The Effect of Ketotifen on Inflammatory Markers in Allergic Conjunctivitis: An Open, Uncontrolled Study

Abstract

Abstract: : Purpose: The efficacy and safety of ketotifen eye drop treatment in AC management is perfectly known by several studies, but the mechanism of action at the biochemical levels is poorly understood so we decided to perform an open, uncontrolled study in order to investigate the effect of the topical administration of ketotifen fumarate 0,05% on biochemical markers of inflammation on conjunctival cells in patients with AC. Methods: Nineteen patients with symptoms and signs of AC (itching, discharge, burning, redness, increase in the watery discharge, swelling and presence of follicles) and with a history of allergy were prescribed with three daily instillation of one drop of eyewash ketotifen fumarate 0,05% in both eyes, during thirty days and they were studied by measuring clinical and immunologic parameters. Results: Ketotifen fumarate treatment had a significantly clinical reduction of the total symptoms and signs score (p<0.0001) for each patient after thirty days. Moreover, each symptom was significantly reduced at any time of clinical evaluation (p<0.0001). Although the percentage of HLA-DR+ epithelial cells diminished only in 58% of patients, the numbers of CD29+ and eotaxin+ epithelial cells dropped significantly in 68% and 73% of them (p<0.02) as a consequence of the treatment. In 9 out of 19 patients a simultaneous decrease in the percentage of epithelial cells positive for CD29 and eotaxin was observed. Conclusion: Ketotifen besides the well known effect in reducing signs and symptoms of AC significantly diminished production of eotaxin and expression of CD29 by epithelial cells in patients with seasonal AC.

Keywords: conjunctivitis • immunomodulation/immunoregulation • flow cytometry