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Changes of ocular surface CD14 and TLR- 4 and TLR-9 in patients with Vernal keratoconjunctivitis: an inflammatory epiphenomenon or a novel pathogenic mechanism?
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  • marta sacchetti,
  • Marcella Nebbioso,
  • marco segatto,
  • irene abicca,
  • Alice Bruscolini,
  • Anna Maria Zicari,
  • Alessandro Lambiase
marta sacchetti
University Sapienza of Rome
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Marcella Nebbioso
Policlinico Umberto I
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marco segatto
University Sapienza of Rome
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irene abicca
University Sapienza of Rome
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Alice Bruscolini
University Sapienza of Rome
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Anna Maria Zicari
Policlinico Umberto 1 Roma
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Alessandro Lambiase
University Sapienza of Rome
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Abstract

Background: CD14 is involved in the modulation of immune reaction via toll-like receptors (TLR) and may influence the development of allergic diseases. The role of CD14 in vernal keratoconjunctivitis (VKC) has not yet been investigated. The aim of this study is to evaluate changes of tear soluble sCD14 and conjunctival CD14, TLR-4 and 9 expression in patients with VKC in the active and quiescent phases. Methods: 18 patients with VKC during active inflammation (group A, N=9), in the quiescent phase (group Q, N=5) and after recovery (group R, N=4) and 10 healthy subjects were included. Patients in group A were treated with corticosteroid eye drops 4 times daily for 7 days. Expression of sCD14 in tears and of CD14, TLR-4, and TLR-9 by conjunctival epithelium were evaluated by Western Blot in all groups and after corticosteroid treatment. Results: expression of sCD14 and of CD14, TLR-4 and TLR-9 was significantly decreased in group A when compared with healthy subjects and with VKC group Q and R. Lower expression of sCD14, CD14, TLR-4 and TLR-9 were significantly correlated with the severity of papillary reaction, while the lower sCD14 was correlated with severity of conjunctival hyperemia. Conjunctival expression of TLR-4, but not sCD14, CD14 and TLR-9, was significantly reduced after topical corticosteroid treatment. Conclusion: tear sCD14, and conjunctival CD14, TLR4 and TLR-9 decreased during ocular surface inflammatory reaction in patients with VKC. CD14 and TLRs may represent potential therapeutic targets, although it requires further studies.