Sacchetti Marta, Plateroti Rocco, Bruscolini Alice, Giustolisi Rosalia, Marenco Marco
Department of Sense Organs, University Sapienza of Rome, Viale del Policlinico, 155, 00161 Rome, Italy.
Life (Basel). 2021 Sep 26;11(10):1012. doi: 10.3390/life11101012.
Vernal keratoconjunctivitis (VKC) is a chronic, recurrent, inflammatory disease of the cornea and conjunctiva mostly affecting boys in prepubertal age. VKC recurrence is characterized by intense symptoms of itching, redness, and photophobia associated with corneal damage, impairment of visual function, and quality of life. The pathogenesis of VKC has not yet been completely understood, and it is still controversial. In fact, VKC is considered an ocular allergic disease due to the involvement of immunoglobulin E, eosinophils, and mast cells, and of a lymphocyte T-helper type 2 reaction. However, approximately half of VKC patients have negative allergological history and testing, suggesting that other pathogenic mechanisms participate in VKC development and severity. Specifically, evidence suggests that genetic, endocrine, neuronal factors and an imbalance of innate immunity are involved in the pathogenesis of VKC. The purpose of this review is to summarize evidence on the pathogenic role of innate immunity, neuroimmune reaction, and hormonal changes in VKC. Increasing understanding of the pathogenic mechanisms behind VKC may lead to the identification of novel biomarkers for diagnosis and/or potential therapeutic targets in order to improve the management of this challenging condition.
春季角结膜炎（VKC）是一种角膜和结膜的慢性、复发性炎症性疾病，主要影响青春期前的男孩。VKC复发的特征是伴有角膜损伤、视功能损害和生活质量下降的强烈瘙痒、眼红和畏光症状。VKC的发病机制尚未完全明确，仍存在争议。事实上，由于免疫球蛋白E、嗜酸性粒细胞、肥大细胞以及2型辅助性T淋巴细胞反应的参与，VKC被认为是一种眼部过敏性疾病。然而，大约一半的VKC患者过敏史和过敏检测呈阴性，这表明其他致病机制也参与了VKC的发生发展及其严重程度。具体而言，有证据表明遗传、内分泌、神经因素以及先天免疫失衡都与VKC的发病机制有关。本综述的目的是总结关于先天免疫、神经免疫反应和激素变化在VKC中致病作用的证据。加深对VKC背后致病机制的理解可能会有助于识别新的诊断生物标志物和/或潜在治疗靶点，从而改善对这一具有挑战性疾病的管理。
