Abstract
Purpose:
Lamellar keratoplasty (LK) has been considered an acceptable alternative surgery for penetrating keratoplasty (PKP), because LK has the advantage of lower risk of graft rejection and intraocular complications, according to recent clinical outcomes. But the relative immunological mechanism of graft rejections for the two procedures is uncertain. To understand the immunological mechanisms of lamellar keratoplasty (LK) and penetrating keratoplasty (PKP) in murine model.
Methods:
PKP or LK was performed C57BL/6 donor grafts and BALB/c recipients and graft opacity was assessed. We evaluated immunologic responses with delayed-type hypersensitivity (DTH) assays, real-time PCR, flow cytoemtry, and immunohistochemistry.
Results:
LK mice showed less graft rejection than PK mice and LK led to less DTH response and IFN-γ secretion in vitro recall assay of T cells from drainage lymph nodes, as compared to PK (acceptance; acc). There was no difference of mRNA expressions of proinflammatory cytokines in the corneas early (5 days), but those of PKacc mice were significantly increased later (3wk). In addition, LK showed less angiogenesis and lymphangiogenesis in grafted cornea than PK, and LK led to decreased number of mature MHC-IIhighCD11c+ cells and IL-12+CD11c+ in the draining LNs and less infiltration of CD3+ T cell into the grafted corneas of transplanted mice.
Conclusions:
LK presents less graft rejection than PK through lower angiogenesis and lymphangiogenesis, which could make pathologic T cells and mature APC less migration into grafted corneas and drainage LNs, respectively.