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Immunopathological study of vernal keratoconjunctivitis.
A M Abu el-Asrar1, J J Van den Oord, K Geboes
1Department of Ophthalmology, Mansoura University Hospital, Egypt.
Summary
Vernal keratoconjunctivitis involves a complex immune response in the eye, with evidence of allergic reactions and both humoral and cell-mediated immunity. Local IgE production in conjunctival tissues appears limited.
Area of Science:
- Ophthalmology
- Immunology
- Allergy
Background:
- Vernal keratoconjunctivitis (VKC) is a bilateral, itching, seasonal eye surface inflammation.
- The immunopathogenesis of VKC is complex and not fully understood.
Purpose of the Study:
- To investigate the in situ immune reactions in conjunctival tissues of patients with VKC.
- To elucidate the roles of different immune cells and antibody responses in VKC.
Main Methods:
- Immunohistochemical techniques were employed.
- A panel of monoclonal and polyclonal antibodies was used to identify immune cells and immunoglobulins.
- Analysis focused on conjunctival tissues, including epithelial and stromal infiltrates, and accessory lacrimal glands.
Main Results:
- Evidence of anaphylactic response with eosinophils and mast cells showing IgE staining.
- Humoral immunity indicated by B-lymphoid follicles, B-lymphocytes, and plasma cells (IgA+, IgG+, IgM+).
- Cell-mediated immunity suggested by T-lymphocytes and dendritic cells; some dendritic cells expressed IgE.
Conclusions:
- VKC exhibits a complex immunopathogenesis involving allergic, humoral, and cell-mediated immune responses.
- IgE is likely not produced locally in conjunctival tissues, despite its presence on some dendritic cells.
- IgA and IgG play significant roles in the humoral response within the conjunctival stroma.