Abstract:
Vernal keratoconjunctivitis (VKC) is a complex and multifactorial disease process that employs Th2 cell-mediated immunologic processes, which involves the overexpression of interleukin 4 (IL-4), IL-5, IL-9, IL-13, and IL-31, and the activation of mast cells that release IL-5 and CCL-11, recruiting eosinophils to the site of inflammation. The disease primarily affects young males and is more common in regions with warm climates. VKC is characterized by persistent and recurrent conjunctival inflammation that can adversely affect the patient\'s quality of life, and, when inadequately treated, may lead to a host of ocular complications, such as corneal shield ulcers and scarring. The major distinct forms of VKC include limbal or palpebral, which may occur in combination. The clinicopathological features of VKC include the presence of pseudogerontoxon, limbal gelatinous hyperplasia, and perilimbal hyperpigmentation. Topical immunomodulators are effective anti-steroidal options for controlling severe and chronic cases of VKC. This review will provide a brief overview of topical immunomodulators, including cyclosporin and tacrolimus, and will highlight the clinical manifestations, pathological mechanisms, and fibroproliferative changes in the conjunctiva that can result from recurrent disease.
摘要:
春季角膜结膜炎(VKC)是一种复杂的多因素疾病过程,采用Th2细胞介导的免疫过程,其中涉及白细胞介素4(IL-4)的过度表达,IL-5,IL-9,IL-13和IL-31,以及释放IL-5和CCL-11的肥大细胞的激活,将嗜酸性粒细胞招募到炎症部位。这种疾病主要影响年轻男性,在气候温暖的地区更常见。VKC的特点是持续性和复发性结膜炎症,可对患者的生活质量产生不利影响。and,如果治疗不当,可能会导致一系列眼部并发症,如角膜屏蔽性溃疡和疤痕。VKC的主要不同形式包括角膜缘或眼睑,这可能发生在组合。VKC的临床病理特征包括存在假性脑龙毒素,角膜缘胶质增生,和周围的色素沉着.局部免疫调节剂是控制严重和慢性VKC病例的有效抗类固醇选择。这篇综述将简要概述局部免疫调节剂,包括环孢菌素和他克莫司,并将突出临床表现,病理机制,和结膜的纤维增生性变化,这可能是由疾病复发引起的。