{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T18:40:37Z","timestamp":1775673637972,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UNSW Sydney"},{"name":"Australian Government Research Training Program Scholarship"},{"name":"University of New South Wales (UNSW)"},{"name":"Faculty of Science Research Infrastructure Scheme"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>The aim of the study was to compare the distribution of corneal and conjunctival epithelial dendritic cells (DCs) in vernal keratoconjunctivitis (VKC), allergic conjunctivitis (AC), and non-allergic controls to examine if the allergy type causes differences in immune cell activation. The prospective study included 60 participants: 20 with VKC, 20 with AC, and 20 non-allergic controls. In vivo confocal microscopy was performed on the right eye. The locations scanned included the corneal centre, inferior whorl, corneal periphery, corneal limbus, and bulbar conjunctiva. The DCs were counted manually, and their morphology was assessed for the largest cell body size, the presence of dendrites, and the presence of long and thick dendrites. The DC density was higher in VKC and AC compared to non-allergic group at all locations (p \u2264 0.01) except at the inferior whorl. The DC density in VKC participants was significantly higher than in AC at the limbus (p &lt; 0.001) but not at other locations. Both the AC and the VKC group had larger DC bodies at the corneal periphery and limbus compared to the non-allergic group (p \u2264 0.03). The study found a higher proportion of participants with DCs exhibiting long dendrites at both the corneal periphery in AC (p = 0.01) and at the corneal centre, periphery, and limbus in VKC, compared to the non-allergic group (p \u2264 0.001). In conclusion, a higher DC density at the limbus may be a marker of more severe VKC. DCs with larger cell bodies and a greater proportion of participants with DCs displaying long dendrites can be potential markers to differentiate allergy from non-allergy, and more severe forms of allergy from milder forms.<\/jats:p>","DOI":"10.3390\/biom13101469","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T05:48:13Z","timestamp":1695966493000},"page":"1469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Dendritic Cell Density and Morphology Can Be Used to Differentiate Vernal Keratoconjunctivitis from Allergic Conjunctivitis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5432-1016","authenticated-orcid":false,"given":"Zahra","family":"Tajbakhsh","sequence":"first","affiliation":[{"name":"School of Optometry and Vision Science, UNSW, Sydney, NSW 2052, Australia"},{"name":"Department of Optometry, School of Allied Health, University of Western Australia, Crawley, WA 6009, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanka","family":"Golebiowski","sequence":"additional","affiliation":[{"name":"School of Optometry and Vision Science, UNSW, Sydney, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-5443","authenticated-orcid":false,"given":"Fiona","family":"Stapleton","sequence":"additional","affiliation":[{"name":"School of Optometry and Vision Science, UNSW, Sydney, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramin","family":"Salouti","sequence":"additional","affiliation":[{"name":"Salouti Cornea Research Center, Salouti Eye Clinic, Shiraz 71839-33636, Iran"},{"name":"Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Hosein","family":"Nowroozzadeh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Zamani","sequence":"additional","affiliation":[{"name":"Salouti Cornea Research Center, Salouti Eye Clinic, Shiraz 71839-33636, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Briggs","sequence":"additional","affiliation":[{"name":"Stats Central, Mark Wainwright Analytical Centre, UNSW, Sydney, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1351-0072","authenticated-orcid":false,"given":"Isabelle","family":"Jalbert","sequence":"additional","affiliation":[{"name":"School of Optometry and Vision Science, UNSW, Sydney, NSW 2052, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13223-020-0403-9","article-title":"A contemporary look at allergic conjunctivitis","volume":"16","author":"Dupuis","year":"2020","journal-title":"Allergy Asthma Clin. Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1183\/09031936.00114514","article-title":"A systematic review of socioeconomic position in relation to asthma and allergic diseases","volume":"46","author":"Uphoff","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1034\/j.1600-0420.2000.078s230038.x","article-title":"Epidemiological study of 134 subjects with allergic conjunctivitis","volume":"78","author":"Belfort","year":"2000","journal-title":"Acta Ophthalmol. Scand"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1755-3768.2008.01347.x","article-title":"Vernal keratoconjunctivitis: A major review","volume":"87","author":"Kumar","year":"2009","journal-title":"Acta Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1177\/11206721211022153","article-title":"Vernal keratoconjunctivitis: An update","volume":"31","author":"Ghiglioni","year":"2021","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/S1542-0124(12)70270-7","article-title":"The dendritic cell in allergic conjunctivitis","volume":"6","author":"Manzouri","year":"2008","journal-title":"Ocul. Surf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"317","DOI":"10.3109\/02713683.2012.747617","article-title":"New twists to an old story: Novel concepts in the pathogenesis of allergic eye disease","volume":"38","author":"Saban","year":"2013","journal-title":"Curr. Eye Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/00130832-200310000-00006","article-title":"Dendritic cells and atopic eczema\/dermatitis syndrome","volume":"3","author":"Koch","year":"2003","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_9","first-page":"94","article-title":"Consensus document on allergic conjunctivitis (DECA)","volume":"25","author":"Montero","year":"2015","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.yexmp.2007.04.007","article-title":"Dynamic changes in conjunctival dendritic cell numbers, anatomical position and phenotype during experimental allergic conjunctivitis","volume":"83","author":"Ohbayashi","year":"2007","journal-title":"Exp. Mol. Pathol."},{"key":"ref_11","first-page":"1","article-title":"Increased dendritic cell density and altered morphology in allergic conjunctivitis","volume":"6","author":"Tajbakhsh","year":"2023","journal-title":"Eye"},{"key":"ref_12","first-page":"53","article-title":"In vivo laser scanning confocal microscopy of vernal keratoconjunctivitis","volume":"39","author":"Le","year":"2011","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/cea.12264","article-title":"An essential role for dendritic cells in vernal keratoconjunctivitis: Analysis by laser scanning confocal microscopy","volume":"44","author":"Liu","year":"2014","journal-title":"Clin. Exp. Allergy"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.ajo.2006.06.057","article-title":"Epithelial dendritic cell distribution in normal and inflamed human cornea: In vivo confocal microscopy study","volume":"142","author":"Mastropasqua","year":"2006","journal-title":"Am. J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1177\/11206721221099778","article-title":"Examination of corneal microstructure in the quiescent phase of vernal keratoconjunctivitis using in vivo confocal microscopy","volume":"33","author":"Csorba","year":"2022","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_16","first-page":"1","article-title":"Dendritiform immune cells with reduced antigen-capture capacity persist in the cornea during the asymptomatic phase of allergic conjunctivitis","volume":"6","author":"Tajbakhsh","year":"2023","journal-title":"Eye"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1080\/02713683.2019.1695845","article-title":"Density and morphology of corneal epithelial dendritic cells are different in allergy","volume":"45","author":"Tajbakhsh","year":"2019","journal-title":"Curr. Eye Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/ceo.13972","article-title":"Corneal immune cell morphometry as an indicator of local and systemic pathology: A review","volume":"49","author":"Chinnery","year":"2021","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_19","first-page":"e302","article-title":"Corneal epithelial dendritic cells, tear neuropeptides and corneal nerves continue to be affected more than 12 months after LASIK","volume":"101","author":"Chao","year":"2022","journal-title":"Acta Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1111\/opo.13087","article-title":"Diurnal changes and topographical distribution of ocular surface epithelial dendritic cells in humans, and repeatability of density and morphology assessment","volume":"43","author":"Tajbakhsh","year":"2023","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.jtos.2019.07.001","article-title":"Corneal epithelial dendritic cell density in the healthy human cornea: A meta-analysis of in-vivo confocal microscopy data","volume":"17","author":"Mobeen","year":"2019","journal-title":"Ocul. Surf."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"191","DOI":"10.2332\/allergolint.11-RAI-0335","article-title":"Japanese guideline for allergic conjunctival diseases","volume":"60","author":"Takamura","year":"2011","journal-title":"Allergol. Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/sj.eye.6700675","article-title":"Vernal keratoconjunctivitis","volume":"18","author":"Bonini","year":"2004","journal-title":"Eye"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.clae.2010.12.008","article-title":"Prevalence and impact of ocular allergy in the population attending UK optometric practice","volume":"34","author":"Wolffsohn","year":"2011","journal-title":"Cont. Lens Anterior Eye"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/00006324-199303000-00011","article-title":"CCLRU standards for success of daily and extended wear contact lenses","volume":"70","author":"Terry","year":"1993","journal-title":"Optom. Vis. Sci. Off. Publ. Am. Acad. Optom."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/j.1365-2567.2006.02533.x","article-title":"Local thermal injury elicits immediate dynamic behavioural responses by corneal Langerhans cells","volume":"120","author":"Ward","year":"2007","journal-title":"Immunology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"742","DOI":"10.3389\/fimmu.2020.00742","article-title":"Intravital multiphoton microscopy of the ocular surface: Alterations in conventional dendritic cell morphology and kinetics in dry eye disease","volume":"11","author":"Jamali","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.immuni.2005.04.004","article-title":"Dynamics and function of langerhans cells in vivo: Dermal dendritic cells colonize lymph node areas distinct from slower migrating langerhans cells","volume":"22","author":"Kissenpfennig","year":"2005","journal-title":"Immunity"},{"key":"ref_29","first-page":"103","article-title":"Ocular manifestations of COVID-19: A systematic review and Meta-analysis","volume":"16","author":"Nasiri","year":"2021","journal-title":"J. Ophthalmic Vis. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1136\/bjophthalmol-2021-319450","article-title":"Corneal confocal microscopy identifies corneal nerve fibre loss and increased dendritic cells in patients with long COVID","volume":"106","author":"Bitirgen","year":"2021","journal-title":"Br. J. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1007\/s40629-021-00180-8","article-title":"Face masks suitable for preventing COVID-19 and pollen allergy. A study in the exposure chamber","volume":"30","author":"Bergmann","year":"2021","journal-title":"Allergo J. Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103206","DOI":"10.1016\/j.amjoto.2021.103206","article-title":"The effect of face mask usage on the allergic rhinitis symptoms in patients with pollen allergy during the covid-19 pandemic","volume":"43","author":"Mengi","year":"2022","journal-title":"Am. J. Otolaryngol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e2217795120","DOI":"10.1073\/pnas.2217795120","article-title":"Redefining the human corneal immune compartment using dynamic intravital imaging","volume":"120","author":"Downie","year":"2023","journal-title":"Proc. Natl. Acad. Sci. USA"}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/13\/10\/1469\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:01:51Z","timestamp":1760130111000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/13\/10\/1469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":33,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["biom13101469"],"URL":"https:\/\/doi.org\/10.3390\/biom13101469","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]}}}