Atopy and serum eosinophil cationic protein in 110 white children with vernal keratoconjunctivitis: differences between tarsal and limbal forms
Article first published online: 5 MAR 2003
Clinical & Experimental Allergy
Volume 33, Issue 3, pages 325–330, March 2003
How to Cite
Pucci, N., Novembre, E., Lombardi, E., Cianferoni, A., Bernardini, R., Massai, C., Caputo, R., Campa, L. and Vierucci, A. (2003), Atopy and serum eosinophil cationic protein in 110 white children with vernal keratoconjunctivitis: differences between tarsal and limbal forms. Clinical & Experimental Allergy, 33: 325–330. doi: 10.1046/j.1365-2222.2003.01538.x
- Issue published online: 5 MAR 2003
- Article first published online: 5 MAR 2003
- Submitted 25 February 2002; revised 18 June 2002; accepted 12 August 2002
- eosinophil cationic protein;
- giant papillae;
- IgE sensitization;
- Vernal keratoconjunctivitis
Background A predominance of Th2 response has been suggested in vernal keratoconjunctivitis (VKC), and a high prevalence of IgE-sensitized (IgE-S) patients has been reported (positive skin prick test or serum-specific-IgE). Palpebral and bulbar VKC are considered to be expressions of the same disease and only occasional racial and histopathological differences are described between the two forms. Tear levels of eosinophil cationic proteins have been correlated with the severity of ocular symptoms; however, there is no published study that demonstrates the presence of serum markers of disease activity.
Objective This study was performed to evaluate the prevalence of IgE-sensitization in palpebral, bulbar and mixed VKC and to determine possible useful markers of disease activity in peripheral circulation.
Methods A total of 110 white VKC patients (mean age 8.3 years, range 3.2–18 years) were evaluated for ocular score in the active phase of the disease. Skin prick tests and serum-specific IgE for common allergens, serum-total IgE, peripheral blood eosinophil counts (PBECs) and serum eosinophil cationic protein (s-ECP) were determined. Fifteen age-matched non-IgE-S control children underwent the same determinations.
Results s-ECP, PBECs and s-total IgE were significantly higher in IgE-S than in non-IgE-S VKC patients and in non-IgE-S VKC patients than in controls. A lower prevalence of IgE-S patients was found in bulbar vs. tarsal (P = 0. 050) or mixed forms (P = 0.002). The score of giant papillae was strongly correlated with s-ECP levels (P < 0.001) and with PBECs (P = 0.001).
Conclusions Our data suggest that an overall eosinophilic response is present in VKC independently of IgE-sensitization; bulbar forms, unlike tarsal and mixed forms, were associated with a low prevalence of IgE-sensitization. Serum ECP was a useful marker of disease activity in tarsal and mixed forms.