J Korean Ophthalmol Soc.  2014 Sep;55(9):1291-1297. 10.3341/jkos.2014.55.9.1291.

Tear Eosinophil Cationic Protein Levels in Allergic Keratoconjunctivitis

• Lim BS
• Chung SH

• KMID: 2217111
• DOI: http://doi.org/10.3341/jkos.2014.55.9.1291

Abstract

PURPOSE
To evaluate tear eosinophil cationic protein (ECP) as a severity marker for atopic keratoconjunctivitis (AKC) and seasonal/perennial allergic conjunctivitis (SAC/PAC).
METHODS
Tear ECP levels were measured by chemiluminescent immunometric assay in 7 eyes of 7 patients with AKC, 13 eyes of 13 patients with SAC/PAC, and 10 eyes of 10 healthy control subjects. All AKC and SAC/PAC patients underwent conjunctival injection and papillary formation grading. Tear ECP levels were investigated with reference to the clinical parameters of allergic conjunctivitis (papillary formation and conjunctival injection scoring).
RESULTS
Tear ECP levels in patients with AKC were significantly higher than those in patients with SAC/PAC and in control subjects (p = 0.012 and p = 0.003, respectively). The number of patients with papillary formation scores of 2-3 was significantly higher in the AKC group than in the SAC/PAC group (p = 0.016). The number of patients with conjunctival injection scores of 2-3 did not significantly differ between the AKC and SAC/PAC groups (p = 0.128). All AKC patients obtained papillary formation scores of 2-3, and tear ECP levels in patients with conjunctival injection scores of 2-3 were significantly higher than in patients with scores of 0-1 in the AKC group (p < 0.001). In the SAC/PAC group, tear ECP levels in patients with papillary formation scores of 2-3 were significantly higher than in patients with scores of 0-1 (p = 0.046).
CONCLUSIONS
This study suggests that tear ECP was a useful marker to diagnose and assess the severity of disease in patients with AKC as well as SAC/PAC. It would be useful to monitor therapeutic outcome in allergic conjunctivitis.

Keyword

Atopic keratoconjunctivitis; Conjunctival injection score; Papillary formation score; Seasonal/perennial allergic conjunctivitis; Tear eosinophil cationic protein

MeSH Terms

Conjunctivitis, Allergic
Eosinophil Cationic Protein*
Humans
Keratoconjunctivitis*
Eosinophil Cationic Protein

Figure

• 

  Figure 1. Tear ECP level in allergic conjunctivitis patients. Tear ECP level in AKC patients was significantly higher compared to patients with SAC/PAC or control. Tear ECP level in SAC/PAC patients was significantly higher than the control. ECP = eosinophil cationic protein; AKC = atopic keratoconjunctivitis; SAC = seasonal allergic conjunctivitis; PAC = perennial allergic conjunctivitis.

• 

  Figure 2. Tear ECP level according to the clinical severity of AKC and SAC/PAC patients. (A) Tear ECP level in SAC/PAC patients with papillary scores of 2-3 was significantly higher compared to patients with scores of 0-1. All AKC patients showed papillary scores of 2-3. In scores of 2-3 group, tear ECP levels in AKC patients was significantly higher than those in SAC/PAC patients. (B) Tear ECP level in AKC patients with conjunctival injection scores of 2-3 was significantly higher compared to patients with scores of 0-1. In SAC/PAC patients, tear ECP level did not differ between conjunctival injection scores of 2-3 and 0-1 groups. In scores of 2-3 group, tear ECP levels in AKC patients was significantly higher than those in SAC/PAC patients. ECP = eosinophil cationic protein; AKC = atopic keratoconjunctivitis; SAC = seasonal allergic conjunctivitis; PAC = perennial allergic conjunctivitis.

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