Conjunctival provocation with airborne allergen in patients with atopic keratoconjunctivitis
Article first published online: 20 SEP 2011
© 2011 Blackwell Publishing Ltd
Clinical & Experimental Allergy
Volume 42, Issue 1, pages 58–65, January 2012
How to Cite
- Issue published online: 27 DEC 2011
- Article first published online: 20 SEP 2011
- Manuscript Accepted: 29 JUL 2011
- Manuscript Revised: 20 JUL 2011
- Manuscript Received: 29 MAR 2011
- Swedish Asthma and Allergy Association Research Foundation
- St Eriks Forskningsstiftelse
- Konsul Th C Berg Foundation
- the Swedish Foundation for Eye and Vision Research
- Swedish Research Council
- Stockholm County Council and Karolinska Institutet
- atopic keratoconjunctivitis;
- seasonal allergic conjunctivitis;
Atopic keratoconjunctivitis (AKC) is a chronic eye disease with periods of exacerbations. Many patients experience no obvious seasonal variation, although a majority of patients are allergic to common airborne allergens.
To investigate the allergic reaction, to conjunctival provocation with airborne allergens, in patients with AKC.
Eleven patients with AKC and birch and/or grass pollen allergy participated in the study, which was performed outside the pollen season. Five patients with seasonal allergic conjunctivitis (SAC) and five healthy subjects were included for validation purposes. The challenge was performed in one eye with the allergen, to which the patient was reactive, and with dilution buffer in the other eye. Signs and symptoms from both eyes were graded at baseline and at 10 min, 8 and 48 h after provocation. Tear fluid was collected from both eyes for cytokine analyses at baseline and at 8 and 48 h.
A significant change in clinical symptoms and signs, (redness and chemosis) was evident 10 min after provocation compared with baseline (P = 0.005) and compared with the unprovoked eye (P = 0.005) in AKC subjects. These parameters were normalized after 8 and 48 h. A significant increase for IFN-γ (P = 0.021) and IL-6 (P = 0.015), and a near significant increase for IL-10 (P = 0.066) were seen in the tear fluid of the challenged eye at 48 h after provocation vs. baseline and vs. the control eye for IFN-γ (P = 0.005), IL-6 (P = 0.028) and IL-10 (P = 0.008) in AKC subjects.
Conclusion and Clinical Relevance
In this single dose allergen provocation study, AKC patients responded with a typical IgE-mediated allergic reaction. An increase in cytokines at 48 h after the challenge was demonstrated and might, with further studies, give us a better understanding of the nature of inflammation in AKC.