PubMed Health⌕ Search

Biomedical subjects

James I McGill

Publications and source records attributed to James I McGill.

3 recordsLinked to original sources

A review of the use of olopatadine in allergic conjunctivitis.

Ocular allergies are very common and range in intensity from mild, self-resolving, acute conditions to serious, chronic disease that can severely affect vision. The vast majority of sufferers experience relatively mild symptoms, which are often seasonal in nature. Treatments should be simple, comfortable and very safe. They should be able to respond to an ongoing attack but also provide long-term relief from symptoms. Mast cell degranulation is central to all forms of ocular allergic disease and so treatment has concentrated on preventing this process or antagonizing the effects of the primary mediator, histamine. Olopatadine is a relatively new selective H1 antagonist that has mast cell stabilizing properties and has been shown to affect release of TNFalpha and various cytokines from conjunctival epithelial cells. This paper reviews the local ocular use of olopatadine and discusses the place of the drug in the treatment of allergic eye disease.

Conjunctivitis, Allergic↗

Human ocular mast cells.

PURPOSE OF REVIEW: Seasonal allergic conjunctivitis is a common and clinically significant type I hypersensitivity response, in which the mast cell is considered to play a pivotal role in causing the signs and symptoms, including ocular itching, hyperaemia, lacrimation and chemosis. This review focuses on the biology of the human mast cell, particularly that of the human conjunctiva. RECENT FINDINGS: The ocular mast cell not only releases histamine and eicosanoids into the extravascular environment when activated, but also synthesizes the cytokines IL-4 and TNF-alpha. The number of IL-4 messenger RNA-positive mast cells found in the conjunctival submucosa increases threefold in seasonal allergic conjunctivitis 'in season' compared with 'out of season', suggesting a role in disease. Treatment of the eye with 2% nedocromil sodium eye drops twice a day for 2 weeks reduced the tear concentrations of both histamine and prostaglandin D(2) by more than 70% at 30 min after challenge (both <0.05) illustrating an effective mast cell stabilizing effect in the conjunctiva. SUMMARY: Mast cells are a heterogeneous family of cells that are pivotal in initiating the signs and symptoms of seasonal allergic conjunctivitis. The expression of cytokines also endows them with the ability to initiate the inflammatory cascade, resulting in eosinophil accumulation associated with vernal conjunctivitis. Drug modulation of mast cell activity, although reducing the acute symptoms of active disease, also reduces the cytokine stimulus for the development of chronic allergic inflammation.

Allergens↗

Ocular developmental abnormalities and glaucoma associated with interstitial 6p25 duplications and deletions.

PURPOSE: Mutations in the forkhead transcription factor gene FOXC1 on 6p25 cause a range of ocular developmental abnormalities, with associated glaucoma. However, FOXC1 mutations have not been found in all similarly affected pedigrees mapping to this interval. This study was undertaken to investigate the potential role of 6p25 rearrangements in causing such phenotypes. METHODS: Two large families with autosomal dominant iris hypoplasia and early-onset glaucoma, 21 probands with Axenfeld-Rieger phenotypes not attributable to PITX2 mutations, and 7 individuals with documented 6p25 cytogenetic rearrangements, were investigated by genotyping and fluorescence in situ hybridization, with markers and probes from the 6p25 region. RESULTS: Interstitial 6p25 duplications were present in the unrelated families with iris hypoplasia, whereas an interstitial 6p25 deletion was identified in one Axenfeld-Rieger pedigree. Larger cytogenetic rearrangements, leading to trisomy or monosomy of the 6p25 region, resulted in microcornea and Rieger syndrome phenotypes, respectively. All the rearrangements encompassed FOXC1, increasing or decreasing the number of FOXC1 copies present, and appeared to correlate with the phenotypes observed. CONCLUSIONS: These findings represent the first example of both interstitial duplications and deletions cosegregating with a human developmental disorder that is attributable to altered dose of transcription factor. The data presented provide additional evidence for the pathogenicity of altered gene dosage of FOXC1 and suggest that a common mechanism is responsible for rearrangements of 6p25.

Base Sequence↗