Mystery eye: Human adenovirus and the enigma of epidemic keratoconjunctivitis.
Adaptive immunity
Epidemic keratoconjunctivitis
Human adenovirus
Innate immunity
Subepithelial infiltrates
Journal
Progress in retinal and eye research
ISSN: 1873-1635
Titre abrégé: Prog Retin Eye Res
Pays: England
ID NLM: 9431859
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
18
10
2019
revised:
20
12
2019
accepted:
26
12
2019
pubmed:
1
1
2020
medline:
20
5
2021
entrez:
1
1
2020
Statut:
ppublish
Résumé
Known to occur in widespread outbreaks, epidemic keratoconjunctivitis (EKC) is a severe ocular surface infection with a strong historical association with human adenovirus (HAdV). While the conjunctival manifestations can vary from mild follicular conjunctivitis to hyper-acute, exudative conjunctivitis with formation of conjunctival membranes, EKC is distinct as the only form of adenovirus conjunctivitis in which the cornea is also involved, likely due to the specific corneal epithelial tropism of its causative viral agents. The initial development of a punctate or geographic epithelial keratitis may herald the later formation of stromal keratitis, and manifest as subepithelial infiltrates which often persist or recur for months to years after the acute infection has resolved. The chronic keratitis in EKC is associated with foreign body sensation, photophobia, glare, and reduced vision. However, over a century since the first clinical descriptions of EKC, and over 60 years since the first causative agent, human adenovirus type 8, was identified, our understanding of this disorder remains limited. This is underscored by a current lack of effective diagnostic tools and treatments. In part, stasis in our knowledge base has been encouraged by the continued acceptance, and indeed propagation of, inaccurate paradigms pertaining to disease etiology and pathogenesis, particularly with regard to mechanisms of innate and adaptive immunity within the cornea. Owing to its often persistent and medically refractory visual sequelae, reconsideration of key aspects of EKC disease biology is warranted to identify new treatment targets to curb its worldwide socioeconomic burden.
Identifiants
pubmed: 31891773
pii: S1350-9462(19)30113-2
doi: 10.1016/j.preteyeres.2019.100826
pmc: PMC7302964
mid: NIHMS1547918
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
100826Subventions
Organisme : NEI NIH HHS
ID : P30 EY014104
Pays : United States
Organisme : NEI NIH HHS
ID : R01 EY013124
Pays : United States
Organisme : NEI NIH HHS
ID : R01 EY021558
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Rahul A. Jonas – none to disclose. Lawson Ung – none to disclose. Jaya Rajaiya and James Chodosh – work funded by National Institutes of Health grants EY013124, EY021558, and EY014104, a Senior Scientific Investigator Award grant from Research to Prevent Blindness, Inc., New York, NY, and the Massachusetts Lions Eye Research Fund.
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