357 Tear IL-4 is Decreased in Allergic Conjunctivitis Patients with Negative Skin Test After Dialyzable Leukocyte Extracts Treatment

BACKGROUND: It has been suggested that sublingual immunotherapy induces immune regulation, however in patients with clinical ophthalmological diagnosis as allergic conjunctivitis with negative skin test reactivity (ACNST) this treatment is not useful. Dialyzable leukocyte extracts (DLE) have been used in atopic dermatitis and asthma. The aim of this work was to evaluate treatment of ACNST with DLE and to analyze the microenvironment provided by tear and serum cytokines in patients before and after DLE treatment. METHODS: 10 ACNST-patients with negative skin test were included in this study. ACNST diagnosis was based on a clinical history and full ophthalmologic examination according to the diagnosis standards of the American Academy of Ophthalmology. Coproparasitoscopic negative for parasites was documented This study was approved by Scientific and Ethics Committees if Institute of Ophthalmology “Conde de la Valenciana “, Mexico City an all subjects gave their informed consent to obtain samples. Tear and Serum Samples were collected to determine cytokines IL2, IL-4, IL-5, IFN-g, TNF-a, IL-10 by cytometric bead arrays (CBA), following manufacturer's instructions. RESULTS: Patients showed lower significant levels of L-4 after 6 months of treatment, without changes in IL2, IL5, TNFa and IL10. Significant Clinical improvement was also observed since 3 months of treatment and was maintained until the end of 6 months. CONCLUSIONS: DLE could be an excellent therapeutic tool to improve the clinical outcome in ACNST patients; it is possible that clinical improvement could be Tear IL-4 dependent.