Immune responses in monkeys to lenses from patients with contact lens induced giant papillary conjunctivitis.

The clinicopathologic findings in contact lens-induced giant papillary conjunctivitis (GPC) suggest that the syndrome is the result of a complex immunological process, an idea supported by the presence of elevated tear concentrations of IgG and IgE in GPC. Several groups of investigators have proposed that GPC may be due, in part, to the coating of the contact lens. To test this hypothesis we undertook development of an animal model of GPC in cynomolgus monkeys. Two soft contact lenses from patients with GPC, two from asymptomatic contact lens wearers, and two clean, unused lenses were each placed in one eye and held in place with a partial tarsorrhaphy. Tears from the two monkeys with GPC lenses showed increased levels of IgG (43 +/- 10 micrograms/mL), IgA (54.3 +/- 12.8 micrograms/mL) and IgE (7.7 +/- 3.3 IU/mL) 35-75 days post-lens placement. While the tears from the two monkeys with clean lenses, and the two monkeys with lenses from asymptomatic contact lens wearers had elevated levels of IgG compared to the contralateral control eye without a lens, the tear IgE levels remained normal. Histopathology studies of tarsal conjunctival biopsy material from the monkeys with GPC lenses showed an intense round cell infiltrate at the epithelial-stromal junction. Mast cells were seen in the epithelial layers. These studies suggest that some factor (or factors) in the lens coating from GPC patients was able to induce a local tear IgE response and histopathological changes in monkeys. These changes are similar to the histopathological and immunological findings in human patients with GPC.