Abstract
Background
Probiotics have been shown to improve allergic inflammation. The aim of this study was to evaluate the efficacy of Lactobacillus Acidophilus eye-drops in controlling signs and symptoms of vernal keratoconjunctivitis (VKC).
Methods
Seven patients (mean age 11.8 ± 4.3; five M, two F) with mild to moderate VKC were included in the study. Lactobacillus Acidophilus diluted in saline solution (2 × 108 CFU/ml) was administrated as eye-drops four times daily for 4 weeks in both eyes. Clinical signs (conjunctival hyperemia, chemosis, secretion, Trantas dots, superficial punctuate keratitis) and symptoms (itching, photophobia, burning, tearing) were evaluated and scored from 0 to 3 at baseline, after 2 and 4 weeks of treatment. Total sign (TSS) and symptom (TSyS) scores were calculated. Conjunctival impression cytology was performed in three patients at baseline and after 4 weeks of treatment, in order to evaluate the expression of ICAM-1 and TLR-4.
Results
In the six out of seven patients who completed the study, symptoms were significantly improved after both 2 weeks (TSyS: baseline 6.7 ± 0.9 vs 4.1 ± 1.2; p = 0.017) and 4 weeks (TSyS: baseline 6.7 ± 0.9 vs 3.6 ± 1.2, p = 0.011) of treatment. A significant improvement of clinical signs was observed after 4 weeks of treatment (TSS: baseline 7.5 ± 1.6 vs 3.9 ± 1.7, p = 0.034) but not after 2 weeks of treatment (TSS: baseline 7.5 ± 1.6 vs 5.3 ± 1.5; NS). In particular, photophobia was significantly reduced (2 ± 0.6 vs 1 ± 0.3; p = 0.023) at 2 weeks, while at 4 weeks the scores for itching (1.8 ± 0.3 vs 1 ± 0.3), tearing (1.6 ± 0.4 vs 0.8 ± 0.2), conjunctival hyperemia (2.3 ± 0.2 vs 1.4 ± 0.5) and chemosis (1.2 ± 0.4 vs 0.4 ± 0.4) were significantly lower compared to baseline. A down-regulation of ICAM-1 and TLR-4 was observed in two patients showing clinical improvement after 4 weeks of treatment.
Conclusion
Our open pilot study showed that 1-month treatment with probiotic eye-drops improves signs and symptoms in patients with VKC. Additional double-blind controlled clinical trials with a larger sample of patients are needed to confirm the effects of topical Lactobacilli on VKC patients.
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Iovieno, A., Lambiase, A., Sacchetti, M. et al. Preliminary evidence of the efficacy of probiotic eye-drop treatment in patients with vernal keratoconjunctivitis. Graefes Arch Clin Exp Ophthalmol 246, 435–441 (2008). https://doi.org/10.1007/s00417-007-0682-6
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DOI: https://doi.org/10.1007/s00417-007-0682-6