Department of Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.
Cornea. 2013 Aug;32(8):1149-54. doi: 10.1097/ICO.0b013e31828ffdf8.
The aims of this study were to evaluate the efficacy of topical 0.05% cyclosporine A on clinical signs and symptoms of vernal keratoconjunctivitis (VKC) and to examine its effect on tear cytokine levels.
Twenty-one patients with active VKC and 15 healthy volunteers were included. Patients were treated with topical 0.05% cyclosporine A. Symptoms and signs were scored on the day of enrollment and at the end of month 1 and month 3. Tear and serum samples were collected before and on the third month of treatment. Interleukin (IL)-2, soluble IL-2 receptor (sIL-2R), IL-3, IL-4, IL-5, IL-6, IL-9, IL-13, IL-17, eotaxin, tumor necrosis factor alpha (TNF-α), and interferon gamma (IFN-γ) in cell-free tear and serum supernatants were measured by multiplex bead analysis.
At the end of month 1 and month 3 with topical 0.05% cyclosporine A treatment, statistically a significant decrease was observed in sign and symptom scores of the patients (P < 0.0001). Tear IL-2, sIL-2R, IL-9, IL-17, IFN-γ, and eotaxin levels in VKC patients were significantly higher than those in controls (P < 0.05). IL-3, IL-4, IL-5, and TNFα levels tended to be higher in VKC patients. There was also statistically significant reduction from before 0.05% cyclosporine A treatment to after treatment in tear levels of IL-4, IL-5, IL-17A, TNFα, IFN-γ, and eotaxin (P < 0.05). IL-2 and sIL-2R levels tended to be lower than pretreatment levels.
Topical 0.05% cyclosporine A is effective in alleviating signs and symptoms of VKC patients and shows its effect probably by decreasing the local production of some inflammatory mediators in tears.
本研究旨在评估局部应用 0.05%环孢素 A 治疗春季角结膜炎（VKC）的临床疗效，并观察其对泪液细胞因子水平的影响。
纳入 21 例活动期 VKC 患者和 15 例健康志愿者。患者接受局部应用 0.05%环孢素 A 治疗。在入组当天和第 1 个月及第 3 个月对症状和体征进行评分。在治疗前和治疗第 3 个月采集泪液和血清样本。采用多因子 bead 分析检测细胞游离泪液和血清上清液中白细胞介素（IL）-2、可溶性 IL-2 受体（sIL-2R）、IL-3、IL-4、IL-5、IL-6、IL-9、IL-13、IL-17、嗜酸性粒细胞趋化因子、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）的水平。
在第 1 个月和第 3 个月局部应用 0.05%环孢素 A 治疗后，患者的体征和症状评分均有显著下降（P<0.0001）。VKC 患者的泪液中 IL-2、sIL-2R、IL-9、IL-17、IFN-γ和嗜酸性粒细胞趋化因子水平显著高于对照组（P<0.05）。IL-3、IL-4、IL-5 和 TNF-α水平在 VKC 患者中也呈升高趋势。与治疗前相比，治疗后 VKC 患者的泪液中 IL-4、IL-5、IL-17A、TNF-α、IFN-γ和嗜酸性粒细胞趋化因子水平也有显著下降（P<0.05）。IL-2 和 sIL-2R 水平也呈下降趋势，低于治疗前水平。
局部应用 0.05%环孢素 A 可有效缓解 VKC 患者的体征和症状，其作用机制可能是通过降低泪液中某些炎症介质的局部产生。
