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An essential role for dendritic cells in vernal keratoconjunctivitis: analysis by laser scanning confocal microscopy
1Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China.
Insights
Dendritic cells (DCs) are elevated in vernal keratoconjunctivitis (VKC) patients. Treatment reduced DC density, suggesting DCs are a therapeutic target for VKC.
Area of Science:
- Ophthalmology
- Immunology
- Cell Biology
Background:
- Vernal keratoconjunctivitis (VKC) pathogenesis involves CD4+ T helper type 2 cells and antigen-presenting cells.
- Dendritic cells (DCs) are crucial antigen-presenting cells implicated in VKC.
- This study investigates the density, distribution, and morphology of DCs in VKC patients using in vivo confocal microscopy.
Purpose of the Study:
- To survey the density, distribution, and morphology of dendritic cells (DCs) in patients with vernal keratoconjunctivitis (VKC).
- To evaluate the dynamic changes in DCs following treatment for VKC.
Main Methods:
- In vivo confocal microscopy was used to examine 35 VKC patients and 35 age-matched controls.
- DC density, morphology, and distribution were assessed before and at 1, 3, and 6 months after treatment with fluorometholone and cyclosporine A eye drops.
- Age differences between VKC and control groups were statistically significant.
Main Results:
- VKC patients exhibited significantly higher DC densities in the bulbar conjunctiva, limbus, and peripheral cornea compared to controls.
- Treatment led to a significant decrease in DC density at the conjunctiva by 3 months.
- DC densities at the limbus and peripheral cornea also decreased significantly post-treatment but remained higher than controls.
Conclusions:
- In vivo confocal microscopy is effective for monitoring dynamic changes of DCs in VKC.
- Dendritic cells play a critical role in VKC.
- DCs represent a potential therapeutic target for managing VKC.
Background:
CD4+ T helper type 2 cells play a central role in the pathogenesis of vernal keratoconjunctivitis (VKC), and antigen-presenting cells are required for the cell activation. In this study, we aimed to survey the density, distribution, and morphology of dendritic cells (DCs) in patients with VKC by in vivo confocal microscopy.
Methods:
Thirty-five patients (mean, 12.4 ± 5.3 years) affected by VKC were included. All patients were treated with 0.1% fluorometholone eye drops and 0.5% cyclosporine A eye drops. The density and morphological and distributional characteristics of DCs in each right eye were evaluated by in vivo confocal microscopy before treatment and at 1, 3, and 6 months after treatment. Thirty-five age-matched normal subjects (mean, 16.5 ± 1.8 years) were studied as controls.
Results:
There was significant difference in age between the VKC group and the control group (F = 18.17, P < 0.05). Compared with normal eyes, increased numbers of DCs were found in patients with VKC, with mean cell densities of 244.09 ± 59.76 cells/mm(2) at the bulbar conjunctiva, 574.53 ± 87.34 cells/mm(2) at the limbus, and 403.32 ± 106.59 cells/mm(2) at the peripheral cornea before treatment. These DCs exhibited a typical dendritic shape. At 3 months after treatment, the DC density at the conjunctiva decreased significantly (P < 0.05), approximating that in the controls. At 3 and 6 months, the DC densities at the limbus and peripheral cornea also decreased significantly (P < 0.05), but were still statistically higher than those in the controls. These DCs, with small dendritic processes or irregular shapes, were observed to gradually locate at the epithelial basal membrane and subbasal nerve plexus.
Conclusions:
In vivo confocal microscopy appears to be a valuable tool in evaluating the dynamic change of DCs at the conjunctiva and cornea. DCs play an essential role in VKC and therefore may constitute a target for therapeutic intervention for VKC.
