Procollagens and inflammatory cytokine concentrations in tarsal and limbal vernal keratoconjunctivitis

Exp Eye Res. 1998 Jul;67(1):105-12. doi: 10.1006/exer.1998.0499.


To quantify the presence of inflammatory/fibrogenic cytokines and procollagens type I (PICP) and III (PIIIP) in active and non-active tarsal and limbal forms of vernal keratoconjunctivitis (VKC), tear and blood samples were collected from 27 VKC patients (20 active and 7 non-active) and 15 normal subjects. Upper tarsal conjunctival biopses were obtained from 8 controls and 8 tarsal VKC patients. From biopses of 4 tarsal VKC, fibroblasts were cultured in F12 medium with 10% FCS. TGF-beta 1, IL-1 alpha, IL-1 beta, IL-6 and TNF-alpha, PICP and PIIIP were measured in: (1) tears, (2) homogenized conjunctival tissues, (3) serum, (4) supernatants of tissue cultures at 24 hr, and fibroblast primary passage cultures. Results showed: (1) in tears, TGF-beta 1 and TNF were identified in several active VKC patients without significant differences between the tarsal and the limbal forms. IL-1 beta (27 +/- 51 pg ml-1, P = 0.03) and IL-6 (28 +/- 43 pg ml-1, P = 0.006) were significantly increased in tarsal VKC compared to controls. Both control and non-active VKC tear samples had undetectable levels of all of the above cytokines. PICP and PIIIP were significantly increased in tarsal VKC compared to both limbal VKC and controls. Non-active VKC levels were similar to controls. (2) In homogenized VKC tissues, TGF-beta 1 and IL-6 were both significantly increased compared to controls (P < 0.01) while no increases were observed in IL-1 and TNF-alpha. (3) In serum, IL-1 alpha, IL-1 beta and TNF-alpha were higher in VKC patients compared to controls. (4) In vitro fibroblasts from VKC patients showed an increased production of TGF-beta 1, IL-1 alpha, IL-1 beta, IL-6, TNF-alpha, PICP, and PIIIP over time. Increased levels of TGF-beta 1, IL-1 and IL-6 in VKC tissues and tears indicate a local production of these cytokines in active VKC. Collagen hyperproduction occurs only in active tarsal VKC and may be related to high levels of TGF-beta 1, IL-1 and IL-6. Increased serum levels of IL-1 and TNF-alpha suggests that systemic immunological changes occur in VKC. Cell culture can be used as a model to further study the pathogenesis of VKC and its characteristic local fibroblast activation.

MeSH terms

  • Adolescent
  • Biomarkers / analysis
  • Cells, Cultured
  • Child
  • Conjunctiva / chemistry*
  • Conjunctivitis, Allergic / immunology*
  • Conjunctivitis, Allergic / metabolism*
  • Culture Techniques
  • Cytokines / analysis*
  • Cytokines / blood
  • Female
  • Fibroblasts / chemistry
  • Humans
  • Interleukin-1 / analysis
  • Interleukin-6 / analysis
  • Male
  • Peptide Fragments / analysis
  • Procollagen / analysis*
  • Procollagen / blood
  • Tears / chemistry*
  • Tears / immunology
  • Transforming Growth Factor beta / analysis


  • Biomarkers
  • Cytokines
  • Interleukin-1
  • Interleukin-6
  • Peptide Fragments
  • Procollagen
  • Transforming Growth Factor beta
  • procollagen type I carboxy terminal peptide