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The Conjunctiva-Associated Lymphoid Tissue in Chronic Ocular Surface Diseases

Published online by Cambridge University Press:  08 May 2017

Rodolfo Mastropasqua ,
Luca Agnifili ,
Vincenzo Fasanella ,
Mario Nubile ,
Agbeanda A. Gnama ,
Gennaro Falconio ,
Paolo Perri ,
Silvio Di Staso  and
Cesare Mariotti
Rodolfo Mastropasqua
Affiliation:
Moorfields Eye Hospital, London EC1V 2PD, UK
Luca Agnifili*
Affiliation:
Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti 66100, Italy
Vincenzo Fasanella
Affiliation:
Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti 66100, Italy
Mario Nubile
Affiliation:
Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti 66100, Italy
Agbeanda A. Gnama
Affiliation:
Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti 66100, Italy
Gennaro Falconio
Affiliation:
Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d’Annunzio of Chieti-Pescara, Chieti 66100, Italy
Paolo Perri
Affiliation:
Department of Biomedical and Surgical Sciences, Division of Ophthalmology, University of Ferrara, Ferrara 44100, Italy
Silvio Di Staso
Affiliation:
Department of Surgical Science, Ophthalmic Clinic, University of L’Aquila, L’Aquila 67100, Italy
Cesare Mariotti
Affiliation:
Eye Clinic, Polytechnic University of Marche, Ancona 60020, Italy
*
*Corresponding author. [email protected]
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Abstract

Ocular surface diseases (OSDs) represent a widely investigated field of research given their growing incidence and the negative impact on quality of life. During OSDs, cytokines generated by damaged epithelia trigger and deregulate the lymphoid cells composing the eye-associated lymphoid tissues, inducing an immune-mediated chronic inflammation that amplifies and propagates the disease during time. The conjunctiva-associated lymphoid tissue (CALT), given its particular position that permits immune cells covering the cornea, might play a crucial role in the development of OSDs. Despite the recognized inflammatory role of mucosa-associated lymphoid tissues in other stations taking contact with the external environment (gut or bronchus), CALT did not gain the deserved consideration. In the last years, the diffusion of the in vivo confocal microscopy (IVCM) stimulated the interest to CALT, especially in dry eye, ocular allergy, and glaucoma. Though the initial stimuli were different, IVCM documented similar changes, represented by increased lymphoid cells within the diffuse layer, follicles and interfollicular spaces. These findings, which need to be validated by immunohistology, support the CALT stimulation during OSDs. However, while an involvement of the CALT in OSDs is hypothesizable, the exact role of this structure in their pathogenesis remains unclear and warrants further investigations.

Keywords

conjunctiva-associated lymphoid tissuein vivo confocal microscopyocular surface diseaseglaucoma therapy dry eye diseaseocular allergy
Type
Review Article
Information
Microscopy and Microanalysis , Volume 23 , Issue 4 , August 2017 , pp. 697 - 707
Copyright
© Microscopy Society of America 2017 

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Footnotes

†

R. M. and L. A. equally contributed to this work and share primary authorship.

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