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Recent reports have demonstrated the expression of intercellular adhesion molecule-1 (ICAM-1; CD54) on the epithelium in various allergic diseases and inflammatory conditions, including the bronchial epithelium of patients with allergic asthma, conjunctival epithelium of allergic patients after allergen-specific challenge, and corneal epithelium of rejected corneal allografts. We investigated the presence of ICAM-1 expression on the corneal epithelium from a patient with vernal keratoconjunctivitis (VKC). Immunohistochemical staining of the diseased cornea demonstrated abundant ICAM-1 expression on the corneal epithelium. Immunoreactive ICAM-1 appeared to localize primarily to the cells of the basal and middle layers of the corneal epithelium. No staining was detected on the ocular surface epithelium. The normal, healthy cornea demonstrated no significant ICAM-1 expression on any of the epithelial layers, similar to that previously reported. To the best of our knowledge, this is the first report of ICAM-1 expression on the corneal epithelium from a patient with VKC.

An indirect immunofluorescence assay detected eosinophil granule major basic protein in the inflammatory debris covering deepithelialized cornea in two patients with vernal keratoconjunctivitis. A slight degree of non-specific fluorescence was present in the control autopsy corneas. High concentrations of the eosinophil granule major basic protein inhibit epithelial migration and protein synthesis, whereas low concentrations affect epithelial migration. The results suggest participation of eosinophil granule major basic protein in the ulcerative process.

A hapten (DNP) model of topically induced ocular anaphylaxis has been developed. Rats immunized with DNP-Ascaris were skin-tested with DNP-bovine serum albumin (DNP-BSA) and Evans blue and challenged topically with varying amounts of di-DNP-lysine. The degree of clinical conjunctival edema was assessed, and eye tissues were evaluated histologically. Clinical conjunctival edema and histologic mast cell degranulation increased with higher concentration of di-DNP-lysine. In general, rats with positive skin tests showed more clinical conjunctival edema and more mast cell degranulation than those with negative skin tests. Three other groups of rats with positive skin tests to the DNP-BSA were injected intravenously with 125I-BSA and challenged topically with di-DNP-lysine. Retention of 125I-BSA in ocular adnexa and in globes was higher in di-DNP-lysine- than in PBS-challenged eyes. The hapten model simulates the ocular component of human hay fever in that ocular anaphylaxis is induced in immunized rats by topical challenge with antigen alone.