Cytokine levels and clinical characteristics in the tear fluid of patients with atopic dermatitis and atopic keratoconjunctivitis

Purpose: To investigate the relationship between the cytokine levels in the tear fluid and the severity of ocular surface disease in patients with atopic dermatitis (AD) and atopic keratoconjunctivitis (AKC). Methods: Tear fluid was collected from 104 AD patients with stratified AKC severity and the healthy controls, who all underwent ophthalmological examination. Cytokine levels in tear fluid were analyzed with Luminex multiplex assays. Results: Increased levels of eotaxin-3, IFN-β, IFN-γ, IL-1β, IL-13, IL-15, IL-17A, IL-2, IL-4, IL-6, IL-8, MCP-4, MIP-1α, MIP-1β, MMP-9, MPIF-1 and MPO were observed in moderate-severe AKC group and IL-6, IL-8 and IFN-γ was associated with AKC severity. The participants with AKC had higher frequencies of atopic comorbidities and the severity of AD was associated with more severe AKC. Conclusions: AKC severity was associated with AD severity, more atopic comorbidities, and increased levels of tear fluid cytokines associated with Th1, -2 and -3 immune response.