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Tajbakhsh Z, Jalbert I, Stapleton F, Alghamdi A, Gray PE, Briggs N, Altavilla B, Mobeen R, Golebiowski B. Dendritiform immune cells with reduced antigen-capture capacity persist in the cornea during the asymptomatic phase of allergic conjunctivitis. Eye (Lond) 2023; 37:2768-2775. [PMID: 36747108 PMCID: PMC10482935 DOI: 10.1038/s41433-023-02413-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/13/2022] [Accepted: 01/20/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Increased density and altered morphology of dendritic cells (DC) in the cornea and conjunctiva occur during active allergic conjunctivitis. This study investigated whether inflammation (characterised by altered DC density and morphology) persists during the symptom-free phase of allergic conjunctivitis. METHODS Twenty participants (age 43.3 ± 14.3 years, 55% female) assessed during their active (symptomatic) phase of allergic conjunctivitis were re-examined during the asymptomatic phase. Ocular allergy symptoms and signs were evaluated during both phases, and five ocular surface locations (corneal centre, inferior whorl, corneal periphery, corneal limbus, and bulbar conjunctiva) were examined using in vivo confocal microscopy (HRT III). DC were counted manually, and their morphology was assessed for cell body size, presence of dendrites, presence of long dendrites and presence of thick dendrites using a grading system. Mixed model analysis (DC density) and non-parametric tests (DC morphology) were used to examine differences between phases. RESULTS DC density at corneal locations did not change between the active and asymptomatic phases (p ≥ 0.22). However, corneal DC body size was smaller and fewer DC presented with long dendrites during the asymptomatic phase (p ≤ 0.02). In contrast, at the bulbar conjunctiva, DC density was reduced during the asymptomatic phase compared to the active phase (p = 0.01), but there were no changes in DC morphology. CONCLUSIONS Dendritiform immune cell numbers persist in the cornea during the symptom-free phase of allergic conjunctivitis, whereas conjunctival DC appear to return to a baseline state. The morphology of these persisting corneal DC suggests their antigen-capture capacity is reduced during the asymptomatic phase.
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Affiliation(s)
- Zahra Tajbakhsh
- School of Optometry and Vision Science, UNSW, Sydney, Australia.
| | | | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, Australia
| | - Ali Alghamdi
- School of Optometry and Vision Science, UNSW, Sydney, Australia
| | - Paul E Gray
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, Australia
| | - Nancy Briggs
- Stats Central, Mark Wainwright Analytical Centre, UNSW, Sydney, Australia
| | - Betina Altavilla
- Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, Australia
| | - Rabia Mobeen
- School of Optometry and Vision Science, UNSW, Sydney, Australia
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Bong SK, Park NJ, Lee SH, Lee JW, Kim AT, Liu X, Kim SM, Yang MH, Kim YK, Kim SN. Trifuhalol A Suppresses Allergic Inflammation through Dual Inhibition of TAK1 and MK2 Mediated by IgE and IL-33. Int J Mol Sci 2022; 23:ijms231710163. [PMID: 36077570 PMCID: PMC9456157 DOI: 10.3390/ijms231710163] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
The activation and degranulation of immune cells play a pivotal role in allergic inflammation, a pathological condition that includes anaphylaxis, pruritus, and allergic march-related diseases. In this study, trifuhalol A, a phlorotannin isolated from Agarum cribrosum, inhibited the degranulation of immune cells and the biosynthesis of IL-33 and IgE in differentiated B cells and keratinocytes, respectively. Additionally, trifuhalol A suppressed the IL-33 and IgE-mediated activation of RBL-2H3 cells through the regulation of the TAK1 and MK2 pathways. Hence, the effect of trifuhalol A on allergic inflammation was evaluated using a Compound 48/80-induced systemic anaphylaxis mouse model and a house dust mite (HDM)-induced atopic dermatitis (AD) mouse model. Trifuhalol A alleviated anaphylactic death and pruritus, which appeared as an early-phase reaction to allergic inflammation in the Compound 48/80-induced systemic anaphylaxis model. In addition, trifuhalol A improved symptoms such as itching, edema, erythema, and hyperkeratinization in HDM-induced AD mice as a late-phase reaction. Moreover, the expression of IL-33 and thymic stromal lymphopoietin, inflammatory cytokines secreted from activated keratinocytes, was significantly reduced by trifuhalol A administration, resulting in the reduced infiltration of immune cells into the skin and a reduction in the blood levels of IgE and IL-4. In summarizing the above results, these results confirm that trifuhalol A is a potential therapeutic candidate for the regulation of allergic inflammation.
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Affiliation(s)
- Sim-Kyu Bong
- Natural Products Research Institute, Korea Institute of Sceience and Technology (KIST), Gangneung 25451, Korea
| | - No-June Park
- Natural Products Research Institute, Korea Institute of Sceience and Technology (KIST), Gangneung 25451, Korea
- Division of Bio-Medical Science and Technology, KIST School, University of Science and Technology, Seoul 02792, Korea
| | - Sang Heon Lee
- Natural Products Research Institute, Korea Institute of Sceience and Technology (KIST), Gangneung 25451, Korea
| | - Jin Woo Lee
- Natural Products Research Institute, Korea Institute of Sceience and Technology (KIST), Gangneung 25451, Korea
| | - Aaron Taehwan Kim
- Department of Food Science, University of Massachusetts, Amherst, MA 01003, USA
| | - Xiaoyong Liu
- Haizhibao Deutschland GmbH, Heiliggeistgasse 28, 85354 Freising, Germany
| | - Sang Moo Kim
- Department of Marine Food Science and Technology, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung 25457, Korea
| | - Min Hye Yang
- College of Pharmacy, Pusan National University, Busan 46241, Korea
| | - Yong Kee Kim
- College of Pharmacy, Sookmyung Women's University, Seoul 04310, Korea
| | - Su-Nam Kim
- Natural Products Research Institute, Korea Institute of Sceience and Technology (KIST), Gangneung 25451, Korea
- Division of Bio-Medical Science and Technology, KIST School, University of Science and Technology, Seoul 02792, Korea
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Dattoli SD, Baiula M, De Marco R, Bedini A, Anselmi M, Gentilucci L, Spampinato S. DS-70, a novel and potent α 4 integrin antagonist, is an effective treatment for experimental allergic conjunctivitis in guinea pigs. Br J Pharmacol 2018; 175:3891-3910. [PMID: 30051467 DOI: 10.1111/bph.14458] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/12/2018] [Accepted: 07/13/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Allergic conjunctivitis is an eye inflammation that involves the infiltration of immune cells into the conjunctiva via cell surface-adhesion receptors, such as integrin α4 β1 . These receptors interact with adhesion molecules expressed on the conjunctival endothelium and may be a target to treat this disease. We synthesized DS-70, a novel α/β-peptidomimetic α4 integrin antagonist, to prevent the conjunctival infiltration of immune cells and clinical symptoms in a model of allergic conjunctivitis. EXPERIMENTAL APPROACH In vitro, DS-70 was pharmacologically characterized using a scintillation proximity procedure to measure its affinity for α4 β1 integrin, and its effect on cell adhesion mediated by different integrins was also evaluated. The effects of DS-70 on vascular cell adhesion molecule-1 (VCAM-1)-mediated degranulation of a human mast cell line and an eosinophilic cell line, which both express α4 β1 , and on VCAM-1-mediated phosphorylation of ERK 1/2 in Jurkat E6.1 cells were investigated. Effects of DS-70 administered in the conjunctival fornix of ovalbumin-sensitized guinea pigs were evaluated. KEY RESULTS DS-70 bound to integrin α4 β1 with nanomolar affinity, prevented the adhesion of α4 integrin-expressing cells, antagonized VCAM-1-mediated degranulation of mast cells and eosinophils and ERK 1/2 phosphorylation. Only 20% was degraded after an 8 h incubation with serum. DS-70 dose-dependently reduced the clinical symptoms of allergic conjunctivitis, conjunctival α4 integrin expression and conjunctival levels of chemokines and cytokines in ovalbumin-sensitized guinea pigs. CONCLUSIONS AND IMPLICATIONS These findings highlight the role of α4 integrin in allergic conjunctivitis and suggest that DS-70 is a potential treatment for this condition.
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Affiliation(s)
| | - Monica Baiula
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Rossella De Marco
- Department of Chemistry "G. Ciamician", University of Bologna, Bologna, Italy
| | - Andrea Bedini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Michele Anselmi
- Department of Chemistry "G. Ciamician", University of Bologna, Bologna, Italy
| | - Luca Gentilucci
- Department of Chemistry "G. Ciamician", University of Bologna, Bologna, Italy
| | - Santi Spampinato
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
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LOMAZI EA, BRANDALISE NA, SERVIDONI MDFPC, CARDOSO SR, MEIRELLES LR. MAST CELLS DISTINGUISH EOSINOPHILIC ESOPHAGITIS IN PEDIATRIC PATIENTS. ARQUIVOS DE GASTROENTEROLOGIA 2017; 54:192-196. [DOI: 10.1590/s0004-2803.201700000-23] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/01/2017] [Indexed: 01/07/2023]
Abstract
ABSTRACT BACKGROUND: Mast cells exert a substantial role in gastrointestinal allergic diseases. Therefore, it is reasonable to presume that mast cell may aid diagnosis in eosinophilic gastroenteropathy. OBJECTIVE: To evaluate whether mast cell count in the esophageal epithelium can discriminate eosinophilic esophagitis, proton-pump inhibitor (PPI)-responsive eosinophilic esophagitis and gastroesophageal reflux esophagitis. METHODS: Retrospectively we reviewed the files of 53 consecutive patients (age: 7.8 years; range: 8-14 years) with definitive diagnose established during clinical follow up in a universitary outpatient clinic as follow: eosinophilic esophagitis (N=23), PPI-responsive eosinophilic esophagitis (N=15) and gastroesophageal reflux esophagitis (N=15). Eosinophil count in the esophageal epithelium in slides stained with H-E was reviewed and immunohistochemistry for mast cell tryptase was performed. RESULTS: Count of eosinophils/high-power field (HPF) higher than 15 were found in 14 out of 15 reflux esophagitis patients. The mean count of eosinophils/HPF was similar in eosinophilic esophagitis patients and in those with PPI-responsive eosinophilic esophagitis (42 and 39 eosinophils/HPF, respectively, P=0.47). Values of mast cell tryptase (+) were higher in eosinophilic esophagitis [median: 25 mast cells/HPF; range (17-43) ] and in PPI-responsive eosinophilic esophagitis patients [25 (16-32) ], compared to reflux esophagitis [4 (2-14) ], P<0.001. There was no difference between the mean count of mast cells/HPF in the esophageal epithelium of eosinophilic esophagitis patients and PPI-responsive eosinophilic esophagitis patients, respectively, 26 and 24 mast cells/HPF, P=0.391. CONCLUSION: Tryptase staining of mast cells differentiates eosinophilic esophagitis from reflux esophagitis.
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Kamegasawa A, Chaoul MM, El Dib R. Oral antihistamines for seasonal allergic conjunctivitis. Hippokratia 2017. [DOI: 10.1002/14651858.cd011172.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Amélia Kamegasawa
- Botucatu Medical School, UNESP - Univ Estadual Paulista; Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Distrito de Rubião Júnior, s/n Botucatu São Paulo Brazil 18618-970
| | - Mauricio M Chaoul
- Botucatu Medical School, UNESP - Univ Estadual Paulista; Distrito de Rubião Júnior, s/n Botucatu Brazil
| | - Regina El Dib
- Institute of Science and Technology, Unesp - Univ Estadual Paulista; Department of Biosciences and Oral Diagnosis; Botucatu Brazil
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Almaliotis D, Michailopoulos P, Gioulekas D, Giouleka P, Papakosta D, Siempis T, Karampatakis V. Allergic conjunctivitis and the most common allergens in Northern Greece. World Allergy Organ J 2013; 6:12. [PMID: 23866689 PMCID: PMC3726364 DOI: 10.1186/1939-4551-6-12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/09/2013] [Indexed: 11/15/2022] Open
Abstract
Background Ocular allergies affect a great part of the general population and often co exist with other allergic manifestations. In the present study, the prevalence of allergic conjunctivitis and the commonest allergens in allergic patients at an outpatient unit in Thessaloniki, Greece were evaluated. Methods This is a retrospective study regarding allergic patients who referred to an outpatient clinic between the 1st of January of 1996 and the 31st of December 2010. They completed relative questionnaires concerning their allergic condition. The patients who were included in our study had allergic conjunctivitis confirmed by ophthalmologists and were divided into 4 groups. The criteria used were the existence of allergic conjunctivitis alone or with other allergic co- morbidities. The patients then underwent skin prick tests after consent according to current guidelines. Results The archives of 1239 allergic patients were evaluated and 497 patients (40,11%) who manifested eye allergic symptoms were included in our study. 448 patients (90.14%) had allergic conjunctivitis in conjunction with asthma or rhinitis or both. 370 patients underwent skin prick tests and 284 of them (124 males-160 females) were positive for at least 1 of the 8 tested allergens (76.75%). 166 were positive to a grass mix (58.45%), 130 to olea European (45.77%), 124 to dust mites mix (43.66%), 58 to cypress (20.42%), 71 to parietaria officinalis (25.00%), 67 to cat dander (23.59%), 35 to dog dander (12.32%) and 32 to Altenaria (11.26%). Conclusions Symptoms of ocular allergy are very common in patients with allergic rhinitis and asthma. Men had slightly higher percentages of positive skin prick tests, except for dog dander and Altenaria. Conjunctivitis should not be overlooked as an allergic entity when evaluating allergic patients.
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Affiliation(s)
- Diamantis Almaliotis
- Laboratory of Experimental Opthalmology, Medical School, Aristotle University of Thessaloniki, University Campus, Thessaloniki 54124, Greece.
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Abstract
Allergic conjunctivitis (AC) represents a spectrum of disorders, comprising seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC) and giant papillary conjunctivitis. Of these ocular allergy types, SAC and PAC are the most common.The most striking difference within this group of ocular diseases is that SAC and PAC remain self-limited without ocular surface damage, while AKC and VKC can compromise the cornea, causing ulcers and scarring and can ultimately lead to vision loss. Data on AC in the Asia Pacific is scarce however some understanding of prevalence of the condition has been obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) studies and more recently from the Allergies in Asia Pacific study as well as some information from individual country surveys. Unfortunately none of this data has been collected using validated survey instruments specifically designed for AC. Surveys such as ISAAC have been predominantly concerned with respiratory allergic symptoms with questions added that incorporate some ocular symptoms. These questionnaires do not detect individuals who may have AC in the absence of allergic rhinitis. Using hospital ophthalmology outpatient populations for prevalence studies of ocular allergy immediately introduces a bias towards the more severe, complex forms of the condition as patients with the milder forms of SAR and PAR will rarely present to a hospital outpatient clinic. There is a real need for the development of validated questionnaires specifically addressing ocular allergy. There are no widely accessible studies examining prevalence of the complex forms of ocular allergy (AKC, VKC) in Asia Pacific region. This review will provide an overview of ocular allergy, its classification, clinical presentation and differential diagnosis, and will also discuss what is known about the epidemiology of ocular allergy in the Asian Pacific region.
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Affiliation(s)
- Constance H. Katelaris
- University of Western Sydney and Campbelltown Hospital, Campbelltown 2560 NSW, Australia
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Flocea P, Verestiuc L, Popa M, Sunel V, Lungu A. Crosslinked Networks Based on Polysaccharides and Collagen for Pilocarpine Sustained Release. JOURNAL OF MACROMOLECULAR SCIENCE PART A-PURE AND APPLIED CHEMISTRY 2010. [DOI: 10.1080/10601321003742196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Ozaki A, Fukushima A, Ishida W, Zinchuk O, Fukata K, Hayashi Y, Enzan H, Takata M, Yagita H, Ueno H. Analysis of Ag-presenting cells in the conjunctiva during the development of experimental immune-mediated blepharoconjunctivitis. Curr Eye Res 2009; 29:277-86. [PMID: 15590473 DOI: 10.1080/02713680490516873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to investigate the phenotypes of antigen (Ag) presenting cells (APCs) in the conjunctiva during the development of experimental immune-mediated blepharoconjunctivitis (EC), which serves as a model for investigation of severe types of human allergic conjunctivitis. METHODS Brown Norway rats treated by ovalbumin (OVA) were used in this study. To confirm the restriction of MHC class II by OVA-specific T cells, monoclonal Abs against MHC class II were added to the conventional proliferation assay. To evaluate the MHC class II expression in the conjunctiva during the development of EC, an immunohistochemical analysis, either as the single or double staining, was performed. Conjunctival fibroblast cell lines were established from naive rats and the MHC class II expression was evaluated by flow cytometric analysis. To examine the roles of costimulatory molecules, OVA-specific T cells were stimulated with anti-TcR Ab and anti-CD28 Ab and then subjected for Western blotting to evaluate the ERK phosphorylation. Finally, in vivo expression of B7 molecules was examined immunohistochemically. RESULTS OVA-specific T cells recognized OVA in the context of MHC class II. MHC class II was expressed in conjunctival macrophages but not in fibroblasts. EC induction was accompanied by abundant infiltration of macrophages positive for MHC class II. MHC class II was also expressed in conjunctival epithelial cells by EC induction. Stimulation from CD28 was necessary for ERK phosphorylation. B7-2, but not B7-1, was expressed in the conjunctiva. CONCLUSION Conjunctival macrophages may represent a major source of APCs for the induction of EC in the conjunctiva.
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Affiliation(s)
- Akemi Ozaki
- Department of Ophthalmology, Kochi Medical School, Kohasu, Oko-cho, Nankoku City 783-8505, Japan
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Qasem AR, Bucolo C, Baiula M, Spartà A, Govoni P, Bedini A, Fascì D, Spampinato S. Contribution of alpha4beta1 integrin to the antiallergic effect of levocabastine. Biochem Pharmacol 2008; 76:751-62. [PMID: 18680729 DOI: 10.1016/j.bcp.2008.07.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2008] [Revised: 07/07/2008] [Accepted: 07/08/2008] [Indexed: 11/30/2022]
Abstract
Levocabastine is an antiallergic drug acting as a histamine H1-receptor antagonist. In allergic conjunctivitis (AC), it may also antagonize up-regulation of the intercellular adhesion molecule-1 (ICAM-1) expressed on epithelial conjunctival cells. However, little is known about its effects on eosinophils, important effector cells in AC. The adhesion molecule integrin alpha(4)beta(1) is expressed in eosinophils; it interacts with the vascular cell adhesion molecule-1 (VCAM-1) and fibronectin (FN) in vascular endothelial cells and contributes to eosinophil activation and infiltration in AC. This study provides evidence that in a scintillation proximity assay levocabastine (IC(50) 406 microM), but not the first-generation antihistamine chlorpheniramine, displaced (125)I-FN binding to human integrin alpha(4)beta(1) and, in flow cytometry analysis, levocabastine antagonized the binding of a primary antibody to integrin alpha(4) expressed on the Jurkat cell surface. Levocabastine, but not chlorpheniramine, binds the alpha(4)beta(1) integrin and prevents eosinophil adhesion to VCAM-1, FN or human umbilical vascular endothelial cells (HUVEC) in vitro. Similarly, levocabastine affects alpha(L)beta(2)/ICAM-1-mediated adhesion of Jurkat cells. In a model of AC levocabastine eye drops reduced the clinical aspects of the late-phase reaction and the conjunctival expression of alpha(4)beta(1) integrin by reducing infiltrated eosinophils. We propose that blockade of integrin-mediated cell adhesion might be a target of the antiallergic action of levocabastine and may play a role in preventing eosinophil adhesion and infiltration in AC.
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Affiliation(s)
- Ahmed R Qasem
- Department of Medicine, Health Science Campus, University of Toledo, OH, USA
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Intranasal corticosteroids and the eye: from negative ocular effects to clinical efficacy as a class effect. Ann Allergy Asthma Immunol 2008; 100:506-8. [PMID: 18517085 DOI: 10.1016/s1081-1206(10)60478-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Sumi T, Fukushima A, Fukuda K, Kumagai N, Nishida T, Yagita H, Ueno H. Differential contributions of B7-1 and B7-2 to the development of murine experimental allergic conjunctivitis. Immunol Lett 2006; 108:62-7. [PMID: 17109973 DOI: 10.1016/j.imlet.2006.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2006] [Revised: 09/29/2006] [Accepted: 10/10/2006] [Indexed: 10/23/2022]
Abstract
B7-1 and B7-2 are the co-stimulatory molecules that are involved in activation of T cells. We investigated whether B7-1 and B7-2 play a role in the development of T cell-mediated experimental allergic conjunctivitis (EC). EC was induced in Balb/c mice by active immunization with ragweed (RW) followed by RW challenge in eye drops. These mice were treated with neutralizing anti-B7-1 Ab, anti-B7-2 Ab, both Abs, anti-cytotoxic T lymphocyte-associated Ag-4 (CTLA-4) Ab or normal IgGs as controls either during the induction phase or the effector phase. With regard to the induction phase treatment, EC was significantly attenuated when both anti-B7-1 and anti-B7-2 Abs were injected. In contrast, anti-CTLA-4 Ab treatment significantly exacerbated EC. With regard to the effector phase treatment, anti-B7-2 Ab alone significantly attenuated EC, while anti-CTLA-4 Ab tended to exacerbate EC. Collectively, B7-1 and B7-2 differently contribute to the development of EC during the induction and effector phases.
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Affiliation(s)
- Tamaki Sumi
- Department of Ophthalmology, Kochi Medical School, Kohasu, Oko-cho, Nankoku-city 783-8505, Japan
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Williams PB, Sheppard JD. Omalizumab: a future innovation for treatment of severe ocular allergy? Expert Opin Biol Ther 2005; 5:1603-9. [PMID: 16318424 DOI: 10.1517/14712598.5.12.1603] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Conjunctival and corneal manifestations of atopic keratoconjunctivitis (AKC) are chronic, disabling and may be blinding. In common with other allergic diseases, such as asthma and atopic dermatitis, AKC is characterised by an allergen-induced immune response mediated through expression of IgE. The humanised monoclonal IgE antibody Xolair (omalizumab) complexes with free circulating IgE, thereby preventing binding of IgE to FcepsilonRI receptors on immune cells. Omalizumab effectively alleviates the signs and symptoms of asthma. Given the pivotal role of IgE in the allergic cascade, it is hypothesised that omalizumab has potential as an entirely new therapeutic approach to AKC.
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Affiliation(s)
- Patricia B Williams
- Thomas R. Lee Centre for Ocular Pharmacology, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23501, USA.
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Bielory L, Lien KW, Bigelsen S. Efficacy and tolerability of newer antihistamines in the treatment of allergic conjunctivitis. Drugs 2005; 65:215-28. [PMID: 15631542 DOI: 10.2165/00003495-200565020-00004] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Treatment for allergic conjunctivitis has markedly expanded in recent years, providing opportunities for more focused therapy, but often leaving both physicians and patients confused over the variety of options. As monotherapy, oral antihistamines are an excellent choice when attempting to control multiple early-phase, and some late-phase, allergic symptoms in the eyes, nose and pharynx. Unfortunately, despite their efficacy in relief of allergic symptoms, systemic antihistamines may result in unwanted adverse effects, such as drowsiness and dry mouth. Newer second-generation antihistamines (cetirizine, fexofenadine, loratadine and desloratadine) are preferred over older first-generation antihistamines in order to avoid the sedative and anticholinergic effects that are associated with first-generation agents. When the allergic symptom or complaint, such as ocular pruritus, is isolated, focused therapy with topical (ophthalmic) antihistamines is often efficacious and clearly superior to systemic antihistamines, either as monotherapy or in conjunction with an oral or intranasal agent. Topical antihistaminic agents not only provide faster and superior relief than systemic antihistamines, but they may also possess a longer duration of action than other classes including vasoconstrictors, pure mast cell stabilisers, NSAIDs and corticosteroids. Many antihistamines have anti-inflammatory properties as well. Some of this anti-inflammatory effect seen with 'pure' antihistamines (levocabastine and emedastine) may be directly attributed to the blocking of the histamine receptor that has been shown to downregulate intercellular adhesion molecule-1 expression and, in turn, limit chemotaxis of inflammatory cells. Some topical multiple-action histamine H(1)-receptor antagonists (olopatadine, ketotifen, azelastine and epinastine) have been shown to prevent activation of neutrophils, eosinophils and macrophages, or inhibit release of leukotrienes, platelet-activating factors and other inflammatory mediators. Topical vasoconstrictor agents provide rapid relief, especially for redness; however, the relief is often short-lived, and overuse of vasoconstrictors may lead to rebound hyperaemia and irritation. Another class of topical agents, mast cell stabilisers (sodium cromoglicate [cromolyn sodium], nedocromil and lodoxamide), may be considered; however, they generally have a much slower onset of action. The efficacy of mast cell stabilisers may be attributed to anti-inflammatory properties in addition to mast cell stabilisation. In the class of topical NSAIDs, ketorolac has been promoted for ocular itching but has been found to be inferior for relief of allergic conjunctivitis when compared with olopatadine and emedastine. Lastly, topical corticosteroids may be considered for severe seasonal ocular allergy symptoms, although long-term use should be avoided because of risks of ocular adverse effects, including glaucoma and cataract formation.
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Affiliation(s)
- Leonard Bielory
- Department of Medicine, Pediatrics and Ophthalmology, Division of Allergy, Immunology and Rheumatology, UMDNJ-New Jersey Medical School, Immuno-Ophthalmology Service, 90 Bergen Street, DOC Suite 4700, Newark, NJ 07103, USA.
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