IgE and eosinophil cationic protein (ECP) as markers of severity in the diagnosis of atopic keratoconjunctivitis

• Published in: British journal of ophthalmology Vol. 96; no. 4; pp. 581 - 586
• Main Authors: Wakamatsu, Tais H, Satake, Yoshiyuki, Igarashi, Ayako, Dogru, Murat, Ibrahim, Osama M A, Okada, Naoko, Fukagawa, Kazumi, Shimazaki, Jun, Fujishima, Hiroshi
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.04.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Allergies; atopic keratoconjunctivitis; Atopy; Biological and medical sciences; Biomarkers - metabolism; clinical trial; Clinical trials; Colleges & universities; conjunctiva; Conjunctiva - metabolism; Conjunctivitis, Allergic - complications; Conjunctivitis, Allergic - diagnosis; Conjunctivitis, Allergic - metabolism; contact lens; cornea; Cytotoxicity; Diagnosis, Differential; diagnostic tests/investigation; Diseases of cornea, anterior segment and sclera; Edema; Eosinophil cationic protein; Eosinophil Cationic Protein - metabolism; Eosinophilia - diagnosis; Eosinophilia - etiology; Eosinophilia - metabolism; experimental and laboratory; Eye diseases; Female; fluorescein; Follow-Up Studies; Hospitals; Humans; IgE; imaging; Immunoglobulin E; Immunoglobulin E - metabolism; immunology; Inflammation; Keratoconjunctivitis; Keratoconjunctivitis - complications; Keratoconjunctivitis - diagnosis; Keratoconjunctivitis - metabolism; lacrimal gland; Leukocytes (eosinophilic); Male; Medical sciences; Miscellaneous; ocular surface; Ophthalmology; Pathogenesis; Patients; Prospective Studies; Proteins; Severity of Illness Index; stem cells; Tears; treatment medical; treatment surgery; wound healing; Young Adult; Allergy; Immunopathology; IgE; Keratopathy; Conjunctiva disease; Marker; Atopy; Eye disease; Keratoconjunctivitis; Diagnosis; Ophthalmology; Eosinophil cationic protein; Anterior segment disease
• ISSN: 0007-1161; 1468-2079; 1468-2079
• DOI: 10.1136/bjophthalmol-2011-300143

AimsTo evaluate tear and serum IgE and eosinophil cationic protein (ECP) as severity markers for atopic keratoconjunctivitis (AKC).MethodsThirty 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.ResultsThe 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.ConclusionThis 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.