Respiratory syncytial virus may be a pathogen in allergic conjunctivitis

Cornea. 2002 Mar;21(2 Suppl 1):S39-45. doi: 10.1097/00003226-200203001-00009.


Purpose: The host response to allergens appears to be regulated by T helper type 2 cell patterns of local cytokine production. We hypothesized that respiratory syncytial virus (RSV) infects the normal conjunctival epithelium and produces interleukin (IL)-4, causing a local allergic reaction.

Methods: Giemsa staining, immunocytochemical study, flow cytometric analysis, and reverse-transcriptase polymerase chain reaction (RT-PCR) were performed on tear and cytology samples from individuals with allergic and postoperative conjunctivitis. Histamine was assayed by radioimmunoassay, and IL-4 by enzyme-linked immunosorbent assay.

Results: The total number of cells collected by brush cytology did not differ between allergic and postoperative conjunctivitis. The levels of IL-4 and histamine in the specimens and mean IL-4 tear level were significantly increased in patients with allergic conjunctivitis. Cytocentrifuge preparations contained conjunctival epithelial cells with lymphocytes (a few CD3- and CD4-bearing cells), mast cells, eosinophils, and higher human leukocyte antigen (HLA)-DR expression in allergic patients. RT-PCR analysis showed that samples from allergic conjunctivitis expressed increased transcripts of IL-4 and IL-13. A higher percentage of RSV sequences were detected in allergic patient samples. Immunocytochemical study and RT-PCR showed that epithelial cells were infected with RSV. Average concentrations of IL-4 in culture supernatants were higher than levels in uninfected cells.

Conclusions: These results suggest that the clinical features of human allergic conjunctivitis are associated with T helper type 2 cytokine expression. RSV in conjunctival epithelial cells may be an environmental pathogen in allergic conjunctivitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Conjunctivitis, Allergic / metabolism
  • Conjunctivitis, Allergic / virology*
  • Enzyme-Linked Immunosorbent Assay
  • Epithelial Cells / metabolism
  • Epithelial Cells / virology
  • Eye Infections, Viral / metabolism
  • Eye Infections, Viral / virology*
  • Female
  • Flow Cytometry
  • HLA-DR Antigens / metabolism
  • Histamine / metabolism
  • Humans
  • Interleukin-4 / metabolism
  • Male
  • Middle Aged
  • RNA, Messenger / metabolism
  • RNA, Viral / analysis
  • RNA, Viral / isolation & purification
  • Radioimmunoassay
  • Respiratory Syncytial Virus Infections / metabolism
  • Respiratory Syncytial Virus Infections / virology*
  • Respiratory Syncytial Virus, Human / genetics
  • Respiratory Syncytial Virus, Human / isolation & purification
  • Respiratory Syncytial Virus, Human / pathogenicity*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Tears / metabolism


  • HLA-DR Antigens
  • RNA, Messenger
  • RNA, Viral
  • Interleukin-4
  • Histamine