Leonardi Andrea, De Dominicis Chiara, Motterle Laura
Ophthalmology Unit, Department of Neuroscience, University of Padua, Italy.
Curr Opin Allergy Clin Immunol. 2007 Oct;7(5):429-35. doi: 10.1097/ACI.0b013e3282ef8674.
The immunopathogenesis of ocular allergic disorders is generally related to the specific immunoglobulin E-mediated mast cell activation and the following cascade of inflammatory mediators. Seasonal and perennial allergic conjunctivitis, however, are the only ocular diseases to involve solely type I hypersensitivity. The other main forms, vernal and atopic keratoconjunctivitis, have a more complex immunological basis and a chronic inflammatory component. Involvement of inflammatory cells, particularly eosinophils and T cells, cytokines and proteases can lead to more serious corneal damage with vision-threatening potential.
Experimental allergic conjunctival models and clinical research studies have shown that T helper type 2-related mechanisms are definitely involved in the sensitization phase of ocular allergy, however, both T helper type 1 and type 2 cytokines are overexpressed in the active disease, contributing to the development of ocular inflammation.
A review of the recent literature allows us to better understand the mechanisms involved in the development of ocular allergy and to guide us toward a more schematic approach, which could possibly be useful in forming a new classification, standardizing clinical phases and individuating new treatment targets.
眼部过敏性疾病的免疫发病机制通常与特异性免疫球蛋白E介导的肥大细胞活化以及随后的一系列炎症介质有关。然而，季节性和常年性过敏性结膜炎是仅涉及I型超敏反应的眼部疾病。其他主要形式，如春季角结膜炎和特应性角结膜炎，具有更复杂的免疫学基础和慢性炎症成分。炎症细胞，特别是嗜酸性粒细胞和T细胞、细胞因子和蛋白酶的参与可导致更严重的角膜损伤，具有威胁视力的潜在风险。
实验性过敏性结膜模型和临床研究表明，2型辅助性T细胞相关机制肯定参与眼部过敏的致敏阶段，然而，1型和2型辅助性T细胞细胞因子在活动性疾病中均过度表达，促进眼部炎症的发展。
对近期文献的综述使我们能够更好地理解眼部过敏发生发展的机制，并指导我们采用更具系统性的方法，这可能有助于形成新的分类、规范临床阶段并确定新的治疗靶点。
