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The effect of cyclophosphamide on the recovery from a local chlamydial infection. Guinea-pig inclusion conjunctivitis (GPIC).

The immune mechanism involved in the recovery from and resistance to guinea-pig inclusion conjunctivitis (GPIC) was studied. Guinea-pigs were injected with a dose of cyclophosphamide (CY) (300 mg/kg wt) that inhibits antibody synthesis. Such treatment was shown to produce a cellular depletion in the B-cell area without producing an appreciable change in the T-cell area of the spleen and lymph nodes. CY treatment markedly delayed the appearance of secretory immunoglobulin A antibody to GPIC in the tears, and other classes of antibodies to GPIC and sheep erythrocyte in the serum. Furthermore, recovery from infection was impaired and a subsequent injection of CY prolonged the duration of infection. The results indicate that B cells may play an important role in the control of this infection.

Animals↗

Antazoline phosphate and naphazoline hydrochloride, singly and in combination for the treatment of allergic conjunctivitis-a controlled, double-blind clinical trial.

A controlled, double-blind comparison of naphalzoline hydrochloride 0.05%, antazoline phosphate 0.5%, a combination of both components and a placebo was performed on 51 ragweed sensitive patients presenting allergic conjunctivitis. Evaluation of response at various times after instillation of medication for lacrimation, conjunctival inflammation, pruritus, photophobia and pain showed naphazoline hydrochloride, antazoline phosphate and the combination product superior to placebo. The combination product was statistically significantly superior for conjunctival inflammation and photophobia. The need for post-challenge treatment with epinephrine hydrochloride was significantly less in those eyes treated with the combination product. demonstrating prophylactic efficacy.

Adolescent↗

Isolation of avian influenza virus (H10N7) from an emu (Dromaius novaehollandiae) with conjunctivitis and respiratory disease.

Avian influenza virus was isolated from the conjunctiva of a male emu chick. Clinical observations included ocular discharge, dyspnea, and mild respiratory signs. Lesions included conjunctivitis, tracheitis, bronchopneumonia, and airsacculitis. Escherichia coli was isolated from the conjunctiva and the sinus, and Staphylococcus sp. was isolated from the conjunctiva. Influenza A viral nucleoprotein was detected immunohistochemically in epithelial cells of the bronchi, lung parenchyma and tracheal mucosa, and mononuclear inflammatory cells within the exudate of the bronchial lumen; conjunctiva, air sacs, kidney, intestine, and liver were negative for the viral nucleoprotein. The isolated influenza virus was typed as H10N7 and was determined to be nonpathogenic for chickens.

Air Sacs↗

[The clinico-statistical aspects in allergic conjunctivitis].

Ocular allergy represents the hypersensitivity reaction of the ocular surfaces in contact with the external environment. Allergic conjunctivitis are one of the frequent disorders of the clinical practice. In this paper we present statistically the cases attended in our service for one year, a few pathogenetical factors; the positive diagnose and the therapeutic strategy.

Conjunctivitis, Allergic↗

[Azelastine in the treatment of allergic conjunctivitis].

The efficiency of azelastin (eye drops) in allergic conjunctivitis was evaluated. Ophthalmological, specific allergological, bacteriological, and cytological studies were carried out in 3 groups of patients. Group 1 was treated with claritin (orally), group 2 with azelastin (eye drops), and group 3 with both. The treatment was effective in all 3 groups. Regression of the clinical symptoms started earlier in groups 2 and 3 and was observed throughout the entire period of observation.

Administration, Oral↗

Alteration in goblet cell numbers and mucin gene expression in a mouse model of allergic conjunctivitis.

PURPOSE: To determine whether the number of filled conjunctival goblet cells and mucin gene expression are altered in a mouse model of allergic conjunctivitis. METHODS: A/J mice were sensitized intraperitoneally with cat dander or the peptide P3-1 from the protein Fel d1. Two weeks later, the mice were challenged for 7 consecutive days with eye drops containing the allergens. Conjunctival tissue was harvested at 0, 6, 24, or 48 hours after final antigen challenge. Control samples were naïve animals and mice sensitized with cat dander and challenged with OVA-peptide or PBS. The mean number of filled goblet cells per square millimeter in three forniceal fields for each group was determined in wholemounts of conjunctiva prepared using rhodamine-phalloidin labeling followed by confocal microscopy. RNA was isolated from conjunctiva of the contralateral eye and taken for relative quantitation of mRNA of the goblet cell mucin Muc5AC and the epithelial membrane-spanning mucin Muc4, by real-time RT-PCR. RESULTS: The number of filled goblet cells was significantly decreased with both cat dander and P3-1, after final ocular challenge (P < 0.001). The most significant decrease over naïve mice was seen at 6 hours after final challenge with both allergens. The number of filled goblet cells was still decreased but was returning toward naïve levels at 24 hours (P < 0.05), and at 48 hours no significant difference was seen compared with naïve, PBS-treated, and OVA-peptide-treated control samples. For both cat dander and P3-1, Muc5AC and Muc4 mRNA was found to be decreased at the time of final ocular challenge. The level of Muc5AC mRNA from goblet cells rebounded from the decrease to show an increase over control by 24 hours after final challenge, and by 48 hours, the mRNA level had returned to naïve control range. In contrast, significant increases in Muc5AC mRNA were evident after final control challenge with PBS or OVA-peptide, indicating a potential irritant effect of drop application. The Muc4 mRNA level was significantly reduced at all time points except 24 hours after the last challenge. By comparison with allergen-challenged eyes, no change in Muc4 message levels was noted at any time point in OVA-peptide- or PBS-treated control eyes. CONCLUSIONS: These findings demonstrate that, in the conjunctiva of mice, repetitive application of allergens induces a reduction in the number of filled goblet cells and a decrease in Muc5AC and Muc4 mRNAs. After a period of 24 to 48 hours, the goblet cell number return to naïve levels, and goblet cell mucin mRNA levels return to above or within normal range, indicating a rapid recovery in the mucus secretion system.

Allergens↗

[Ligneous conjunctivitis: a case report].

We report a case of ligneous conjunctivitis in a young patient and we describe the clinical findings and the histological aspects of the lesions, which allows us to sum up the treatment of this rare disorder. We recommend the use of topical ciclosporine, heparin, and corticosteroids. To conclude we analyse the different way in which the disease can evolue.

Administration, Topical↗

When is red eye not just conjunctivitis?

Red eyes are not 'just conjunctivitis' when there is significant pain or associated loss of sight. However, you are pretty safe to treat pain-free eyes and the normally seeing red eye with reasurance, lid hygiene advice and bland topical medication. But beware patients wearing soft lenses, and the red eyes of tiny babies or elderly patients, particularly those with apparent acute gastroenteritis.

Conjunctivitis↗

[Effects of iodine on experimental allergic conjunctivitis].

PURPOSE: To evaluate the anti-allergic effect of iodine in an allergic conjunctivities model. METHODS: Guinea pigs (n = 107) were administered iodine at three different concentrations in feed. Twenty Guinea pigs were passively sensitized by serum containing ovalbumin (OA) antibody, and eighteen Guinea pigs were actively sensitized by OA intraperitoneal injection. OA was dropped into the eye and the degree of chemosis was determined 15 minutes after challenge. Six hours later, eosinophils infiltrating the conjunctiva were counted, and iodine, histamine and triiodothyronine concentrations in blood were measured. In addition, platelet activating factor (PAF) was dropped into the eye of sixty non-sensitized Guinea pigs. Eosinophils infiltrating the conjunctiva were counted at 30 min, and 1, 2, and 4 hours later. Mast cells in the conjunctiva of nine other non-sensitized Guinea pigs were observed under an electron microscope to determine the effect of iodine on mast cells. RESULTS: As the iodine concentration in blood increased, there was less chemosis, fewer eosinophils, and a lower histamine concentration in the blood. Eosinophilic infiltration induced by PAF was not inhibited. Granules showing a low-density area in mast cells were increased. CONCLUSION: Iodine exerted an anti-allergic effect, thought to be mediated through mast cells rather than PAF.

Animals↗

Detection & differentiation of Coxsackie A 24 variant isolated from an epidemic of acute haemorrhagic conjunctivitis in north India by RT-PCR using a novel primer pair.

BACKGROUND & OBJECTIVES: An epidemic of acute haemorrhagic conjunctivitis (AHC) occurred in north India during July to September 1994. We report a reverse transcription-polymerase chain reaction (RT-PCR) using known and novel primers to differentiate and identify the CA 24 virus isolated from the epidemic of AHC. METHODS: Conjunctival swabs were collected from 46 patients (in 12 patients from both the eyes) yielding 58 swabs. The swabs were inoculated in RD 19S and HeLa-199 cell monolayers and observed for cytopathic effect. Serum neutralizing antibodies were tested in 17 acute and 10 convalescent phase serum samples. RT-PCR was done on 9 isolates (7 Coxsackie A 24 and 2 ECHO-1 as identified by neutralization test) using known and a novel primer. Fourteen virus isolates (9 CA 24, 3 ECHO-1 and 2 untyped) were inoculated in suckling mice and these mice were observed daily for 10 days for flaccid paralysis of hind limb or death. RESULTS: Cytopathic virus was isolated from conjunctival swabs in 21 of 46 (45.6%) patients subjected to virus isolation. Sixteen of 21 (76.2%) isolates were neutralized by CA 24 specific antisera, 3 isolates were identified as ECHO-1 with Schmidt enteroviruses antiserum pools while 2 remained untypable. Of these 21 isolates, 9 representative isolates (7 CA 24 and 2 ECHO-1) tested by RT-PCR had enterovirus common region DNA but did not show any amplification in RT-PCR with EV-70 specific primers (VP-1 and VP-3). Using CA 24 specific novel (VP 3-1) primers amplification was seen in 6 of 7 CA 24 isolates while 2 ECHO-1 remained unamplified. In contrast with 3C-proteinase region primers, only 2 of 7 CA 24 were amplified along with false amplification of both ECHO-1. Serum neutralizing antibodies were seen in 2 of 17 (11.7%) acute phase sera and 6 of the 10 (60%) convalescent phase sera while in paired sera (available in two patients) a four-fold rise in titres were observed. Hind-limb paralysis and/or death occurred in all suckling mice inoculated with CA 24 isolates while mice remained healthy after inoculation with 3 isolates of ECHO-1 and 2 untypable isolates. INTERPRETATION & CONCLUSION: The epidemic of AHC was caused by a variant of CA 24. Molecular typing can detect and differentiate between CA 24 and EV-70 viruses. Novel primer pair was found useful in the identification and confirmation of CA 24 isolates.

Adolescent↗

[Effectiveness and impact in the quality of life of ketotifen ophthalmic solution. Results of zeta study in patients with seasonal allergic conjunctivitis].

PURPOSE: To study the effectiveness of ketotifen ophthalmic solution (0.25 mg/ml) in seasonal allergic conjunctivitis (SAC) and the impact on the patient's quality of life. METHODS: A multicentric, longitudinal, prospective study was designed. 284 Spanish ophthalmologists participated recruiting 1145 patients with SAC. After obtaining the informed consent, a drop of ketotifen ophthalmic solution was instilled. At the visit, clinical symptoms pre and post-treatment were assessed. The patients answered a questionnaire of quality of life (QOL) pre-treatment and minimum one week after initiating the treatment. The qualitative variables were described by the percentage, and the quantitative were described by the average, median, standard deviation, and maximum and minimum values. The effectiveness (change of intensity of the symptoms) and the quality of life were studied by the Wilcoxon test with a significance level of 5% (alpha = 0.05). RESULTS: Following the instillation of the ketotifen ophthalmic solution the intensity of the ocular symptoms (redness, edema, tearing, secretion, photophobia and visual acuity impairment) decreased significantly. Comparing both QOL, we observed a statistically significant reduction of the limitation perceived by the patients in their daily activities, animic state and ocular symptoms. In 0,7% some adverse event was referred, none was serious and only in one case the probable relationship with the drug was specified. CONCLUSION: The results of the ZETA study demonstrate the tolerability and effectiveness of the ketotifen ophthalmic solution for all the symptoms of SAC in clinical practice, observing improvement in the quality of life of the patient.

Adolescent↗

[A preliminary epidemiological survey of acute hemorrhagic conjunctivitis in Guangzhou during July to September in 1988].

An epidemic of acute hemorrhagic conjunctivitis (AHC) occurred in Guangzhou from July to September in 1988. The main clinical symptoms were feeling of foreign, smart pain, discharging ege, facial edema and conjunctival congestion. In some cases there were headache and fever. The patients recovered rapidly. Epidemiologic feature were that the incubation period of AHC is short, rapid spread, wide prevalence and high attack rate. Approximately 490000 cases of AHC are estimated to occur in Guangzhou from July to September in 1988, with the attack rate is about 79.5%. Most patients were 20 to 59 age group (72.3%). The highest age of patient was 79 years old. The lowest age of patient was 6 months old. Both etiologic and serologic studies showed that this outbreak of AHC was caused by EV70, and then developed a mixed epidemic of Cox A24 and EV70.

Adolescent↗

[An etiology study on the 1986 epidemic of acute hemorrhagic conjunctivitis in China].

An epidemic of Acute Hemorrhagic Conjunctivitis (AHC) broke out in Shanghai, Henan and Fujian provinces of China in 1986. Twenty four strains of etiologically suspected virus were then isolated but not correctly identified. In 1990 9 out of 24 strains from these three places were re-examined by us in our laboratory, and found feasible to be neutralized by CA 24V antiserum, but not by antiserum to EV 70 as once reported by Henan. It was also found that these viruses (one strain from each of these three places) produced pathogenic changes in suckling mice, showed definite immuno-fluorescence with Mcabs, and were neutralized by McAbs against CA 24V which was isolated from Beijing by our laboratory in 1988. It is evident that all the isolates isolated from Shanghai, Henan and Fujian provinces in 1986 were Coxsackie-virus A 24 variant (CA 24V).

Animals↗

Neisserian conjunctivitis; treatment with penicillin.

Data on treatment of 45 patients with Neisserian conjunctivitis demonstrate that penicillin is a reliable therapeutic agent in this disease. Exudate must be frequently flushed out of the conjunctival sac to prevent corneal ulcer and endophthalmitis. Penicillin may be administered intramuscularly or topically, in solution. The use of penicillin solution topically has been demonstrated to be superior to intramuscular penicillin in some cases, and to be adequate in all cases, even when saline solution irrigations are the only other therapy.

Conjunctiva↗

An epidemic of acute haemorrhagic conjunctivitis caused by coxsackie A24 variant.

An epidemic of acute haemorrhagic conjunctivitis (AHC) caused by a variant of coxsackie A24 (cox A24) occurred in Delhi during August to September 1988. Cox A24 antigen was detected by indirect immunofluorescence (IFA) in conjunctival cell smears of 13 of the 38 (34.2%) patients studied. Virus was isolated from conjunctival swabs in 11 (28.9%) patients and all isolates were neutralized by cox A24 antiserum. Five virus strains sent to Virology Division of Centres for Disease Control, Atlanta, USA, were confirmed as cox A24 variant. Enterovirus type 70 (EV70) was not demonstrable either by IFA or neutralization tests. Conjunctival swabs from 10 healthy laboratory controls did not show any evidence of EV70 or cox A24 virus or their antigens.

Acute Disease↗

Clinical signs and symptoms are not enough for the correct diagnosis of allergic conjunctivitis.

BACKGROUND: Allergic Conjunctivitis (AC) has a high incidence in the general population and sometimes it is difficult to make a correct diagnosis, distinguish among the different subtypes of AC, and therefore, to indicate the suitable therapy. OBJECTIVE: To determine the best way to carry out an appropriate diagnosis of AC. METHODS: Thirty-one patients with clinical manifestations of AC and eleven controls were studied by measuring allergic and immunologic parameters. Only those patients confirmed as having AC were treated with ketotifen fumarate and further evaluated. RESULTS: According to allergic and immunological parameters, patients were divided into two groups. Group I patients had positive prick test toward at least one allergen, 60% exhibited high levels of tear-IgE, and only 36% conjunctival eosinophils. By contrast, patients from Group II had negative prick tests and laboratory findings similar to the control group. In group I there was a good correlation between levels of tear-IgE and eosinophils (r = 0.55; p = 0.009); key symptoms and signs and prick test (r = 0.52; p = 0.015), and prick test and eosinophils (r = 0.50 p = 0.022). The cardinal signs and symptoms scores dropped significantly in Group I as a consequence of the treatment (p < 0.0001). CONCLUSION: In order to have a reliable AC diagnosis, allergen-skin prick test, IgE in tears, and conjunctival eosinophils must be studied. Serum IgE is less important.

Adolescent↗