The Experts below are selected from a list of 270 Experts worldwide ranked by ideXlab platform
Stephen C. Pflugfelder - One of the best experts on this subject based on the ideXlab platform.
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Immune - Goblet cell interaction in the conjunctiva.
The ocular surface, 2020Co-Authors: Jehan Alam, Cintia S. De Paiva, Stephen C. PflugfelderAbstract:The conjunctiva is a goblet cell rich mucosal tissue. Goblet cells are supported by tear growth factors and IL-13 produced by resident immune cells. Goblet cell secretions are essential for maintaining tear stability and ocular surface homeostasis. In addition to producing tear stabilizing mucins, they also produce cytokines and retinoic acid that condition monocyte-derived phagocytic cells in the conjunctiva. Aqueous tear deficiency from lacrimal gland Disease and systemic inflammatory conditions results in goblet cell loss that amplifies dry eye severity. Reduced goblet cell density is correlated with more severe Conjunctival Disease, increased IFN-γ expression and antigen presenting cell maturation. Sterile Alpha Motif (SAM) pointed domain epithelial specific transcription factor (Spdef) gene deficient mice that lack goblet cells have increased infiltration of monocytes and dendritic cells with greater IL-12 expression in the conjunctiva. Similar findings were observed in the conjunctiva of aged mice. Reduced retinoic acid receptor (RXRα) signaling also increases Conjunctival monocyte infiltration, IFN-γ expression and goblet cell loss. Evidence suggests that dry eye therapies that suppress IFN-γ expression preserve Conjunctival goblet cell number and function and should be considered in aqueous deficiency.
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Age-Related Conjunctival Disease in the C57BL/6.NOD-Aec1Aec2 Mouse Model of Sjögren Syndrome Develops Independent of Lacrimal Dysfunction.
Investigative ophthalmology & visual science, 2015Co-Authors: In-cheon You, Cintia S. De Paiva, Fang Bian, Eugene A. Volpe, Stephen C. PflugfelderAbstract:Sjogren syndrome (SS) is a chronic systemic autoimmune Disease that targets primarily the salivary and lacrimal glands (LGs), resulting in severe dry mouth (stomatitis sicca) and dry eye (keratoconjunctivitis sicca), respectively.1 Despite extensive efforts to define the genetic, environmental, and/or immunologic basis of human SS, the underlying etiology remains relatively unclear. This is due, in part, to the delay in diagnosis to an average 7 to 10 years after first symptoms, patients are seen in clinics only after onset of overt clinical Disease, and comparative controls are unlikely to volunteer for exocrine gland biopsies. So, in an effort to identify the underlying pathogenesis of SS in humans, numerous mouse models in which various aspects of SS appear spontaneously or are experimentally induced are being intensively investigated.2 Typically, these mouse models show lymphocyte infiltration of the lacrimal and salivary glands, increased expressions of proinflammatory and helper T helper (Th) cytokines, generation of autoantibodies (especially ANAs [antinuclear antibodies] and anti-M3R antibodies), and eventually decreased tear and saliva secretion. In recent years, several mouse strains, including nonobese diabetic (NOD), MRL/lpr, CD25 knockout (KO) strains, and C57BL/6.NOD-Aec1Aec2 (Aec) mouse, have been used to study the immunopathogenic mechanisms of SS.2–,9 The Aec mouse is a recently generated model in which two genetic intervals, the Idd3 region (designated Aec1, autoimmune exocrinopathy) of chromosome 3 and the Idd5 (designated Aec2) of chromosome 1, derived from the NOD mouse were bred into the SS-nonsusceptible C57BL/6 (B6) mouse.7 These two genetic intervals have been shown to be responsible for a SS-like Disease manifestation to develop in the NOD. Because Aec mice have a B6 genetic background, these mice do not exhibit signs of autoimmune diabetes and abnormal development of LGs, and LG histology is normal prior to onset of SS-like Disease.2 Aec mice exhibit several features found in human SS, including lymphocytic infiltration of salivary glands and LGs, reduced tear production, and the presence of serum autoantibodies.6–,9 However, the Disease process is not fully synchronized between individual mice,8 and the ocular surface Disease has not been described. Therefore, in the present study, we compared LGs and ocular surface alterations between Aec and B6 strains at various time points.
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age related Conjunctival Disease in the c57bl 6 nod aec1aec2 mouse model of sjogren syndrome develops independent of lacrimal dysfunction
Investigative Ophthalmology & Visual Science, 2015Co-Authors: Cintia S. De Paiva, In-cheon You, Fang Bian, Eugene A. Volpe, Stephen C. PflugfelderAbstract:Sjogren syndrome (SS) is a chronic systemic autoimmune Disease that targets primarily the salivary and lacrimal glands (LGs), resulting in severe dry mouth (stomatitis sicca) and dry eye (keratoconjunctivitis sicca), respectively.1 Despite extensive efforts to define the genetic, environmental, and/or immunologic basis of human SS, the underlying etiology remains relatively unclear. This is due, in part, to the delay in diagnosis to an average 7 to 10 years after first symptoms, patients are seen in clinics only after onset of overt clinical Disease, and comparative controls are unlikely to volunteer for exocrine gland biopsies. So, in an effort to identify the underlying pathogenesis of SS in humans, numerous mouse models in which various aspects of SS appear spontaneously or are experimentally induced are being intensively investigated.2 Typically, these mouse models show lymphocyte infiltration of the lacrimal and salivary glands, increased expressions of proinflammatory and helper T helper (Th) cytokines, generation of autoantibodies (especially ANAs [antinuclear antibodies] and anti-M3R antibodies), and eventually decreased tear and saliva secretion. In recent years, several mouse strains, including nonobese diabetic (NOD), MRL/lpr, CD25 knockout (KO) strains, and C57BL/6.NOD-Aec1Aec2 (Aec) mouse, have been used to study the immunopathogenic mechanisms of SS.2–,9 The Aec mouse is a recently generated model in which two genetic intervals, the Idd3 region (designated Aec1, autoimmune exocrinopathy) of chromosome 3 and the Idd5 (designated Aec2) of chromosome 1, derived from the NOD mouse were bred into the SS-nonsusceptible C57BL/6 (B6) mouse.7 These two genetic intervals have been shown to be responsible for a SS-like Disease manifestation to develop in the NOD. Because Aec mice have a B6 genetic background, these mice do not exhibit signs of autoimmune diabetes and abnormal development of LGs, and LG histology is normal prior to onset of SS-like Disease.2 Aec mice exhibit several features found in human SS, including lymphocytic infiltration of salivary glands and LGs, reduced tear production, and the presence of serum autoantibodies.6–,9 However, the Disease process is not fully synchronized between individual mice,8 and the ocular surface Disease has not been described. Therefore, in the present study, we compared LGs and ocular surface alterations between Aec and B6 strains at various time points.
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evaluation of ocular surface inflammation in the presence of dry eye and allergic Conjunctival Disease
Ocular Surface, 2005Co-Authors: Michael E Stern, Karyn F Siemasko, Jianping Gao, Margarita Calonge, Jerry Y Niederkorn, Stephen C. PflugfelderAbstract:The ocular inflammatory Diseases dry eye and allergic conjunctivitis are mediated by CD4+ T cells. Th1 cells secrete interferon (IFN)-gamma and are implicated in mediating the Disease process in dry eye. Allergic conjunctivitis has been classically defined as a Th2 Disease because of the predominance of Th2 cytokines interleukin (IL)-4 and IL-13. A multi-hit antigen challenge mouse model of allergic conjunctivitis provides evidence that IFN-gamma, a Th1 cytokine, acts as an endothelium gatekeeper by regulating endothelial expression of vascular adhesion molecule-1 required for inflammatory Conjunctival cell infiltration. Current research encourages an in-depth evaluation of the exact role Th1 and Th2 cells play in ocular inflammation.
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Mucous Membrane Pemphigoid in a Patient With Chronic Lymphocytic Leukemia
Cornea, 2004Co-Authors: Rajeev K Seth, Stephen C. PflugfelderAbstract:Purpose: To describe a case of mucous membrane pemphigoid (MMP) with ocular manifestations in a patient subsequently diagnosed with B-cell chronic lymphocytic leukemia (CLL). Methods: Case report and literature review. Results: A 64-year-old man presented with redness and irritation of both eyes. The patient also had blistering lesions on the roof of his mouth, trunk, and buttocks as well as bilateral Conjunctival ulceration and symblepharon formation. A complete blood count performed before initiating treatment of presumed mucous membrane pemphigoid revealed a markedly increased white blood cell count (83,920) with a predominance of lymphocytes. Hematologic evaluation including immunophenotyping flow cytometry resulted in the diagnosis of B-cell chronic lymphocytic leukemia. Cyclophosphamide treatment improved his MMP and decreased the white blood cell count. Conclusions: Mucous membrane pemphigoid has been reported in association with a variety ofnonhematologic malignancies. This case suggests that mucous membrane pemphigoid may also occur in B-cell CLL and supports the concept that autoantibodies play a role in the pathogenesis of this cicatricial Conjunctival Disease.
Jun Shoji - One of the best experts on this subject based on the ideXlab platform.
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Japanese guidelines for allergic Conjunctival Diseases 2020.
Allergology international : official journal of the Japanese Society of Allergology, 2020Co-Authors: Dai Miyazaki, Jun Shoji, Nobuyuki Ebihara, Yuichi Ohashi, Eiichi Uchio, Etsuko Takamura, Shigeki Okamoto, Yoshiyuki Satake, Shigeaki Ohno, Kenichi NambaAbstract:The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic Conjunctival Disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease 2019. Allergic Conjunctival Disease is defined as "a Conjunctival inflammatory Disease associated with a Type I allergy accompanied by some subjective or objective symptoms." Allergic Conjunctival Disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include Conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by Conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic Conjunctival Diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic Conjunctival Disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the abovementioned drugs.
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Topical Tacrolimus for Chronic Allergic Conjunctival Disease with and without Atopic Dermatitis.
Current eye research, 2019Co-Authors: Jun Shoji, Hiroshi Fujishima, Naoki Kumagai, Yuichi Ohashi, Atsuki Fukushima, Dai Miyazaki, Eiichi Uchio, Etsuko Takamura, Kenichi Namba, Nobuyuki EbiharaAbstract:Purpose/Aim: This study evaluated the efficacy of topical 0.1% tacrolimus ophthalmic suspension for treating chronic allergic Conjunctival Disease with and without atopic dermatitis.Materials and M...
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Japanese guidelines for allergic Conjunctival Diseases 2017
Elsevier, 2017Co-Authors: Etsuko Takamura, Jun Shoji, Nobuyuki Ebihara, Naoki Kumagai, Yuichi Ohashi, Eiichi Uchio, Shigeki Okamoto, Yoshiyuki Satake, Shigeaki Ohno, Yayoi NakagawaAbstract:The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic Conjunctival Disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition) revised in 2010. Allergic Conjunctival Disease is defined as “a Conjunctival inflammatory Disease associated with a Type I allergy accompanied by some subjective or objective symptoms.” Allergic Conjunctival Disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include Conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by Conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic Conjunctival Diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic Conjunctival Disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the abovementioned drugs
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A quality of life questionnaire for Japanese allergic Conjunctival Disease
Nippon Ganka Gakkai zasshi, 2012Co-Authors: Kazumi Fukagawa, Jun Shoji, Hiroshi Fujishima, Atsuki Fukushima, Kenichi Namba, Tamaki Sumi, Shigeki Okamoto, Yoshiyuki Satake, Shigeaki Ohno, Nobuyoshi KitaichiAbstract:PURPOSE To establish a specific quality of life (QOL) questionnaire for Japanese allergic Conjunctival Disease (ACD) (Japanese allergic Conjunctival Disease QOL questionnaire: JACQLQ). SUBJECTS AND METHODS A multicenter study was conducted in 521 patients with ACD and 127 healthy volunteers (total 648 cases). The JACQLQ ver. 0 was developed by modifying the Japanese rhino-conjunctivitis QOL questionnaire (JRQLQ). The participants were asked to complete the questionnaire, and objective scores were determined by an ophthalmologist using a slit lamp. To confirm validity, item and factor analyses were conducted and correlation coefficients were calculated. RESULTS The items were grouped into four subscales (Daily activity, Psychological well-being, Eye symptoms, Nasal symptoms) after factor analysis. The JACQLQ had good item-internal consistency (Cronbach's alpha: 0.846-0.934). QOL scores were correlated with eye itching, eye irritation and tearing. Objective scores were correlated with eye redness, eye itching and eye irritation. Face scores were correlated with eye itching, eye irritation and eye redness. CONCLUSION The JACQLQ is a useful tool for assessing Disease specific QOL in ACD.
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Japanese Guideline for Allergic Conjunctival Diseases
Allergology international : official journal of the Japanese Society of Allergology, 2011Co-Authors: Etsuko Takamura, Jun Shoji, Nobuyuki Ebihara, Naoki Kumagai, Yuichi Ohashi, Eiichi Uchio, Shigeki Okamoto, Yoshiyuki Satake, Shigeaki Ohno, Yayoi NakagawaAbstract:ABSTRACT The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic Conjunctival Disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition) revised in 2010. Allergic Conjunctival Disease is defined as “a Conjunctival inflammatory Disease associated with a Type I allergy accompanied by some subjective or objective symptoms.” Allergic Conjunctival Disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include Conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by Conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic Conjunctival Diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic Conjunctival Disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the abovementioned drugs.
Mitsuru Sawa - One of the best experts on this subject based on the ideXlab platform.
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Concentration of Soluble Interleukin-6 Receptors in Tears of Allergic Conjunctival Disease Patients
Japanese Journal of Ophthalmology, 2007Co-Authors: Jun Shoji, Atsuri Kawaguchi, Aki Gotoh, Noriko Inada, Mitsuru SawaAbstract:Purpose To evaluate the significance of soluble interleukin-6 receptor (sIL-6R) in tears as a clinical indicator of Disease exacerbation in patients with allergic conjunctivitis Disease (ACD).
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Evaluation of Total and Allergen-Specific Secretory IgA in Tears of Allergic Conjunctival Disease Patients
Japanese journal of ophthalmology, 2007Co-Authors: Noriko Inada, Jun Shoji, Mai Hoshino, Mitsuru SawaAbstract:Purpose To investigate the variations in total secretory IgA (sIgA) and house dust mite (HDM)-specific sIgA antibodies in tears of patients with allergic Conjunctival Disease (ACD).
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Concentration of Soluble Interleukin-6 Receptors in Tears of Allergic Conjunctival Disease Patients
Japanese journal of ophthalmology, 2007Co-Authors: Jun Shoji, Atsuri Kawaguchi, Aki Gotoh, Noriko Inada, Mitsuru SawaAbstract:To evaluate the significance of soluble interleukin-6 receptor (sIL-6R) in tears as a clinical indicator of Disease exacerbation in patients with allergic conjunctivitis Disease (ACD). The study groups comprised 13 patients (13 eyes) with vernal keratoconjunctivitis (VKC group), 13 patients (13 eyes) with atopic keratoconjunctivitis (AKC group), 11 patients (11 eyes) with giant papillary conjunctivitis (GPC group), and 10 healthy volunteers (10 eyes) as a control. Tear samples were collected by the Schirmer I method using filter paper. Tear samples were eluted and the concentration of sIL-6R in tear samples was determined by enzyme-linked immunosorbent assay. Impression cytology using a nitrocellulose membrane was applied to the upper tarsal conjunctiva, and the mRNA of the signal-transducing molecule glycoprotein 130 (gp130) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was extracted from the membrane and analyzed by semiquantitative reverse transcription-polymerase chain reaction. In the VKC group, the clinical score was graded on the basis of allergic inflammation of the ocular surface, and the correlation between the concentration of sIL-6R and the clinical score was studied. The concentration of sIL-6R in tears in the VKC, AKC, GPC, and control groups was 5.1 ± 4.7, 1.2 ± 1.7, 2.6 ± 2.8, and 0.5 ± 4.3 (mean ± SD) ng/ml, respectively. The concentrations of sIL-6R in tears in the VKC and GPC groups were significantly higher than those in the control group (P < 0.001 and 0.05, respectively). The AKC group showed no significant change in the concentration of sIL-6R in tears in comparison with the control group. The gp130/GAPDH mRNA ratio was significantly higher in the patients with ACD than in control individuals (P < 0.05). The concentration of sIL-6R in tears and the clinical score of allergic inflammation of the ocular surface were significantly correlated in the VKC group (r = 0.53, P < 0.01). We concluded that IL-6/sIL-6R complex trans-signaling via gp130 is an exacerbating factor of ACD, and that the concentration of sIL-6R in tears is a useful clinical biomarker in patients with ACD. Jpn J Ophthalmol 2007;51:332–337 © Japanese Ophthalmological Society 2007
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Evaluation of Total and Allergen-Specific Secretory IgA in Tears of Allergic Conjunctival Disease Patients
Japanese Journal of Ophthalmology, 2007Co-Authors: Noriko Inada, Jun Shoji, Mai Hoshino, Mitsuru SawaAbstract:Purpose To investigate the variations in total secretory IgA (sIgA) and house dust mite (HDM)-specific sIgA antibodies in tears of patients with allergic Conjunctival Disease (ACD). Methods The subjects comprised 40 patients (40 eyes) with ACD and 21 healthy individuals as a control. Patients with ACD comprised three groups: 16 patients (16 eyes) with perennial allergic conjunctivitis (PAC group), 11 patients (11 eyes) with atopic keratoconjunctivitis (AKC group), and 13 patients (13 eyes) with vernal keratoconjunctivitis (VKC group). Tear samples were taken by the Schirmer I method using filter paper. Tear samples were eluted and analyzed for total sIgA and HDM-specific sIgA antibodies in tears by enzyme-linked immunosorbent assay. Results The mean (±SD) value of total sIgA in tears in the control, PAC, AKC, and VKC groups was 1446.7 ± 1220.1, 706.8 ± 567.2, 440.4 ± 151.8, and 460.8 ± 340.6 µg/ml, respectively. Total sIgA values were significantly lower in the VKC group than in the control group. We defined the HDM index as the ratio of HDM-specific sIgA to total sIgA. The HDM index in the VKC ( P < 0.001), AKC ( P < 0.001), and PAC ( P < 0.001) groups was significantly higher compared with those in the control group. Conclusions Low levels of total sIgA and high levels of HDM-specific sIgA indicate a local pathogenic factor in ACD. Jpn J Ophthalmol 2007;51:338–342 © Japanese Ophthalmological Society 2007
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Concentration of Soluble Interleukin-6 Receptors in Tears of Allergic Conjunctival Disease Patients
Japanese Journal of Ophthalmology, 2007Co-Authors: Jun Shoji, Atsuri Kawaguchi, Aki Gotoh, Noriko Inada, Mitsuru SawaAbstract:Purpose To evaluate the significance of soluble interleukin-6 receptor (sIL-6R) in tears as a clinical indicator of Disease exacerbation in patients with allergic conjunctivitis Disease (ACD). Methods The study groups comprised 13 patients (13 eyes) with vernal keratoconjunctivitis (VKC group), 13 patients (13 eyes) with atopic keratoconjunctivitis (AKC group), 11 patients (11 eyes) with giant papillary conjunctivitis (GPC group), and 10 healthy volunteers (10 eyes) as a control. Tear samples were collected by the Schirmer I method using filter paper. Tear samples were eluted and the concentration of sIL-6R in tear samples was determined by enzyme-linked immunosorbent assay. Impression cytology using a nitrocellulose membrane was applied to the upper tarsal conjunctiva, and the mRNA of the signal-transducing molecule glycoprotein 130 (gp130) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was extracted from the membrane and analyzed by semiquantitative reverse transcription-polymerase chain reaction. In the VKC group, the clinical score was graded on the basis of allergic inflammation of the ocular surface, and the correlation between the concentration of sIL-6R and the clinical score was studied. Results The concentration of sIL-6R in tears in the VKC, AKC, GPC, and control groups was 5.1 ± 4.7, 1.2 ± 1.7, 2.6 ± 2.8, and 0.5 ± 4.3 (mean ± SD) ng/ml, respectively. The concentrations of sIL-6R in tears in the VKC and GPC groups were significantly higher than those in the control group ( P < 0.001 and 0.05, respectively). The AKC group showed no significant change in the concentration of sIL-6R in tears in comparison with the control group. The gp130/GAPDH mRNA ratio was significantly higher in the patients with ACD than in control individuals ( P < 0.05). The concentration of sIL-6R in tears and the clinical score of allergic inflammation of the ocular surface were significantly correlated in the VKC group ( r = 0.53, P < 0.01). Conclusions We concluded that IL-6/sIL-6R complex trans-signaling via gp130 is an exacerbating factor of ACD, and that the concentration of sIL-6R in tears is a useful clinical biomarker in patients with ACD. Jpn J Ophthalmol 2007;51:332–337 © Japanese Ophthalmological Society 2007
Naoki Kumagai - One of the best experts on this subject based on the ideXlab platform.
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Topical Tacrolimus for Chronic Allergic Conjunctival Disease with and without Atopic Dermatitis.
Current eye research, 2019Co-Authors: Jun Shoji, Hiroshi Fujishima, Naoki Kumagai, Yuichi Ohashi, Atsuki Fukushima, Dai Miyazaki, Eiichi Uchio, Etsuko Takamura, Kenichi Namba, Nobuyuki EbiharaAbstract:Purpose/Aim: This study evaluated the efficacy of topical 0.1% tacrolimus ophthalmic suspension for treating chronic allergic Conjunctival Disease with and without atopic dermatitis.Materials and M...
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Japanese guidelines for allergic Conjunctival Diseases 2017
Elsevier, 2017Co-Authors: Etsuko Takamura, Jun Shoji, Nobuyuki Ebihara, Naoki Kumagai, Yuichi Ohashi, Eiichi Uchio, Shigeki Okamoto, Yoshiyuki Satake, Shigeaki Ohno, Yayoi NakagawaAbstract:The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic Conjunctival Disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition) revised in 2010. Allergic Conjunctival Disease is defined as “a Conjunctival inflammatory Disease associated with a Type I allergy accompanied by some subjective or objective symptoms.” Allergic Conjunctival Disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include Conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by Conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic Conjunctival Diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic Conjunctival Disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the abovementioned drugs
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Japanese Guideline for Allergic Conjunctival Diseases
Allergology international : official journal of the Japanese Society of Allergology, 2011Co-Authors: Etsuko Takamura, Jun Shoji, Nobuyuki Ebihara, Naoki Kumagai, Yuichi Ohashi, Eiichi Uchio, Shigeki Okamoto, Yoshiyuki Satake, Shigeaki Ohno, Yayoi NakagawaAbstract:ABSTRACT The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic Conjunctival Disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition) revised in 2010. Allergic Conjunctival Disease is defined as “a Conjunctival inflammatory Disease associated with a Type I allergy accompanied by some subjective or objective symptoms.” Allergic Conjunctival Disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include Conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by Conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic Conjunctival Diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic Conjunctival Disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the abovementioned drugs.
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role of structural cells of the cornea and conjunctiva in the pathogenesis of vernal keratoconjunctivitis
Progress in Retinal and Eye Research, 2006Co-Authors: Naoki Kumagai, Ken Fukuda, Youichiro Fujitsu, Kazutaka Yamamoto, Teruo NishidaAbstract:Vernal keratoconjunctivitis (VKC) is a severe type of allergic Conjunctival Disease characterized by the presence both of various corneal epithelial and stromal lesions as well as of Conjunctival proliferative changes such as giant papillae of the upper tarsal conjunctiva and limbal lesions. These clinical findings as well as various pathophysiological characteristics of VKC are distinct from those of other types of ocular allergy and allergic Diseases of other organs. The outer eye possesses specific allergological characteristics, one of which is communication between the cornea and conjunctiva through a thin layer of tear fluid. Fibroblasts of the cornea and the conjunctiva are activated by proinflammatory and T helper 2 (Th2) cell-derived cytokines. Corneal fibroblasts enhance ocular allergic reactions as a result of their activation-induced expression both of chemokines such as eotaxin and TARC as well as of adhesion molecules such as ICAM-1 and VCAM-1, all of which together promote the activation and infiltration of eosinophils and Th2 lymphocytes. In contrast, corneal epithelial cells suppress such reactions by physically separating corneal fibroblasts from bioactive substances in tear fluid. Exaggerated proliferation of and deposition of extracellular matrix by Conjunctival fibroblasts likely exacerbate Conjunctival inflammation. Restoration of an intact corneal epithelium and inhibition of the activities of corneal and Conjunctival fibroblasts may provide a basis for the development of new treatments for severe ocular allergic Diseases such as VKC.
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Treatment of Corneal Lesions in Individuals with Vernal Keratoconjunctivitis
Allergology International, 2005Co-Authors: Naoki Kumagai, Ken Fukuda, Youichiro Fujitsu, Keisuke Seki, Teruo NishidaAbstract:Vernal keratoconjunctivitis, a severe form of allergic Conjunctival Disease, is characterized by the development of various types of corneal lesions in conjunction with proliferative changes in the conjunctiva. Expression of bioactive substances, such as chemokines and adhesion molecules, by corneal fibroblasts likely contribute to the formation of corneal lesions by promoting local infiltration, activation, and survival of immune cells. Proliferation and deposition of extracellular matrix by Conjunctival fibroblasts also may provide conditions which support the activation and survival of immune cells. Topical administration of corticosteroids is the principal mode of treatment for Conjunctival inflammation in individuals with vernal keratoconjunctivitis. In some individuals, however, the surgical removal of Conjunctival giant papillae or of corneal plaques is indicated.
Teruo Nishida - One of the best experts on this subject based on the ideXlab platform.
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role of structural cells of the cornea and conjunctiva in the pathogenesis of vernal keratoconjunctivitis
Progress in Retinal and Eye Research, 2006Co-Authors: Naoki Kumagai, Ken Fukuda, Youichiro Fujitsu, Kazutaka Yamamoto, Teruo NishidaAbstract:Vernal keratoconjunctivitis (VKC) is a severe type of allergic Conjunctival Disease characterized by the presence both of various corneal epithelial and stromal lesions as well as of Conjunctival proliferative changes such as giant papillae of the upper tarsal conjunctiva and limbal lesions. These clinical findings as well as various pathophysiological characteristics of VKC are distinct from those of other types of ocular allergy and allergic Diseases of other organs. The outer eye possesses specific allergological characteristics, one of which is communication between the cornea and conjunctiva through a thin layer of tear fluid. Fibroblasts of the cornea and the conjunctiva are activated by proinflammatory and T helper 2 (Th2) cell-derived cytokines. Corneal fibroblasts enhance ocular allergic reactions as a result of their activation-induced expression both of chemokines such as eotaxin and TARC as well as of adhesion molecules such as ICAM-1 and VCAM-1, all of which together promote the activation and infiltration of eosinophils and Th2 lymphocytes. In contrast, corneal epithelial cells suppress such reactions by physically separating corneal fibroblasts from bioactive substances in tear fluid. Exaggerated proliferation of and deposition of extracellular matrix by Conjunctival fibroblasts likely exacerbate Conjunctival inflammation. Restoration of an intact corneal epithelium and inhibition of the activities of corneal and Conjunctival fibroblasts may provide a basis for the development of new treatments for severe ocular allergic Diseases such as VKC.
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Treatment of Corneal Lesions in Individuals with Vernal Keratoconjunctivitis
Allergology International, 2005Co-Authors: Naoki Kumagai, Ken Fukuda, Youichiro Fujitsu, Keisuke Seki, Teruo NishidaAbstract:Vernal keratoconjunctivitis, a severe form of allergic Conjunctival Disease, is characterized by the development of various types of corneal lesions in conjunction with proliferative changes in the conjunctiva. Expression of bioactive substances, such as chemokines and adhesion molecules, by corneal fibroblasts likely contribute to the formation of corneal lesions by promoting local infiltration, activation, and survival of immune cells. Proliferation and deposition of extracellular matrix by Conjunctival fibroblasts also may provide conditions which support the activation and survival of immune cells. Topical administration of corticosteroids is the principal mode of treatment for Conjunctival inflammation in individuals with vernal keratoconjunctivitis. In some individuals, however, the surgical removal of Conjunctival giant papillae or of corneal plaques is indicated.