EOSINOPHIL CATIONIC PROTEIN IN TEARS OF NORMAL SUBJECTS AND PATIENTS AFFECTED BY VERNAL KERATOCONJUNCTIVITIS

The objectives of this study were to determine: 1) levels of tear eosi nophil cationic protein (ECP) in patients with vernal keratoconjunctiv itis (VKC); 2) the effect of pharmacologic therapy on ECP release; and 3) the correlation of this mediator with the severity of the disease. Tears were collected fi om 10 controls and 20 VKC patients before and after therapy for cytologic analysis and ECP measurement by radioimmu noassay. Ocular signs and symptoms were evaluated before tear collecti on. Mean ECP levels in controls were 7.5 +/- 0.4 mu g/l, and in VKC pa tients, 988.3 +/- 128 mu g/l before therapy (P<0.001) and 566.3 +/- 12 1 mu g/l after therapy (P<0.005). In dexamethasone (Dex) 0.1% or cyclo sporin A (CsA) 2% patients (five per group), tear ECP decreased signif icantly after 7-14 days of treatment. Disodium cromoglycate (DSCG) 4% (five patients) for 14 days did not significantly affect ECP levels. E CP levels were significantly correlated with allergic signs (P<0.001), symptoms (P<0.001), and the number of eosinophils in tears (P<0.005). The results of this study suggest that tear ECP levels accurately ref lect the clinical status of VKC patients. The measurement of ECP may p rove useful not only in the diagnosis and monitoring of allergic disea se, but also as an objective parameter for the evaluation of new antia llergic therapies.