[Remodeling in ocular allergic diseases].

Vernal keratoconjunctivitis (VKC), a chronic and severe form of ocular allergic disease, is characterized by tissue remodeling such as the formation of giant papillae at the upper tarsal conjunctiva and the development of corneal plaques. Giant papillae develop as a result of infiltration of inflammatory cells, changes in the epithelial layer, increased deposition of extracellular matrix molecules, proliferation of conjunctival fibroblasts, and an increase in the number of blood vessels. Corneal plaques form subsequent to corneal epithelial defects, and their surface remains uncovered by the corneal epithelium; consequensly, corneal epithelial cells are not able to attach to or migrate over the plaques. These remodeling lesions not only affect tissue structure but also contribute to amplification of allergic inflammation in the conjunctiva and cornea. Recent evidence from in vitro studies indicates that activated fibroblasts play a central role in the induction and amplification of ocular allergic inflammation and the consequent development of giant papillae and corneal disorders in individuals with VKC. Tissue remodeling thus represents a potential therapeutic target for treatment of VKC.