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Original article
IgE and eosinophil cationic protein (ECP) as markers of severity in the diagnosis of atopic keratoconjunctivitis
  1. Tais H Wakamatsu1,2,
  2. Yoshiyuki Satake3,
  3. Ayako Igarashi3,
  4. Murat Dogru1,3,
  5. Osama M A Ibrahim1,2,
  6. Naoko Okada2,
  7. Kazumi Fukagawa2,4,
  8. Jun Shimazaki3,
  9. Hiroshi Fujishima5
  1. 1Johnson & Johnson Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan
  2. 2Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
  3. 3Department of Ophthalmology, Tokyo Dental College, Ichikawa Hospital, Chiba, Japan
  4. 4Ryogoku Eye Clinic, Tokyo, Japan
  5. 5Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan
  1. Correspondence to Professor Hiroshi Fujishima, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Kanagawa 230-8501, Japan; hfujishima6{at}


Aims To evaluate tear and serum IgE and eosinophil cationic protein (ECP) as severity markers for atopic keratoconjunctivitis (AKC).

Methods Thirty eyes of 30 patients with AKC and 10 eyes of 10 healthy control subjects were examined in this prospective study. All subjects underwent fluorescein staining, conjunctival injection, conjunctival oedema and papillary formation grading. Tear and serum IgE and ECP levels were measured, and correlations between them investigated with reference to the ocular surface clinical parameters.

Results The mean fluorescein scores, conjunctival injection, oedema scores and papillary formation were significantly higher in AKC patients compared to controls (p<0.05). Higher total IgE and ECP levels were detected in AKC tears compared with the control group. Tear ECP levels showed a significant correlation with fluorescein staining, conjunctival injection and oedema scores (r=0.70, 0.62 and 0.62, respectively). Tear IgE had no correlation with clinical signs. Serum IgE and ECP levels were elevated in AKC patients but did not show any correlation with clinical signs.

Conclusion This study suggests the presence of an eosinophilic response in AKC disease independent of IgE sensitisation. Tear ECP was a useful marker delineating the severity of ocular surface disease in AKC.

  • Eosinophil cationic protein
  • IgE
  • atopic keratoconjunctivitis
  • cornea
  • conjunctiva
  • immunology
  • inflammation
  • ocular surface
  • lacrimal gland
  • contact lens
  • imaging
  • diagnostic tests/investigation
  • clinical trial
  • experimental and laboratory
  • treatment medical
  • stem cells
  • wound healing
  • treatment surgery
  • tears

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  • This work was presented at the 6th International Conference on the Tear Film and Ocular Surface: Basic Science and Clinical Relevance, 22–25 September 2010, Florence, Italy.

  • Competing interests None.

  • Ethics approval The study protocol was approved by the Ethics Committee of Mita Hospital, International University of Health and Welfare and the Tokyo Dental College Ichikawa Hospital review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.