in allergic inflammation and tissue remodelling occurring in allergic diseases.

Immunolocalization of cytokines to mast cells in normal and allergic conjunctiva

Recently, the potential role of mast cells in allergic reactions has been extended by the discovery that these cells synthesize, store and secrete multifunctional cytokines. Seasonal allergic conjunctivitis is characterized as an immediate hypersensitivity reaction, in which allergen binds to specific IgE on mast cells, leading to release of pre-formed and newly synthesized inflammatory mediators. In this study we aimed to localize the cytokines IL-4, IL-5, IL-6, IL-8 and TNF alpha to conjunctival mast cells and to examine the relationship between mast cell-associated cytokines and allergic conjunctivitis. Immunohistochemistry was performed on serial sections of conjunctival biopsies from patients with seasonal allergic conjunctivitis, in and out of the hay fever season, as well as from non-allergic volunteers. IL-4, IL-5, IL-6 and TNF alpha were localized to mast cells in normal and allergic conjunctiva. IL-8 was localized to mast cells in two patients with seasonal allergic conjunctivitis, one during and the other outside the pollen season. Using the monoclonal antibody 3H4, which identifies the secreted form of IL-4, biopsies from patients with active seasonal allergic conjunctivitis contained a significantly higher proportion of mast cells positive for IL-4, than those from out-of-season patients (P=<0.016). There was no difference between the two groups in the number of mast cells immunostained by the antibody 4D9 which identifies the stored form of IL-4. These results suggest that conjunctival mast cells can store a range of multifunctional cytokines and release IL-4 during active disease, which may give them an important role in upregulating allergic inflammation in the conjunctiva.

Immunolocalization of cytokines to mast cells in normal and allergic conjunctiva

Immunolocalization of cytokines to mast cells in normal and allergic conjunctiva

Quantitative evaluation of inflammatory cells in seasonal allergic conjunctivitis.

This study aimed to investigate the inflammatory changes occurring in the allergic conjunctiva due to different allergens. Ninety-two allergic conjunctivitis patients were divided into two groups: group I showed cedar pollen sensitivity only; group II showed sensitivities to cedar pollen and household dust or mites. Using brush cytology procedures, quantitative evaluation of inflammatory cells in the conjunctiva was made. The mean proportion of the neutrophils and lymphocytes in group II was significantly higher than the percentage of neutrophils in group I. The counts of eosinophils showed no significant difference between groups I and II. Our results suggest that the eosinophil numbers are not different between the allergic conjunctivitis groups. The neutrophilic and lymphocytic increase in allergic conjunctivitis may be due to two distinct groups of antigens.

Histamine and Tryptase Levels in Allergic Conjunctivitis and Vernal Keratoconjunctivitis

Tryptase is useful as a specific and accurate indicator of mast cell activation, whereas histamine, a mast cell's major mediator, also exists in basophils. The aim of this study is to investigate histamine and tryptase levels in allergic conjunctiva. We measured histamine and tryptase levels in conjunctival epithelial cell suspension of children with allergic conjunctivitis (AC) and vernal kerato-conjunctivitis (VKC), and controls, and we evaluated correlations with clinical observations. Both the histamine and tryptase levels in VKC were significantly higher than controls (p < 0.05, p < 0.01), and histamine levels in VKC was also greater than AC (p < 0.05). The histamine/tryptase (H/T) ratios were 0.03 +/- 0.04 in AC, 0.08 +/- 0.09 in VKC and 0.006 +/- 0.006 in controls. The H/T ratios in VKC were significantly higher than controls (p < 0.05) and AC (p < 0.05), and were also found to correlate with the superficial punctate keratopathy (SPK) score (r2 = 0.89). Analyzing the histamine and tryptase levels in conjunctival epithelium may be useful in evaluating the allergic ocular surface, especially in the cases with SPK, where the increase in the histamine levels is not accompanied by an increase in tryptase levels. This suggests an important role for inflammatory cells such as basophils infiltrating into the conjunctival epithelium in allergic reactions.

Immunofluorescent staining of plasma cells in the allergic conjunctiva

Immunofluorescent staining of plasma cells in the allergic conjunctiva