Bonini Sergio
Chair Allergology and Clinical Immunology, Second University of Naples and IRCCS San Raffaele, Rome, Italy.
Chem Immunol Allergy. 2006;91:110-20. doi: 10.1159/000090247.
The eye is largely exposed to foreign substances, and ocular tissues have a complete array of immune cells to interact with offending antigens. In particular, the external eye represents an ideal site for immediate hypersensitivity reactions because of the high number of mast cells in the eyelids and bulbar conjunctiva, as well as for the potential local synthesis of IgE. In fact, the involvement of the eye was part of the original description of hay fever by Charles Blackley in 1873. In a large epidemiological survey of allergic patients we reported since 1987, 40% had symptoms possibly related to allergic conjunctival disease. However, the participation of the conjunctiva to the multiorgan picture of allergy is largely underestimated. Allergic eye diseases have long been referred to the classical Type I hypersensitivity mechanism according to Coombs and Gell. Recently, however, the tremendous progress in understanding allergic mechanisms and inflammation has brought new insights into the pathophysiology of several allergic diseases, including those of the eye. Accordingly, several systematic descriptions of allergic eye diseases should be revisited. In particular, the classification of the various forms of a 'red eye' of allergic origin appears inadequate to answer the progress achieved in their multifactorial pathogenesis.
眼睛很大程度上暴露于外来物质，眼部组织拥有一整套免疫细胞来与有害抗原相互作用。特别是，由于眼睑和球结膜中肥大细胞数量众多以及局部合成IgE的可能性，眼球表面是速发型超敏反应的理想部位。事实上，眼部受累是查尔斯·布莱克利在1873年对花粉热的最初描述的一部分。在我们自1987年以来对过敏患者进行的一项大型流行病学调查中，40%的患者有可能与过敏性结膜疾病相关的症状。然而，结膜在过敏的多器官表现中的作用在很大程度上被低估了。长期以来，变应性眼病一直被归为根据库姆斯和盖尔分类的经典I型超敏反应机制。然而，最近在理解过敏机制和炎症方面取得的巨大进展为包括眼部疾病在内的几种变应性疾病的病理生理学带来了新的见解。因此，变应性眼病的一些系统描述应该重新审视。特别是，过敏性起源的“红眼”各种形式的分类似乎不足以应对其多因素发病机制方面取得的进展。
