Asia Pac Allergy.  2017 Apr;7(2):57-64. 10.5415/apallergy.2017.7.2.57.

Allergic conjunctivitis in Asia

Affiliations
  • 1Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore 308433, Singapore. bernard_thong@ttsh.com.sg

Abstract

Allergic conjunctivitis (AC), which may be acute or chronic, is associated with rhinitis in 30%-70% of affected individuals, hence the term allergic rhinoconjunctivitis (AR/C). Seasonal and perennial AC is generally milder than the more chronic and persistent atopic and vernal keratoconjunctivitis. Natural allergens like house dust mites (HDM), temperate and subtropical grass and tree pollen are important triggers that drive allergic inflammation in AC in the Asia-Pacific region. Climate change, environmental tobacco smoke, pollutants derived from fuel combustion, Asian dust storms originating from central/north Asia and phthalates may also exacerbate AR/C. The Allergies in Asia Pacific study and International Study of Asthma and Allergies in Childhood provide epidemiological data on regional differences in AR/C within the region. AC significantly impacts the quality of life of both children and adults, and these can be measured by validated quality of life questionnaires on AR/C. Management guidelines for AC involve a stepped approach depending on the severity of disease, similar to that for allergic rhinitis and asthma. Topical calcineurin inhibitors are effective in certain types of persistent AC, and sublingual immunotherapy is emerging as an effective treatment option in AR/C to grass pollen and HDM. Translational research predominantly from Japan and Korea involving animal models are important for the potential development of targeted pharmacotherapies for AC.

Keyword

Allergens; Allergen immunotherapy; Epidemiology; Quality of life

MeSH Terms

Adult
Allergens
Asia*
Asian Continental Ancestry Group
Asthma
Calcineurin Inhibitors
Child
Climate Change
Conjunctivitis, Allergic*
Desensitization, Immunologic
Drug Therapy
Dust
Epidemiology
Humans
Hypersensitivity
Inflammation
Japan
Korea
Models, Animal
Poaceae
Pollen
Pyroglyphidae
Quality of Life
Rhinitis
Rhinitis, Allergic
Seasons
Smoke
Sublingual Immunotherapy
Tobacco
Translational Medical Research
Trees
Allergens
Calcineurin Inhibitors
Dust
Smoke

Reference

1. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TA, Ring J, Thien F, Van Cauwenberge P, Williams HC. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004; 113:832–836.
Article
2. Leonardi A, Castegnaro A, Valerio AL, Lazzarini D. Epidemiology of allergic conjunctivitis: clinical appearance and treatment patterns in a population-based study. Curr Opin Allergy Clin Immunol. 2015; 15:482–488.
3. Leonardi A, Bogacka E, Fauquert JL, Kowalski ML, Groblewska A, Jedrzejczak-Czechowicz M, Doan S, Marmouz F, Demoly P, Delgado L. Ocular allergy: recognizing and diagnosing hypersensitivity disorders of the ocular surface. Allergy. 2012; 67:1327–1337.
Article
4. Solomon A. Allergic manifestations of contact lens wearing. Curr Opin Allergy Clin Immunol. 2016; 16:492–497.
Article
5. Katelaris CH. Ocular allergy in the Asia Pacific region. Asia Pac Allergy. 2011; 1:108–114.
Article
6. Uthaisangsook S. Prevalence of asthma, rhinitis, and eczema in the university population of Phitsanulok, Thailand. Asian Pac J Allergy Immunol. 2007; 25:127–132.
7. Yadav SP, Goel HC, Chanda R, Ranga R, Gupta KB. A clinical profile of allergic rhinitis in Haryana. Indian J Allergy Asthma Immunol. 2001; 15:13–15.
8. Choi H, Lee SB. Nonseasonal allergic conjunctivitis in the tropics: experience in a tertiary care institution. Ocul Immunol Inflamm. 2008; 16:141–145.
Article
9. Katelaris CH, Lai CK, Rhee CS, Lee SH, Yun WD, Lim-Varona L, Quang VT, Hwang J, Singh H, Kim J, Boyle JM, Dhong HJ, Narayanan P, Vicente G, Blaiss M, Sacks R. Nasal allergies in the Asian-Pacific population: results from the Allergies in Asia-Pacific Survey. Am J Rhinol Allergy. 2011; 25:Suppl 1. S3–S15.
Article
10. Aït-Khaled N, Pearce N, Anderson HR, Ellwood P, Montefort S, Shah J. ISAAC Phase Three Study Group. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Allergy. 2009; 64:123–148.
Article
11. Fok AO, Wong GW. What have we learnt from ISAAC phase III in the Asia-Pacific rim? Curr Opin Allergy Clin Immunol. 2009; 9:116–122.
Article
12. Jalbert I, Golebiowski B. Environmental aeroallergens and allergic rhino-conjunctivitis. Curr Opin Allergy Clin Immunol. 2015; 15:476–481.
Article
13. van Vliet AJ, Overeem A, De Groot R, Jacobs AF, Spieksma FT. The influence of temperature and climate change on the timing of pollen release in the Netherlands. Int J Climatol. 2002; 22:1757–1767.
Article
14. Ziska L, Knowlton K, Rogers C, Dalan D, Tierney N, Elder MA, Filley W, Shropshire J, Ford LB, Hedberg C, Fleetwood P, Hovanky KT, Kavanaugh T, Fulford G, Vrtis RF, Patz JA, Portnoy J, Coates F, Bielory L, Frenz D. Recent warming by latitude associated with increased length of ragweed pollen season in central North America. Proc Natl Acad Sci U S A. 2011; 108:4248–4251.
Article
15. Wolf J, O'Neill NR, Rogers CA, Muilenberg ML, Ziska LH. Elevated atmospheric carbon dioxide concentrations amplify Alternaria alternata sporulation and total antigen production. Environ Health Perspect. 2010; 118:1223–1228.
16. Mimura T, Ichinose T, Yamagami S, Fujishima H, Kamei Y, Goto M, Takada S, Matsubara M. Airborne particulate matter (PM2.5) and the prevalence of allergic conjunctivitis in Japan. Sci Total Environ. 2014; 487:493–499.
Article
17. Chang CC, Lee IM, Tsai SS, Yang CY. Correlation of Asian dust storm events with daily clinic visits for allergic rhinitis in Taipei, Taiwan. J Toxicol Environ Health A. 2006; 69:229–235.
Article
18. Maspero J, Lee BW, Katelaris CH, Potter PC, Cingi C, Lopatin A, Saffer M, Nadeau G, Walters RD. Quality of life and control of allergic rhinitis in patients from regions beyond western Europe and the United States. Clin Exp Allergy. 2012; 42:1684–1696.
Article
19. Fukagawa K, Fujishima H, Fukushima A, Sumi T, Okamoto S, Shoji J, Satake Y, Ohno S, Namba K, Kitaichi N, Ebihara N, Takahashi H, Kumagai N, Uchino Y, Uchino M, Murayama K, Sakata M, Uchio E, Takamura E, Ohashi Y, Ohkubo K, Satoh T. A quality of life questionnaire for Japanese allergic conjunctival disease. Nippon Ganka Gakkai Zasshi. 2012; 116:494–502.
20. Santos MS, Alves MR, Freitas Dd, Sousa LB, Wainsztein R, Kandelman S, Lozano M, Beltrán F, Lozada OB, Santacruz C, Guzzo G, Zaccarelli Filho CA, Gomes JÁ. Ocular allergy Latin American consensus. Arq Bras Oftalmol. 2011; 74:452–456.
Article
21. Takamura E, Uchio E, Ebihara N, Ohno S, Ohashi Y, Okamoto S, Kumagai N, Satake Y, Shoji J, Nakagawa Y, Namba K, Fukagawa K, Fukushima A, Fujishima H. Japanese Society of Allergology. Japanese guidelines for allergic conjunctival diseases 2017. Allergol Int. 2017; 66:220–229.
Article
22. Sánchez-Hernández MC, Montero J, Rondon C, Benitez del Castillo JM, Velázquez E, Herreras JM, Fernández-Parra B, Merayo-Lloves J, Del Cuvillo A, Vega F, Valero A, Panizo C, Montoro J, Matheu V, Lluch-Bernal M, González ML, González R, Dordal MT, Dávila I, Colás C, Campo P, Antón E, Navarro A. SEAIC 2010 Rhinoconjunctivitis Committee. Spanish Group Ocular Surface-GESOC. Consensus document on allergic conjunctivitis (DECA). J Investig Allergol Clin Immunol. 2015; 25:94–106.
23. Bielory L, Meltzer EO, Nichols KK, Melton R, Thomas RK, Bartlett JD. An algorithm for the management of allergic conjunctivitis. Allergy Asthma Proc. 2013; 34:408–420.
Article
24. Shaker M, Salcone E. An update on ocular allergy. Curr Opin Allergy Clin Immunol. 2016; 16:505–510.
Article
25. Berger WE, Granet DB, Kabat AG. Diagnosis and management of allergic conjunctivitis in pediatric patients. Allergy Asthma Proc. 2017; 38:16–27.
Article
26. Vichyanond P, Kosrirukvongs P. Use of cyclosporine A and tacrolimus in treatment of vernal keratoconjunctivitis. Curr Allergy Asthma Rep. 2013; 13:308–314.
Article
27. Labcharoenwongs P, Jirapongsananuruk O, Visitsunthorn N, Kosrirukvongs P, Saengin P, Vichyanond P. A double-masked comparison of 0.1% tacrolimus ointment and 2% cyclosporine eye drops in the treatment of vernal keratoconjunctivitis in children. Asian Pac J Allergy Immunol. 2012; 30:177–184.
28. Wan KH, Chen LJ, Rong SS, Pang CP, Young AL. Topical cyclosporine in the treatment of allergic conjunctivitis: a meta-analysis. Ophthalmology. 2013; 120:2197–2203.
29. Wu MM, Yau GS, Lee JW, Wong AL, Tam VT, Yuen CY. Retrospective review on the use of topical cyclosporin a 0.05% for paediatric allergic conjunctivitis in Hong Kong Chinese. ScientificWorldJournal. 2014; 2014:396987.
Article
30. Keklikci U, Dursun B, Cingu AK. Topical cyclosporine a 0.05% eyedrops in the treatment of vernal keratoconjunctivitis - randomized placebo-controlled trial. Adv Clin Exp Med. 2014; 23:455–461.
31. Ebihara N, Ohashi Y, Uchio E, Okamoto S, Kumagai N, Shoji J, Takamura E, Nakagawa Y, Nanba K, Fukushima A, Fujishima H. A large prospective observational study of novel cyclosporine 0.1% aqueous ophthalmic solution in the treatment of severe allergic conjunctivitis. J Ocul Pharmacol Ther. 2009; 25:365–372.
Article
32. Hazarika AK, Singh PK. Efficacy of topical application of 0.03% tacrolimus eye ointment in the management of allergic conjunctivitis. J Nat Sci Biol Med. 2015; 6:Suppl 1. S10–S12.
Article
33. Al-Amri AM. Long-term follow-up of tacrolimus ointment for treatment of atopic keratoconjunctivitis. Am J Ophthalmol. 2014; 157:280–286.
Article
34. Fukushima A, Ohashi Y, Ebihara N, Uchio E, Okamoto S, Kumagai N, Shoji J, Takamura E, Nakagawa Y, Namba K, Fujishima H, Miyazaki D. Therapeutic effects of 0.1% tacrolimus eye drops for refractory allergic ocular diseases with proliferative lesion or corneal involvement. Br J Ophthalmol. 2014; 98:1023–1027.
Article
35. Fujishima H, Okada N, Matsumoto K, Fukagawa K, Igarashi A, Matsuda A, Ono J, Ohta S, Mukai H, Yoshikawa M, Izuhara K. The usefulness of measuring tear periostin for the diagnosis and management of ocular allergic diseases. J Allergy Clin Immunol. 2016; 138:459–467.e2.
Article
36. Tabatabaian F, Casale TB. Selection of patients for sublingual immunotherapy (SLIT) versus subcutaneous immunotherapy (SCIT). Allergy Asthma Proc. 2015; 36:100–104.
Article
37. Calderon MA, Penagos M, Sheikh A, Canonica GW, Durham S. Sublingual immunotherapy for treating allergic conjunctivitis. Cochrane Database Syst Rev. 2011; (7):CD007685.
Article
38. Pfaar O, Demoly P, Gerth van Wijk R, Bonini S, Bousquet J, Canonica GW, Durham SR, Jacobsen L, Malling HJ, Mösges R, Papadopoulos NG, Rak S, Rodriguez del Rio P, Valovirta E, Wahn U, Calderon MA. European Academy of Allergy and Clinical Immunology. Recommendations for the standardization of clinical outcomes used in allergen immunotherapy trials for allergic rhinoconjunctivitis: an EAACI Position Paper. Allergy. 2014; 69:854–867.
Article
39. Li JT, Bernstein DI, Calderon MA, Casale TB, Cox L, Passalacqua G, Pfaar O, Papadopoulos NG. Sublingual grass and ragweed immunotherapy: Clinical considerations-a PRACTALL consensus report. J Allergy Clin Immunol. 2016; 137:369–376.
Article
40. Creticos PS, Maloney J, Bernstein DI, Casale T, Kaur A, Fisher R, Liu N, Murphy K, Nékám K, Nolte H. Randomized controlled trial of a ragweed allergy immunotherapy tablet in North American and European adults. J Allergy Clin Immunol. 2013; 131:1342–1349.e6.
Article
41. Cox LS, Casale TB, Nayak AS, Bernstein DI, Creticos PS, Ambroisine L, Melac M, Zeldin RK. Clinical efficacy of 300IR 5-grass pollen sublingual tablet in a US study: the importance of allergen-specific serum IgE. J Allergy Clin Immunol. 2012; 130:1327–1334.e1.
Article
42. Didier A, Malling HJ, Worm M, Horak F, Sussman GL. Prolonged efficacy of the 300IR 5-grass pollen tablet up to 2 years after treatment cessation, as measured by a recommended daily combined score. Clin Transl Allergy. 2015; 5:12.
Article
43. Dahl R, Roberts G, de Blic J, Canonica GW, Kleine-Tebbe J, Nolte H, Lawton S, Nelson HS. SQ grass sublingual allergy immunotherapy tablet for disease-modifying treatment of grass pollen allergic rhinoconjunctivitis. Allergy Asthma Proc. 2016; 37:92–104.
Article
44. Davies JM. Grass pollen allergens globally: the contribution of subtropical grasses to burden of allergic respiratory diseases. Clin Exp Allergy. 2014; 44:790–801.
Article
45. Li L, Guan K. Effect on quality of life of the mixed house dust mite/weed pollen extract immunotherapy. Asia Pac Allergy. 2016; 6:168–173.
Article
46. Nolte H, Maloney J, Nelson HS, Bernstein DI, Lu S, Li Z, Kaur A, Zieglmayer P, Zieglmayer R, Lemell P, Horak F. Onset and dose-related efficacy of house dust mite sublingual immunotherapy tablets in an environmental exposure chamber. J Allergy Clin Immunol. 2015; 135:1494–1501.e6.
Article
47. Soh JY, Thalayasingam M, Ong S, Loo EX, Shek LP, Chao SS. Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period. J Laryngol Otol. 2016; 130:272–277.
Article
48. Okubo K, Masuyama K, Imai T, Okamiya K, Stage BS, Seitzberg D, Konno A. Efficacy and safety of the SQ house dust mite sublingual immunotherapy tablet in Japanese adults and adolescents with house dust mite-induced allergic rhinitis. J Allergy Clin Immunol. 2016; 11. 15. pii: S0091-6749(16)31294-5. [Epub]. DOI: 10.1016/j.jaci.2016.09.043.
Article
49. Fukushima A, Yamaguchi T, Ishida W, Fukata K, Liu FT, Ueno H. Cyclosporin A inhibits eosinophilic infiltration into the conjunctiva mediated by type IV allergic reactions. Clin Exp Ophthalmol. 2006; 34:347–353.
Article
50. Shoji J, Sakimoto T, Muromoto K, Inada N, Sawa M, Ra C. Comparison of topical dexamethasone and topical FK506 treatment for the experimental allergic conjunctivitis model in BALB/c mice. Jpn J Ophthalmol. 2005; 49:205–210.
Article
51. Xu C, He X, Liu W, Chen Y, Zhou C, Duan Z, Lu Q, Yan X, Zhang Z, Zheng R. An inhibitor peptide of toll-like receptor 2 shows therapeutic potential for allergic conjunctivitis. Int Immunopharmacol. 2017; 46:9–15.
Article
52. Chen J, Zhang J, Zhao R, Jin J, Yu Y, Li W, Wang W, Zhou H, Su SB. Topical application of interleukin-28A attenuates allergic conjunctivitis in an ovalbumin-induced mouse model. Invest Ophthalmol Vis Sci. 2016; 57:604–610.
Article
53. Kwon JY, Lee HS, Joo CK. TRPV1 antagonist suppresses allergic conjunctivitis in a murine model. Ocul Immunol Inflamm. 2016; 10. 11:1–9. [Epub]. DOI: 10.1080/09273948.2016.1231330.
Article
54. Mizutani N, Nabe T, Yoshino S. Topical ocular treatment with monoclonal antibody Fab fragments targeting Japanese cedar pollen Cry j 1 inhibits Japanese cedar pollen-induced allergic conjunctivitis in mice. Eur J Pharmacol. 2017; 798:105–112.
Article
55. Lee HS, Kwon JY, Joo CK. Topical administration of β-1,3-glucan to modulate allergic conjunctivitis in a murine model. Invest Ophthalmol Vis Sci. 2016; 57:1352–1360.
Article
56. Chung SH, Choi SH, Choi JA, Chuck RS, Joo CK. Curcumin suppresses ovalbumin-induced allergic conjunctivitis. Mol Vis. 2012; 18:1966–1972.
Full Text Links
  • APA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr