Microcolonization in or Near the Eye is Not Associated with the Degree of Inflammation in Patients with Atopic Keratoconjunctivitis

Abstract

Abstract: : Purpose: Patients with the atopic eczema/dermatitis syndrome have the tendency to develop the potential severe eye disease atopic keratoconjunctivitis (AKC). The importance of microorganisms has been pointed out for the atopic eczema/dermatitis syndrome but has not been investigated for AKC. Methods: 15 patients with AKC and 12 non-IgE-sensitized control individuals without eye disease were included in the study. The severity of the symptoms was compared with the presence of microorganisms on the eyelid, conjunctiva and cilia. The IgE-response to the yeast Malassezia sympodialis and against Staphylococcus aureus B antigen (SEB) was analyzed with the Pharmacia CAP System. The inflammatory response was analyzed with tear cytology by means of quantifying six different cytokines simultaneously with a micro particle based flow cytometric multiplex analysis. The inflammatory cells in tear fluid were analyzed by histochemistry. Results: S. aureus was isolated from 12 of the 15 patients, but not from the controls. Coagulase negative staphylococcus was isolated from 8 of the 15 AKC patients and from 10 of the 12 controls. M. sympodialis was isolated from 3 of the AKC-patients and from 2 of the controls. Two AKC patients showed increased levels of IgE against SEB, 11 patients showed increased IgE-levels against M. sympodialis. No relation was found between the severity of the disease and the presence of microorganisms. AKC-patients showed significantly higher levels of interferon-γ (IFN-γ), tumour nekrosfaktor-α (TNF-α), interleukin-2 (IL-2), IL-4, IL-5 and IL-10 compared to the controls. A correlation was found between the numbers of eosinophils and tear levels of IL-5 (Rs 0.91; p<0.001). An association was found between the severity of the disease and the levels of IFN-γ, TNF-α, and IL-10 in the tears (Rs>0,61; p<0.05). Conclusions: We could not find any evidence for that microcolonization in and near the eye had any relation with the inflammatory response in patients with AKC.

Keywords: cytokines/chemokines • inflammation • microbial pathogenesis: clinical studies