leukotriene-b4 and Corneal-Ulcer

Contact lens induced acute red eye (CLARE) and contact lens induced peripheral ulcer (CLPU) are among the most common contact lens induced inflammatory reactions. Both CLARE and CLPU are characterized by corneal infiltration which indicates the presence of chemoattractants and other inflammatory mediators. The aim of this study was to characterize the cytokine and chemotactic lipid inflammatory mediator profile in the tears of people experiencing CLARE or CLPU. Cytokines IL-1 beta, IL-6, IL-8, GM-CSF and LTB4 in tears were measured by antibody sandwich and competition inhibition enzyme-linked immunosorbent assays (ELISA). Platelet activating factor-like activity was measured by a degranulation assay by measuring the release of labelled serotonin from platelets. The functional role GM-CSF and chemoattractants were determined by flow cytometry and chemotaxis. Increased levels of cytokines and chemoattractants were detected in both CLARE and CLPU tears. CLPU tears showed increased levels of LTB4 (P = 0.002) and PAF-like activity (P = 0.047) whereas CLARE tears showed increased levels of GM-CSF (P = 0.002). IL-8 (P < 0.05). LTB4 (P = 0.002) and PAF-like activity (P = 0.047) compared to control tears. Flow cytometric analysis revealed that incubation of PMN with CLARE tears increased the number of IgA receptors indicating that the GM-CSF in CLARE tears was active. Combinations of suboptimal concentrations (which were found in CLARE and CLPU tears) of IL-8 with either LTB4 or PAF significantly (P < 0.0001) enhanced the chemotactic activity for PMN compared to their individual effects. Our data highlight the possible pathophysiological roles of these inflammatory mediators in leukocyte recruitment and activation during ocular inflammatory responses. The results suggests that GM-CSF, IL-8 and LTB4 are active during corneal pathology and LTB4 or IL-8 may maintain the contact lens induced PMN response in vivo.

Topics: Acute Disease; Analysis of Variance; Cells, Cultured; Contact Lenses; Corneal Ulcer; Cytokines; Dose-Response Relationship, Drug; Flow Cytometry; Granulocyte-Macrophage Colony-Stimulating Factor; Humans; Inflammation Mediators; Interleukin-8; Keratitis; Leukotriene B4; Lipids; Neutrophil Activation; Neutrophils; Platelet Activating Factor; Receptors, Fc; Tears

The role of metabolites of arachidonic acid in experimental Pseudomonas keratitis was studied using inhibitors of arachidonic acid metabolism. Nordihydroguaiaretic acid 1%, which inhibits predominantly the lipoxygenase pathway, and flurbiprofen 0.03%, which inhibits predominantly the cyclo-oxygenase pathway were administered topically to rabbit eyes after intrastromal injection of Pseudomonas aeruginosa. Levels of the cyclo-oxygenase product prostaglandin E2 (PGE2) and the lipoxygenase product leukotriene B4 (LTB4) were measured, and the number of ulcers that had progressed to descemetocele formation by 24 hours was determined. Corneal ulceration was accelerated by flurbiprofen, but nordihydroguaiaretic acid limited the flurbiprofen-induced worsening. The use of flurbiprofen was associated with decreased levels of PGE2 and a relative increase in LTB4, a potent chemoattractant and activator of polymorphonuclear leukocytes. These results suggest that inhibition of the cyclo-oxygenase pathway may be contraindicated in Pseudomonas keratitis; inhibition of lipoxygenase can prevent this worsening of the keratitis.

Topics: Administration, Topical; Animals; Corneal Ulcer; Dinoprostone; Disease Models, Animal; Eye Infections, Bacterial; Flurbiprofen; Leukotriene B4; Masoprocol; Pseudomonas Infections; Rabbits