Journal
CURRENT OPINION IN ALLERGY AND CLINICAL IMMUNOLOGY
Volume 7, Issue 5, Pages 429-435Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ACI.0b013e3282ef8674
Keywords
allergic conjunctivitis; immunopathogenesis; T helper type 2 cytokines
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Purpose of review The immunopathogenesis of ocular allergic disorders is generally related to the specific immunoglobulin E-mediated mast cell activation and the following cascade of inflammatory mediators. Seasonal and perennial allergic conjunctivitis, however, are the only ocular diseases to involve solely type I hypersensitivity. The other main forms, vernal and atopic keratoconjunctivitis, have a more complex immunological basis and a chronic inflammatory component. Involvement of inflammatory cells, particularly eosinophils and T cells, cytokines and proteases can lead to more serious corneal damage with vision-threatening potential. Recent findings Experimental allergic conjunctival models and clinical research studies have shown that T helper type 2-related mechanisms are definitely involved in the sensitization phase of ocular allergy, however, both T helper type 1 and type 2 cytokines are overexpressed in the active disease, contributing to the development of ocular inflammation. Summary A review of the recent literature allows us to better understand the mechanisms involved in the development of ocular allergy and to guide us toward a more schematic approach, which could possibly be useful in forming a new classification, standardizing clinical phases and individuating new treatment targets.
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