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Specific immunoglobulin E antibodies in tear secretions of patients with vernal conjunctivitis

1980; Elsevier BV; Volume: 66; Issue: 2 Linguagem: Inglês

10.1016/0091-6749(80)90057-3

1097-6825

Mark Ballow, Louis M. Mendelson,

Urticaria and Related Conditions

Twenty-twu patients with vernal conjunctivitis (VC) were studied by radjo~llergosorbent test (RAST) for specific IgE antibodies to the ~nhulant pollen allergens in tear secretions.Specijic IgE antibodies were deterred in the tear secretions of 12 (54.5%)patients with VC.Six patients had a positive tear RAST, but the corresponding serum RAST and irnrnediate skin tesf reactivity were negative.The spec$ic tear IgE antibodies appeared to correlate with the seasonal prevalence of the pollen in the environment and the perioa' of maximal symptomatology.Six patients had both positive serum and tear RAST determinations.A double ratio formula with transferrin as a marker for the leakage of plasnla proteins into tear secretions and the "specific activity" ratios of IgE antibody to total IgE between the tear secretions and the set-urn indicated that almost all (79% to 99%) of the tear IgE antibodies were locally produced.IgE antibodies were also detected in the tears offour of 10 patients with allergic conjunctivitis (AC) and of fhree with allergic rhinitis (AR).However, the "specific activity" ratio in the patients with AC and AR with measurable tear IgE suggested that the IgE antibodies were derived from the leakage of serum proteins into the tear secretions.These endings suggest that the pathog~nes~s of VC may be 1gE mediated in some patients and lends support to the concept that speci$c IgE antibodies can be produced locally by the target organ, i.e., conjunctival tissues.Vernal conjunctivitis (VC) is a significant cause of eye disease.'The seasonal incidence, the symptoms of itching, tearing, and photophobia, the presence of eosinophils in the conjunctival secretions, and the response to steroid therapy suggest an immune mechanism.2Previous studies by Allansmith et al.3, 4 Bmuninger and Centifauto," and Little et al6 have suggested that VC is an IgE-mediated disorder.Central to this idea has been the demonstration of increased numbers of IgE plasma cells, mast cells, basophils, and eosinophils in the conjunctival tissues** '3 * as well as the elevation of histamine3 in the tear secretions.We present here a study of specific IgE antibodies to the pollen allergens in the tear secretions of patients