Neutrophil chemotactic factors in the tears of giant papillary conjunctivitis patients.

This study was designed to determine the presence of neutrophil chemotactic factors in the tears of patients with giant papillary conjunctivitis (BPC) secondary to contact lenses. Chemotactic activity was measured using modified Boyden chambers and the chemoattractant formylmethionyl-leucyl-phenylalanine (f-MLP) for 100 percent response. Elevated levels of chemotactic activity were found in the tears of symptomatic patients (80.8 +/- 6.4, % f-MLP) compared with control tears of asymptomatic contact lens wearers (15.7 +/- 3.3%) and non-contact lens wearers (5.6 +/- 1.2%). Using radioimmunoassay, C5a (serum-derived chemoattractant), leukotriene-B4, and interleukin-1 (immune cell-derived chemoattractants) were not detected in the tears of symptomatic patients. The authors determined whether injured conjunctival cells participate in this process by releasing neutrophil chemotactic factors. Isolated rabbit bulbar conjunctiva incubated with culture medium for 4 and 6 hr released high levels of neutrophil chemotactic factors. The release of these factors from injured conjunctiva support the premise that physical trauma of conjunctival cells induced by contact lenses may be an important component of the pathophysiology of giant papillary conjunctivitis.