Understanding Vernal Keratoconjunctivitis: Beyond Allergic Mechanisms

Vernal keratoconjunctivitis (VKC) is a chronic, recurrent, inflammatory disease of the cornea and conjunctiva mostly affecting boys in prepubertal age. VKC recurrence is characterized by intense symptoms of itching, redness, and photophobia associated with corneal damage, impairment of visual functi...

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Bibliographic Details
Published in:Life (Basel, Switzerland) Switzerland), 2021-09, Vol.11 (10), p.1012
Main Authors: Sacchetti, Marta, Plateroti, Rocco, Bruscolini, Alice, Giustolisi, Rosalia, Marenco, Marco
Format: Article
Language:English
Subjects:
allergic disease
Allergic diseases
Asthma
Biomarkers
Conjunctiva
Cornea
Disease
Eosinophils
Extracellular matrix
Histamine
Immunity
Immunoglobulin E
Inflammation
Inflammatory diseases
Innate immunity
Itching
Keratoconjunctivitis
Leukocytes (eosinophilic)
Lymphocytes
Mast cells
Medical personnel
neuroinflammation
Pathogenesis
Pruritus
Puberty
Quality of life
Review
Rhinitis
sex hormones
Signs and symptoms
Steroids
Tumor necrosis factor-TNF
Ulcers
vernal keratoconjunctivitis
Visual perception
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Summary:Vernal keratoconjunctivitis (VKC) is a chronic, recurrent, inflammatory disease of the cornea and conjunctiva mostly affecting boys in prepubertal age. VKC recurrence is characterized by intense symptoms of itching, redness, and photophobia associated with corneal damage, impairment of visual function, and quality of life. The pathogenesis of VKC has not yet been completely understood, and it is still controversial. In fact, VKC is considered an ocular allergic disease due to the involvement of immunoglobulin E, eosinophils, and mast cells, and of a lymphocyte T-helper type 2 reaction. However, approximately half of VKC patients have negative allergological history and testing, suggesting that other pathogenic mechanisms participate in VKC development and severity. Specifically, evidence suggests that genetic, endocrine, neuronal factors and an imbalance of innate immunity are involved in the pathogenesis of VKC. The purpose of this review is to summarize evidence on the pathogenic role of innate immunity, neuroimmune reaction, and hormonal changes in VKC. Increasing understanding of the pathogenic mechanisms behind VKC may lead to the identification of novel biomarkers for diagnosis and/or potential therapeutic targets in order to improve the management of this challenging condition.
ISSN:2075-1729
2075-1729
DOI:10.3390/life11101012