Published Online: March 7, 2016
Chronic ocular allergic diseases such as vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are accompanied by serious comorbidities; however, the underlying pathogenesis remains obscure. Furthermore, diagnosing conjunctival lesions in atopic dermatitis patients and estimating the severity in AKC are important for treatment of ocular allergic diseases.
In a study recently published in The Journal of Allergy & Clinical Immunology (JACI), Fujishima and colleagues investigated whether periostin, a novel mediator and biomarker in allergic inflammation, is involved in the pathogenesis of ocular allergic diseases and whether periostin can be a biomarker for these diseases.
The researchers examined tear periostin in patients with seasonal allergic conjunctivitis (SAC), VKC, and AKC and compared it with tear IL-13 and serum periostin. Furthermore, in AKC patients, they measured tear periostin before and after topical treatment with tacrolimus.
The authors found that tears from ocular allergic disease patients showed significantly high periostin levels compared to allergic patients without conjunctivitis, in AKC, VKC, and SAC patients, in descending order. Tear periostin was associated with serious comorbidities such as large papilla formation and corneal damage in AKC, although both tear IL-13 or serum periostin had little to no such abilities. Furthermore, after topical tacrolimus treatment, tear periostin tended to decrease in most AKC patients along with their clinical improvement.
The authors’ findings suggest that periostin produced in conjunctival tissues stimulated by IL-13 may contribute to the pathogenesis of ocular allergic diseases. Furthermore, tear periostin can be applied as a biomarker to diagnose conjunctivitis in allergic patients and to evaluate disease severity as well as the efficacy of treatments in AKC.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.