Johnson & Johnson Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan.
Br J Ophthalmol. 2012 Apr;96(4):581-6. doi: 10.1136/bjophthalmol-2011-300143. Epub 2012 Jan 23.
To evaluate tear and serum IgE and eosinophil cationic protein (ECP) as severity markers for atopic keratoconjunctivitis (AKC).
Thirty eyes of 30 patients with AKC and 10 eyes of 10 healthy control subjects were examined in this prospective study. All subjects underwent fluorescein staining, conjunctival injection, conjunctival oedema and papillary formation grading. Tear and serum IgE and ECP levels were measured, and correlations between them investigated with reference to the ocular surface clinical parameters.
The mean fluorescein scores, conjunctival injection, oedema scores and papillary formation were significantly higher in AKC patients compared to controls (p<0.05). Higher total IgE and ECP levels were detected in AKC tears compared with the control group. Tear ECP levels showed a significant correlation with fluorescein staining, conjunctival injection and oedema scores (r=0.70, 0.62 and 0.62, respectively). Tear IgE had no correlation with clinical signs. Serum IgE and ECP levels were elevated in AKC patients but did not show any correlation with clinical signs.
This study suggests the presence of an eosinophilic response in AKC disease independent of IgE sensitisation. Tear ECP was a useful marker delineating the severity of ocular surface disease in AKC.
评估泪液和血清 IgE 及嗜酸性粒细胞阳离子蛋白 (ECP) 作为特应性角结膜炎 (AKC) 的严重程度标志物。
本前瞻性研究纳入 30 例 AKC 患者的 30 只眼和 10 名健康对照者的 10 只眼。所有受试者均接受荧光素染色、结膜充血、结膜水肿和乳头形成分级。测量泪液和血清 IgE 和 ECP 水平，并参考眼表临床参数分析它们之间的相关性。
与对照组相比，AKC 患者的平均荧光素评分、结膜充血、水肿评分和乳头形成显著更高（p<0.05）。与对照组相比，AKC 泪液中的总 IgE 和 ECP 水平更高。泪液 ECP 水平与荧光素染色、结膜充血和水肿评分均呈显著相关（r=0.70、0.62 和 0.62）。泪液 IgE 与临床体征无相关性。AKC 患者的血清 IgE 和 ECP 水平升高，但与临床体征无相关性。
本研究提示 AKC 疾病存在与 IgE 致敏无关的嗜酸性粒细胞反应。泪液 ECP 是一种有用的标志物，可描绘 AKC 眼表疾病的严重程度。
