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Life (Basel, Switzerland) Mar 2024Allergic conjunctivitis is one of the common immune hypersensitivity disorders that affect the ocular system. The clinical manifestations of this condition exhibit... (Review)
Review
Allergic conjunctivitis is one of the common immune hypersensitivity disorders that affect the ocular system. The clinical manifestations of this condition exhibit variability contingent upon environmental factors, seasonal dynamics, and genetic predisposition. While our comprehension of the pathophysiological engagement of immune and nonimmune cells in the conjunctiva has progressed, the same cannot be asserted for the cytokines mediating this inflammatory cascade. In this review, we proffer a comprehensive description of interleukins 4 (IL-4), IL-5, IL-6, IL-9, IL-13, IL-25, IL-31, and IL-33, as well as thymic stromal lymphopoietin (TSLP), elucidating their pathophysiological roles in mediating the allergic immune responses on the ocular surface. Delving into the nuanced functions of these cytokines holds promise for the exploration of innovative therapeutic modalities aimed at managing allergic conjunctivitis.
PubMed: 38541674
DOI: 10.3390/life14030350 -
The Journal of Allergy and Clinical... Jun 2024Allergen immunotherapy (AIT) is a recognized key therapeutic modality for the treatment of allergic respiratory disease. Definitive studies have provided evidence-based... (Review)
Review
Allergen Immunotherapy: The Evidence Supporting the Efficacy and Safety of Subcutaneous Immunotherapy and Sublingual Forms of Immunotherapy for Allergic Rhinitis/Conjunctivitis and Asthma.
Allergen immunotherapy (AIT) is a recognized key therapeutic modality for the treatment of allergic respiratory disease. Definitive studies have provided evidence-based data to demonstrate its effectiveness in allergic rhinitis and asthma due to the inhalation of proteinaceous allergic substances from specific seasonal pollens, dust mites, animal allergens, and certain mold spores. Over the ensuing decades, laboratory investigations have provided objective evidence to demonstrate immunologic changes, including production of protective IgG antibody, suppression of IgE antibody, upregulation of regulatory T cells, and induction of a state of immune tolerance to the offending allergen(s). Tangential to this work were carefully designed clinical studies that defined allergen dose and duration of treatment, established the importance of preparing extracts with standardized allergens (or well-defined extracts) based on major protein moieties, and used allergen provocation models to demonstrate efficacy superior to placebo. In the United States, the use of subcutaneous immunotherapy extracts for AIT was grandfathered in by the Food and Drug Administration based on expert literature review. In contrast, sublingual tablet immunotherapy underwent formal clinical development programs (phase I-III clinical trials) that provided the necessary clinical evidence for safety and efficacy that led to regulatory agency approvals for the treatment of allergic rhinitis in properly characterized patients with allergy. The allergy specialist's treatment options currently include traditional subcutaneous AIT and specific sublingual tablets approved for grass, ragweed, house dust mites, trees belonging to the birch-homologous group, and Japanese cedar. Tangential to this are sublingual drops that are increasingly being used off-label (albeit not approved by the Food and Drug Administration) in the United States. This article will review the evidence-based literature supporting the use of these forms of AIT, as well as focus on several current controversies and gaps in our knowledge base that have relevance for the appropriate selection of patients for treatment with specific AIT.
Topics: Humans; Desensitization, Immunologic; Rhinitis, Allergic; Injections, Subcutaneous; Animals; Asthma; Allergens; Conjunctivitis, Allergic; Sublingual Immunotherapy; Administration, Sublingual
PubMed: 38685477
DOI: 10.1016/j.jaip.2024.04.034 -
Biomolecules Sep 2023The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic...
The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic conjunctivitis (AC), and non-allergic controls to examine if the allergy type causes differences in immune cell activation. The prospective study included 60 participants: 20 with VKC, 20 with AC, and 20 non-allergic controls. In vivo confocal microscopy was performed on the right eye. The locations scanned included the corneal centre, inferior whorl, corneal periphery, corneal limbus, and bulbar conjunctiva. The DCs were counted manually, and their morphology was assessed for the largest cell body size, the presence of dendrites, and the presence of long and thick dendrites. The DC density was higher in VKC and AC compared to non-allergic group at all locations ( ≤ 0.01) except at the inferior whorl. The DC density in VKC participants was significantly higher than in AC at the limbus ( < 0.001) but not at other locations. Both the AC and the VKC group had larger DC bodies at the corneal periphery and limbus compared to the non-allergic group ( ≤ 0.03). The study found a higher proportion of participants with DCs exhibiting long dendrites at both the corneal periphery in AC ( = 0.01) and at the corneal centre, periphery, and limbus in VKC, compared to the non-allergic group ( ≤ 0.001). In conclusion, a higher DC density at the limbus may be a marker of more severe VKC. DCs with larger cell bodies and a greater proportion of participants with DCs displaying long dendrites can be potential markers to differentiate allergy from non-allergy, and more severe forms of allergy from milder forms.
Topics: Humans; Conjunctivitis, Allergic; Prospective Studies; Conjunctiva; Cornea; Dendritic Cells
PubMed: 37892151
DOI: 10.3390/biom13101469 -
The Science of the Total Environment Dec 2023Exposure to air pollutants may cause immune responses and further allergic diseases, but existing studies have mostly, if not all, focused on effects of short-term...
BACKGROUND
Exposure to air pollutants may cause immune responses and further allergic diseases, but existing studies have mostly, if not all, focused on effects of short-term exposure to PM on allergic diseases.
OBJECTIVES
We estimated associations of long-term exposure to PM chemical constituents with allergic disease risks and effect modification.
METHODS
We used the baseline of a newly established, provincially representative cohort of 51,480 participants in southwest China. The presence of allergic rhinitis, allergic asthma, urticaria, and allergic conjunctivitis was self-reported by following a formed questionnaire in face-to-face interviews. The average concentrations of PM chemical constituents (NO, SO, NH, organic matter [OM], and black carbon [BC]) over participants' residence were estimated using machine learning models. Logistic regression with double robust estimator and weighted quantile sum regression were used to estimate the effects of PM chemical constituents on allergic disease risks, as well as relative importance of each PM chemical constituent.
RESULTS
Per interquartile range increase in the concentration of all PM chemical constituents was associated with the elevated risks for allergic asthma (OR = 1.79 [1.41-2.26]), allergic conjunctivitis (1.54 [1.19-2.00]), urticaria (1.36 [1.25-1.48]), and allergic rhinitis (1.18 [1.11-1.26]). NO contributed more to risks for allergic asthma (weight = 46.05 %), urticaria (72.29 %), and allergic conjunctivitis (47.65 %), while NH contributed more to allergic rhinitis (78.07 %). OM contributed most to the risks for allergic asthma (30.81 %) and allergic conjunctivitis (31.40 %). BC was also associated with allergic rhinitis, urticaria, and allergic conjunctivitis, only with a considerable weight for urticaria (24.59 %). Joint effects of PM chemical constituents on risks for allergic rhinitis and urticaria were stronger in minorities and farmers than their counterparts.
CONCLUSION
Long-term exposure to PM chemical constituents was associated with the increased allergic disease risks, with NO and NH accounting for the largest variance of the associations. Our findings would serve as scientific evidence for developing more explicit strategies of air pollution control.
Topics: Humans; Air Pollution; Particulate Matter; Cohort Studies; Conjunctivitis, Allergic; Air Pollutants; Asthma; Rhinitis, Allergic; Urticaria; China; Environmental Exposure
PubMed: 37659545
DOI: 10.1016/j.scitotenv.2023.166755 -
Frontiers in Allergy 2024Combined exposures to allergens and air pollutants emerged as a topic of concern in scientific circles by the 1980's, when it became clear that parallel increases in... (Review)
Review
Combined exposures to allergens and air pollutants emerged as a topic of concern in scientific circles by the 1980's, when it became clear that parallel increases in respiratory allergies and traffic-related air pollution had been occurring during the 20th century. Although historically there has been a tendency to treat exposure-related symptoms as allergic or toxicologic in nature, cross-interactions have since been established between the two modalities. For example, exposure to selected air pollutants in concert with a given allergen can increase the likelihood that an individual will become sensitized to that allergen, strongly suggesting that the pollutant acted as an . Although not a review of underlying mechanisms, the purpose of this mini-review is to highlight the potential significance of co-exposure to adjuvant chemicals in predicting allergic sensitization in the respiratory tract. The current discussion emphasizes the upper airway as a model for respiratory challenge studies, the results of which may be applicable-not only to allergic rhinitis-but also to conjunctivitis and asthma.
PubMed: 38533354
DOI: 10.3389/falgy.2024.1374771 -
Ocular Immunology and Inflammation Nov 2023To evaluate the effect of anti-allergic therapy on quality of life (QoL) in children with allergic conjunctivitis (AC) and their parents.
PURPOSE
To evaluate the effect of anti-allergic therapy on quality of life (QoL) in children with allergic conjunctivitis (AC) and their parents.
METHODS
Prospective single-arm intervention study including 55 AC child-parent pairs. The endpoint was that AC was successfully controlled after anti-allergic therapies. The primary outcome was the change in QoL of children from baseline to endpoint as measured by the total Pediatric Quality of Life Inventory (PesdQL) score.
RESULTS
The total PedsQL scores of children and parents were improved after treatment ( < .001). QoL improved greater in children with vernal keratoconjunctivitis/atopic keratoconjunctivitis, those without other allergy outside the eye, and those with lower baseline total PedsQL score. Greater improvement of parents' QoL was associated with longer treating duration, greater improvement of children's QoL, lower baseline parents' total PedsQL score, and more severe baseline children's signs.
CONCLUSION
Both pediatric AC patients' and their parents 'reduced QoL were improved after anti-allergic therapy.
CLINICAL TRIAL REGISTRATION
Chinese Clinical Trial Registry Identifier: ChiCTR2000037866.
Topics: Child; Humans; Quality of Life; Conjunctivitis, Allergic; Anti-Allergic Agents; Prospective Studies; Parents; Surveys and Questionnaires
PubMed: 35914318
DOI: 10.1080/09273948.2022.2103830 -
Cureus Jan 2024Background This study aimed to examine the association of suspended particulate matter (SPM) with outpatient attendance for allergic conjunctivitis. Methodology The...
Background This study aimed to examine the association of suspended particulate matter (SPM) with outpatient attendance for allergic conjunctivitis. Methodology The information on air pollution, encompassing total hydrocarbons, non-methane hydrocarbons, methane, carbon monoxide, nitrogen oxide, nitric oxide, oxidants, and SPM alongside data concerning daily weather conditions such as temperature, wind speed, and humidity, was gathered. Subsequently, the weekly mean values for outpatient visits, air pollution, and weather parameters were computed. Results The number of outpatient visits for allergic conjunctivitis was significantly associated with SPM levels (r = 0.70, p = 0.0037), oxidant levels (r = 0.70, p = 0.0038), wind speed (r = 0.48, p = 0.0472), and humidity (r = 0.77, p = 0.0009) from January to March, as well as SPM levels (r = 0.53, p = 0.0309) and carbon monoxide (r = 0.56, p = 0.0230) from April to June. Multivariate analysis showed that SPM (odds ratio = 1.37, p = 0.0161) and wind velocity (odds ratio = 1.52, p = 0.0038) were significant predictors of the number of outpatient visits from January to December. Conclusions SPM levels were the only independent predictor of outpatient visits for allergic conjunctivitis, suggesting that SPM contributes to the pathophysiology of this condition.
PubMed: 38435920
DOI: 10.7759/cureus.53292 -
Canadian Journal of Ophthalmology.... Oct 2023To evaluate the accuracy of the initial diagnosis in the case of fungal infections of the orbit and identify factors that may influence patient outcomes.
OBJECTIVE
To evaluate the accuracy of the initial diagnosis in the case of fungal infections of the orbit and identify factors that may influence patient outcomes.
METHODS
An institutional review board-approved retrospective chart review was conducted across 2 large academic centres to identify cases of fungal infections involving the orbit from January 1, 1998, to November 15, 2019. Data collected included patient demographics, past medical history, examination findings, diagnosis, treatment, imaging, and outcomes.
RESULTS
Fifty cases of fungal infection involving the orbit were identified. Of these, 33 (66.0%) were initially misdiagnosed as nonfungal diagnoses. Sixteen patients (32.0%) received multiple initial diagnoses. The most common diagnoses on presentation were bacterial cellulitis (n = 12 of 50; 24.0%) and bacterial sinusitis (n = 12 of 50; 24.0%). These were followed by vascular and orbital inflammatory conditions (n = 9 of 50; 18.0%): 5 patients (10.0%) were clinically diagnosed with giant cell arteritis, 3 (6.0%) with nonspecific orbital inflammation, and 1 (2.0%) with optic neuritis. In this subset of patients, 77.8% (n = 7 of 9) were treated initially with systemic steroids. Additional initial diagnoses included neoplastic mass lesions, mucocele, dacryocystitis, cavernous sinus thrombosis, hemorrhage, tick-borne illness, allergic rhinitis, and allergic conjunctivitis. Misdiagnosis was significantly correlated with involvement of the masticator space on imaging (p = 0.04).
CONCLUSION
Fungal infections of the orbit are misdiagnosed in 2 of 3 cases. Nearly 15% of patients who are later diagnosed with fungal disease of the orbit were initially treated with systemic steroids. Misdiagnosis is more frequent when the masticator space is involved.
Topics: Humans; Orbit; Retrospective Studies; Mycoses; Orbital Diseases; Diagnostic Errors
PubMed: 35525264
DOI: 10.1016/j.jcjo.2022.04.007 -
Pediatric Allergy and Immunology :... May 2024Inflammatory bowel disease (IBD) and allergic diseases possess similar genetic backgrounds and pathogenesis. Observational studies have shown a correlation, but the...
BACKGROUND
Inflammatory bowel disease (IBD) and allergic diseases possess similar genetic backgrounds and pathogenesis. Observational studies have shown a correlation, but the exact direction of cause and effect remains unclear. The aim of this Mendelian randomization (MR) study is to assess bidirectional causality between inflammatory bowel disease and allergic diseases.
METHOD
We comprehensively analyzed the causal relationship between inflammatory bowel disease (IBD), Crohn's disease (CD), ulcerative colitis (UC) and allergic disease (asthma, Hay fever, and eczema) as a whole, allergic conjunctivitis (AC), atopic dermatitis (AD), allergic asthma (AAS), and allergic rhinitis (AR) by performing a bidirectional Mendelian randomization study using summary-level data from genome-wide association studies. The analysis results mainly came from the random-effects model of inverse variance weighted (IVW-RE). In addition, multivariate Mendelian randomization (MVMR) analysis was conducted to adjust the effect of body mass index (BMI) on the instrumental variables.
RESULTS
The IVW-RE method revealed that IBD genetically increased the risk of allergic disease as a whole (OR = 1.03, 95% CI = 1.01-1.04, fdr.p = .015), AC (OR = 1.04, 95% CI = 1.01-1.06, fdr.p = .011), and AD (OR = 1.06, 95% CI = 1.02-1.09, fdr.p = .004). Subgroup analysis further confirmed that CD increased the risk of allergic disease as a whole (OR = 1.02, 95% CI = 1.00-1.03, fdr.p = .031), AC (OR = 1.03, 95% CI = 1.01-1.05, fdr.p = .012), AD (OR = 1.06, 95% CI = 1.02-1.09, fdr.p = 2E-05), AAS (OR = 1.05, 95% CI = 1.02-1.08, fdr.p = .002) and AR (OR = 1.03, 95% CI = 1.00-1.07, fdr.p = .025), UC increased the risk of AAS (OR = 1.02, 95% CI = 0.98-1.07, fdr.p = .038). MVMR results showed that after taking BMI as secondary exposure, the causal effects of IBD on AC, IBD on AD, CD on allergic disease as a whole, CD on AC, CD on AD, CD on AAS, and CD on AR were still statistically significant. No significant association was observed in the reverse MR analysis.
CONCLUSION
This Mendelian randomized study demonstrated that IBD is a risk factor for allergic diseases, which is largely attributed to its subtype CD increasing the risk of AC, AD, ASS, and AR. Further investigations are needed to explore the causal relationship between allergic diseases and IBD.
Topics: Humans; Mendelian Randomization Analysis; Inflammatory Bowel Diseases; Genome-Wide Association Study; Genetic Predisposition to Disease; Hypersensitivity; Polymorphism, Single Nucleotide; Asthma; Crohn Disease; Dermatitis, Atopic; Colitis, Ulcerative; Risk Factors; Body Mass Index
PubMed: 38773751
DOI: 10.1111/pai.14147 -
Cutaneous and Ocular Toxicology Jun 2024To study the ocular effects seen among eye cosmetic wearers in the Indian Population.
OBJECTIVE
To study the ocular effects seen among eye cosmetic wearers in the Indian Population.
METHODS
This cross-sectional study was conducted on female participants who had fulfilled the inclusion and exclusion criteria. A detailed history was obtained and thorough ophthalmic evaluation was done. Mann Whitney test was used. Statistical analysis was done using IBM SPSS. < .05 was taken as the level of statistical significance.
RESULTS
Among a total of 225 participants in our study, the mean age was 24.23 ± 1.8, which comprised of young student females. Majority of the females used one eye cosmetic with Kajal ( = 156) being the most predominant. Most frequently encountered symptom upon using eye cosmetics was watering from eyes and ocular pain was the least encountered symptom. Anterior segment examination showed- allergic conjunctivitis and meibomian gland dysfunction being the most and least predominant, respectively. Our study highlights that Kajal predisposes the eyes to significant ocular morbidity with = .039 for dry eye disease, = .041 for allergic conjunctivitis, = .036 for conjunctival pigmentation. Prolonged use of such formulations for more than 4 times a week ( = .046) or even daily ( = .031) for a duration of either 1-5 years ( = .033) or greater than 5 years ( = .027) was found to be statistically significant in causing ocular signs. Non removal of eye cosmetics at the end of the day was significant in causing allergic conjunctivitis ( = .035) and conjunctival pigmentation ( = .021). Plain tap water has been found to be the least effective technique in the removal of such ocular cosmetics with a statistical significance of = .031 in causing ocular signs.
CONCLUSIONS
Eye cosmetics are a significant contributor to the development of ocular surface diseases. Removal of products along with decreased usage seems to be a significant contributor in dampening unwanted adverse effects.
PubMed: 38806172
DOI: 10.1080/15569527.2024.2360735