leukotriene-c4 and Conjunctivitis--Allergic

We compared tear leukotriene B4 (LTB4) and leukotriene C4 (LTC4) levels of vernal keratoconjunctivitis (VKC) patients with those of age-matched controls and evaluated the effects of disodium cromoglycate (DCG) 2%, lodoxamide 0.1% and fluorometholone 0.1% on the tear LTB4 and LTC4 levels of the VKC patients.. Thirty VKC patients were divided into three groups and their tear LTB4 and LTC4 levels measured with an enzyme-linked immunoassay technique before and after treatment with either lodoxamide 0.1%, DCG 2% or fluorometholone 0.1%. The results were compared with the tear LTB4 and LTC4 levels of 10 healthy control subjects. During this trial period, clinical scores for signs and symptoms of VKC were also evaluated.. In the VKC patients median tear LTB4 and LTC4 levels were 349.0 pg/ml (range 213.3-707.7 pg/ml) and 225.2 pg/ml (range 196.1-241.1 pg/ml) respectively--significantly higher than the control group (p = 0.0065 for LTB4 and p = 0.0003 for LTC4). After treatment, LTB4 levels decreased significantly in all treatment groups when compared with baseline (for the lodoxamide group, p = 0.01; for the DCG group, p = 0.008; for the fluorometholone group, p = 0.045). LTC4 levels were also significantly reduced after treatment in all three treatment groups (for the lodoxamide group, p = 0.0209; for the DCG group, p = 0.0284; for the fluorometholone group, p = 0.0109).. Tear LTB4 and LTC4 levels are significantly higher in VKC patients than controls, which points to a possible role of lipoxygenase pathway products in the pathophysiology of ocular allergic disorders. Lodoxamide 0.1%, DCG 2% and fluorometholone 0.1% were all effective in reducing LTB4 and LTC4 levels in VKC.

Topics: Adolescent; Adult; Anti-Allergic Agents; Anti-Inflammatory Agents; Conjunctivitis, Allergic; Cromolyn Sodium; Double-Blind Method; Female; Fluorometholone; Glucocorticoids; Humans; Leukotriene B4; Leukotriene C4; Male; Oxamic Acid; Tears

Allergen extract was used to perform conjunctival provocation test on patients with Japanese cedar pollen conjunctivitis during the off-season, and histamine, tryptase and immunoreactive-leukotriene C4 (i-LTC4), which mainly consisted of LTE4, were measured in the lavage fluids. The results obtained in this study were as following. 1) After instillation of the allergen extract (1:20, w/v, 0.01 ml), histamine reached a maximal level of 4.63 +/- 1.67 ng/ml (mean +/- SE, n = 11) at 5 min. Tryptase appeared more slowly and the peak levels were reached at 5 min (116.6 +/- 49.6 ng/ml) or 10 min (119.4 +/- 63.8 ng/ml). In another set of the experiments, histamine peaked at 5 min (3.84 +/- 1.08 ng/ml, n = 7), and i-LTC4 reached peaks at 5 min (320 +/- 44.4 pg/ml) or 10 min (367 +/- 64.8 pg/ml). The amounts of these mediators decreased to base-line levels by 30 min. 2) The amounts of histamine retrieved from the lavage fluid were significantly correlated with those of tryptase (r = 0.819, p < 0.01, n = 11) and the weight ratio of tryptase to histamine was 41.2 +/- 10.0. These observations suggest that histamine was released from mast cells. 3) A significant correlation between the levels of histamine and i-LTC4 recovered from the lavage fluids was also observed (r = 0.736, p < 0.05, n = 7). 4) Compound 48/80 was instilled in the right eye (7.5 mg/ml, 0.01 ml) and the left eye was given allergen solution.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Allergens; Chymases; Conjunctivitis, Allergic; Histamine Release; Humans; Immunologic Tests; Leukotriene C4; Mast Cells; p-Methoxy-N-methylphenethylamine; Pollen; Serine Endopeptidases; Tryptases

Contact lens-associated giant papillary conjunctivitis (CL-GPC) caused by mechanical and immune mechanisms is a significant problem resulting in contact lens intolerance and discontinuation of contact lens wear. In the present study, tear fluid leukotriene C4 (LTC4) level was evaluated in soft contact lens wearers with and without CL-GPC using ELISA. Statistical analysis showed no significant difference in tear fluid LTC4 between contact lens wearers without GPC and normal controls (p>0.05), but a significant increase in tear LTC4 level in CL-GPC patients (p<0.05). On the basis of this finding, it might be possible to explain redness, conjunctival edema, increased mucoid secretion, and papillary changes by the effect of LTC4 on eye tissues. Effective treatment of CL-GPC might be possible in the future by employing inhibitors of leukotriene synthesis and action.

Topics: Adult; Conjunctivitis, Allergic; Contact Lenses, Hydrophilic; Enzyme-Linked Immunosorbent Assay; Female; Humans; Leukotriene C4; Male; Tears

Leukotrienes have been shown to play a role in the pathogenesis of ocular inflammatory and allergic reactions like vernal keratoconjunctivitis and contact lens-associated giant papillary conjunctivitis. This study was designed to determine leukotriene B4 (LTB4) and leukotriene C4 (LTC4) levels in the tears of patients with ocular prosthesis-associated giant papillary conjunctivitis (OP-GPC) and to evaluate the effects of lodoxamide 0.1% on tear LTB4 and LTC4 levels of OP-GPC patients. Tear LTB4 and LTC4 levels were determined by an ELISA technique in the tears of ten OP-GPC patients before and after treatment with lodoxamide 0.1% for one month. The results were compared with that of ten healthy control subjects. The mean tear LTB4 and LTC4 levels of the OP-GPC patients were significantly higher than those of the control group. After treatment with lodoxamide 0.1%, tear LTB4 and LTC4 levels of the OP-GPC patients decreased significantly. This is the first report of elevated LTB4 and LTC4 levels in tears of OP-GPC patients and it points to the possible role of leukotrienes in the immunopathogenesis of OP-GPC. The results also indicate that lodoxamide 0.1%, a mast cell membrane stabilizer, is effective in significantly reducing tear LTB4 and LTC4 levels in OP-GPC patients.

Topics: Adolescent; Anti-Allergic Agents; Conjunctivitis, Allergic; Enzyme-Linked Immunosorbent Assay; Eye Evisceration; Eye, Artificial; Female; Humans; Leukotriene B4; Leukotriene C4; Male; Ophthalmic Solutions; Oxamic Acid; Tears

We determined the tear levels of LTC4 in contact lens wearers who had minimal irritative symptoms and signs suggesting subclinical conjunctival abnormalities and the possible development of giant papillary conjunctivitis (GPC). We examined 25 patients wearing rigid gas permeable lenses. Ten of the contact lens wearers had minimal irritative symptoms and nonspecific papillary hypertrophy, and 15 patients had no symptoms. We included eight controls chosen from the same age group who were not contact lens wearers and who had normal conjunctiva. Tear samples were examined through the ELISA technique. Elevated levels of LTC4 were found in the tears of symptomatic patients (525.50 +/- 202 pg/mL) compared with tears of asymptomatic contact lens wearers (52.6 +/- 10.2 pg/mL) and the control group (75 +/- 8.4 pg/mL) (P < 0.001). Two patients in the first group developed GPC in the course of their follow-up. The results of this study indicate that detecting tear LTC4 levels in contact lens wearers can give useful information regarding the presence of contact lens related subclinical inflammation and subclinical GPC.

Topics: Biomarkers; Conjunctivitis, Allergic; Contact Lenses; Enzyme-Linked Immunosorbent Assay; Humans; Leukotriene C4; Tears