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Thomas H. Flynn, Masaharu Ohbayashi, Yoshifumi Ikeda, Santa J. Ono, Daniel F. Larkin; Effect of Allergic Conjunctival Inflammation on the Allogeneic Response to Donor Cornea. Invest. Ophthalmol. Vis. Sci. 2007;48(9):4044-4049. doi: 10.1167/iovs.06-0973.
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purpose. Immunologic rejection is the most common cause of corneal allograft rejection. Ipsilateral ocular inflammation has been identified as a predictor of future corneal graft failure. This study investigates the effect of perioperative allergic conjunctivitis on corneal allograft survival.
methods. C57BL6 donor corneas were transplanted into naive A/J mice, A/J mice sensitized to short ragweed (SRW) pollen by intraperitoneal injection and then challenged with topical SRW to induce allergic conjunctivitis (Sens+Chall+), and A/J mice sensitized to SRW and challenged with topical PBS (Sens+Chall−). Syngeneic grafts were also performed in eyes with allergic conjunctivitis. Graft survival and infiltrating cell phenotype in rejected grafts were compared between groups.
results. Mice with allergic conjunctivitis (Sens+Chall+) rejected corneal allografts significantly more quickly than naive mice. Syngeneic grafts in allergic eyes survived indefinitely. The rate of rejection in Sens+Chall− mice was similar to that in naive mice. There were no significant differences, between groups, in the numbers of infiltrating CD4+ cells, CD8+ cells, and macrophages at the time of graft rejection. Eosinophils were seldom observed in rejected grafts in naive and Sens+Chall− mice but were observed consistently in Sens+Chall+ eyes. Eosinophils were also found consistently in the ciliary body of Sens+Chall+ eyes at the time of graft rejection.
conclusions. Active allergic conjunctivitis at the time of transplantation accelerates corneal allograft rejection. Local conjunctival inflammation is an important factor in accelerating rejection.
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