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MT Irkec, B Bozkurt, H Kerimoglu, M Orhan, D Us; Tear Cytokines in Patients with Vernal Keratoconjunctivitis (VKC) Responding Clinically to Topical Olopatadine or Additional Rimexolone . Invest. Ophthalmol. Vis. Sci. 2002;43(13):106.
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Purpose: An increase in the expression of various cytokines has been shown in the conjunctiva in the limbal form of VKC. Olopatadine is a mast cell stabilizer/antihistaminic that can inhibit histamine-stimulated cytokine production by the epithelial cells and release of some chemokines,like eotaxin in ocular allergy.In this study,tear cytokine concentrations in VKC patients who responded clinically to topical olopatadine were compared with those of the unresponsive group,where additional corticosteroid treatment was necessary. Methods: 24 patients (15 males and 9 females, aged 7-21 years)with limbal form of VKC were treated with topical olopatadine 0.1%b.i.d. for two weeks. 12 patients,unresponsive clinically to olopatadine, were treated for another two weeks with additional topical rimexolone 1% t.i.d. Tear samples from the two groups were assayed for IL-4, TNF-alpha,MCP-1 and MIP-1alpha by a competetive enzyme immuneassay (Accucyte) and for eotaxin by home-made ELISA technique. Results: Tear MCP-1 was significantly high (p=0.015) in VKC patients unresponsive to olopatadine. Tear IL-4, TNF-alpha and MIP-1alpha were also elevated,though insignificantly (p=0.184, 0.075 and 0.862,respectively). Treatment with additional rimexolone decreased tear IL-4 significantly (p=0.046)and TNF-alpha (p=0.849) and MCP-1 (p=0.117) insignificantly. Conclusion: VKC patients clinically unresponsive to topical olopatadine had higher concentration of cytokines,especially MCP-1 in tears, and might benefit from additional mild topical corticosteroids.
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