Background: Recently, the potential role of mast cells in allergic reactions has been extended by the discovery that these cells synthesize, store and secrete multifunctional cytokines. Seasonal allergic conjunctivitis is characterized as an immediate hypersensitivity reaction, in which allergen binds to specific IgE on mast cells, leading to release of pre-formed and newly synthesized inflammatory mediators.
Objective: In this study we aimed to localize the cytokines IL-4, IL-5, IL-6, IL-8 and TNF alpha to conjunctival mast cells and to examine the relationship between mast cell-associated cytokines and allergic conjunctivitis.
Methods: Immunohistochemistry was performed on serial sections of conjunctival biopsies from patients with seasonal allergic conjunctivitis, in and out of the hay fever season, as well as from non-allergic volunteers.
Results: IL-4, IL-5, IL-6 and TNF alpha were localized to mast cells in normal and allergic conjunctiva. IL-8 was localized to mast cells in two patients with seasonal allergic conjunctivitis, one during and the other outside the pollen season. Using the monoclonal antibody 3H4, which identifies the secreted form of IL-4, biopsies from patients with active seasonal allergic conjunctivitis contained a significantly higher proportion of mast cells positive for IL-4, than those from out-of-season patients (P=<0.016). There was no difference between the two groups in the number of mast cells immunostained by the antibody 4D9 which identifies the stored form of IL-4.
Conclusions: These results suggest that conjunctival mast cells can store a range of multifunctional cytokines and release IL-4 during active disease, which may give them an important role in upregulating allergic inflammation in the conjunctiva.