Supplementary Material for: Cytokines in Tears during the Secondary Keratoconjunctival Responses Induced by Allergic Reaction in the Nasal Mucosa

Background: Allergic keratoconjunctivitis (KC) can occur in a primary form due to an allergic reaction taking place in the conjunctivae or in a secondary form induced by nasal allergy. Objectives: To search for the cytokine changes in tears accompanying the secondary keratoconjunctival response types (SKCR), caused by the nasal allergy. Methods: In 43 KC patients developing 15 immediate (SIKCR), 16 late (SLKCR) and 12 delayed (SDYKCR) responses to nasal provocation tests with allergens (NPT), the NPTs were repeated with subsequent recording of cytokine concentrations in tears up to 72 h. Results: The SIKCRs (p < 0.001), occurring 10-120 min after the NPT, were accompanied by significant changes (p < 0.05) of interleukin (IL)-4, IL-6, IL-10, IL-12p70 and granulocyte-macrophage colony-stimulating factor (GM-CSF). The SLKCRs (p < 0.01), appearing 5-12 h after the NPT, were associated with significant changes (p < 0.05) of IL-3, IL-4, IL-5, IL-8, IL-10, tumor necrosis factor (TNF)-α, GM-CSF and granulocyte colony-stimulating factor. The SDYKCRs (p < 0.01), occurring 24-48 h after the NPT, were accompanied by significant changes (p < 0.05) of IL-2, IL-8, IL-10, interferon-γ, transforming growth factor-β and TNF-α. Conclusions: The particular SKCR types, induced by an allergic reaction in the nasal mucosa, were accompanied by different cytokine profiles in the tears, suggesting involvement of different hypersensitivity mechanisms. These results also stress the diagnostic usefulness of NPTs combined with monitoring of ocular features in KC patients who did not respond satisfactorily to the topical ophthalmological treatment.