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A. Guo, L. Kuffova, E. Muckersie, M. Robertson; Is Angiogenesis A Significant Risk Factor For Rejection In Corneal Transplantation? . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1301.
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The cornea is an immune privileged tissue with the high rate of success of corneal allografts without cover of immunosuppression. Major contributing components to ocular immune privilege are the blood ocular barrier and the avascularity of the cornea. Accordingly, leaking new vessels invading the host corneal bed are considered a risk factor for graft rejection. In this study the effect of host corneal neovascularisation on graft rejection in two models of murine corneal allograft, a standard suture induced model and a post–herpetic keratitis model, has been compared with rejection in a non–vascularised allograft model.
BALB/c (H–2d), C57BL/6 (H–2b) mouse strains (6–8 weeks old) were used as recipient and donor, respectively. BALB/c and C57BL/6 corneas were transplanted to (a) BALB/c hosts with suture–induced neovascularisation, (b) BALB/c hosts with healed post–HSV keratitis; (c) naïve hosts in a syngeneic(H–2d into H–2d) and allogeneic(H–2d into H–2b) combination. Corneal graft survival measured by degree of opacification was evaluated up to 2 months.
Corneal neovascularisation in suture induced corneas developed within 5days and was severe (grade 4, intensity 0.78±0.02) prior to grafting. Corneal neovascularisation in mice with post–herpetic keratitis developed 12days after the infectious stage, and was moderate (grade 2±0.45, intensity 0.42±0.04) prior to grafting). Corneal allografts in naïve hosts (n=23) rejected with a peak time (opacity score 3.43 ±0.21)at day 20.Corneal allografts (n=14) into host with suture induced corneal neovascularisation rejected with a peak time (3.13±0.12) at day 18. Corneal allografts (n= 9) into vascularised post herpetic corneas rejected ( grade 3.2±0.46) also peaked at day 20. but had a much earlier onset of rejection (day10). Interestingly, syngeneic grafts into vascularised post herpetic corneas (n=15) also peaked day 21 ( grade 3±0.37.) and also had an early onset (day 7).
The data indicate that corneal neovascularisation in isolation is not a major risk factor for graft rejection but may be a concomitant sign for other "high risk" factors for rejection such as previous exposure to foreign antigen.
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