{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:01:46Z","timestamp":1789542106112,"version":"build-2803163510"},"reference-count":151,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,3,9]],"date-time":"2024-03-09T00:00:00Z","timestamp":1709942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Vernal keratoconjunctivitis (VKC) is a complex and multifactorial disease process that employs Th2 cell-mediated immunologic processes, which involves the overexpression of interleukin 4 (IL-4), IL-5, IL-9, IL-13, and IL-31, and the activation of mast cells that release IL-5 and CCL-11, recruiting eosinophils to the site of inflammation. The disease primarily affects young males and is more common in regions with warm climates. VKC is characterized by persistent and recurrent conjunctival inflammation that can adversely affect the patient\u2019s quality of life, and, when inadequately treated, may lead to a host of ocular complications, such as corneal shield ulcers and scarring. The major distinct forms of VKC include limbal or palpebral, which may occur in combination. The clinicopathological features of VKC include the presence of pseudogerontoxon, limbal gelatinous hyperplasia, and perilimbal hyperpigmentation. Topical immunomodulators are effective anti-steroidal options for controlling severe and chronic cases of VKC. This review will provide a brief overview of topical immunomodulators, including cyclosporin and tacrolimus, and will highlight the clinical manifestations, pathological mechanisms, and fibroproliferative changes in the conjunctiva that can result from recurrent disease.<\/jats:p>","DOI":"10.3390\/life14030361","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T06:05:30Z","timestamp":1710137130000},"page":"361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Vernal Keratoconjunctivitis: Immunopathological Insights and Therapeutic Applications of Immunomodulators"],"prefix":"10.3390","volume":"14","author":[{"given":"Navpreet K.","family":"Hehar","sequence":"first","affiliation":[{"name":"Pennsylvania College of Optometry, Salus University, Elkins Park, PA 19027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-2735","authenticated-orcid":false,"given":"DeGaulle I.","family":"Chigbu","sequence":"additional","affiliation":[{"name":"Pennsylvania College of Optometry, Salus University, Elkins Park, PA 19027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,9]]},"reference":[{"key":"ref_1","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_2","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/j.1600-0420.2005.00622.x","article-title":"Case series of 406 vernal keratoconjunctivitis patients: A demographic and epidemiological study","volume":"84","author":"Leonardi","year":"2006","journal-title":"Acta Ophthalmol. 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