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Clinical Severity and Tear Biomarkers, Eosinophil Cationic Protein and CCL23, in Chronic Allergic Conjunctival Diseases

ABSTRACT Purpose: To evaluate the relationship between clinical severity and tear levels of eosinophil cationic protein (ECP) and CC chemokine ligand 23 (CCL23) in patients with chronic allergic conjunctival disease (cACD). Subjects and methods: This clinical study included 21 patients with cACD, including atopic keratoconjunctivitis and vernal keratoconjunctivitis, and 14 subjects as controls. The clinical severity score was determined by objective findings. Tear ECP grade was evaluated using tear ECP levels determined by enzyme immunoassay. CCL23 expression in tears was also determined by enzyme immunoassay. Results: In the cACD group, tear ECP grade was significantly correlated with the clinical severity score. Clinical severity scores and tear ECP grades in the CCL23-positive subgroup were significantly higher than those in the CCL23-negative subgroup. Conclusion: We have confirmed the value of tear ECP grade and CCL23 expression in tears as a severity grading system in patients with cACD.