Cytokine patterns of tears and serum in patients with vernal keratoconjunctivitis

Purpose. To evaluate the expression of cytokine patterns in patients with vernal keratoconjunctivitis (VKC). Methods. Ten patients with severe VKC (mean age 18.3±5.1) were recruited. We determined the serum levels of interleukin (IL)-2, 4, INF-g, IL-2 receptor (IL-2R), and the level of IL-4 in tears. We also measured total IgE and IgG, antigen specific IgE. Cytological study was conducted on brush cytology specimens of the upper tarsal conjunctiva, including an evaluation of results of Giemsa's staining and flow cytometric analysis of HLA-DR. Results. The level of IL-4 and IL-2R in serum and IL-4 in tears increased but IL-2 and INF-g did not increase. The mean serum level of total IgE was elevated, but that of IgG was unaffected. Specific IgE to housedust, dust mite, and cat antigens were positive in many patients. Cytological study of brush cytology specimens of the upper tarsal conjunctiva showed an increase in lymphocytes, eosinophils, basophils, and HLA-DR expressing cells. Conclusions. Cytokine pattern of Th-2 like helper T cells was seen not only in the serum but also tears of patients with VKC. Removing and suppressing these activated cells can be an effective treatment for VKC.