Comparative Analysis of Inflammatory Mediators in Children, Adolescents, and Adults with Vernal Keratoconjunctivitis.

PURPOSE: This study aims to analyze the expression of presumably critical inflammatory mediators including cytokines, chemokines, secretory, binding, and matrix proteins, and IgE in Vernal keratoconjunctivitis (VKC)-relevant age groups: children, adolescents, and adults.

METHODS

The tears (n = 16) and serum (n = 12) samples from active, chronic VKC cases, without treatment at the time of sampling, were collected from the tertiary eye care centers of L V Prasad Eye Institute, located in Hyderabad and Bhubaneswar, during 2021-2022. The age-matched healthy individuals were taken as controls. The subjects were grouped as: children (1-11 years), adolescents (12-21 years), and adults (> 21 years). The expression of a specific panel of Th1- (IL-36γ and MMP-9) and Th2-inflammatory mediators (IL-6, Vitamin D-binding protein (VDBP), MUC5AC, FcεR1, MCP-1, IgE, GM-CSF) was analyzed through ELISA.

RESULTS

Compared to controls, the expression of IgE was upregulated in tears and serum samples of all VKC patients, whereas IL-6, MMP-9, and MUC5AC were upregulated, and VDBP was downregulated in children's tear samples. The VDBP and MCP-1 recorded the highest and lowest protein expression (pg/ml) among all the inflammatory mediators, respectively. The IL-36γ was upregulated in tears and serum samples of adolescents and adults.

CONCLUSIONS

Our results suggest differential expressions of chosen Th1- and Th2-mediators in tears and serum samples of children, adolescents, and adults with active VKC. Compared with controls, our findings specifically suggest: i) upregulation of IgE, IL-6, MMP-9, and MUC5AC, and downregulation of VDBP in tear samples of children, and ii) upregulation of IgE and IL-36γ in adolescents and adults.