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T. H. Flynn, M. Dawson, M. Ohbayashi, D. F. P. Larkin, S. J. Ono; Effect of Allergic Conjunctivitis on Early Post-keratoplasty Corneal Inflammation. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5758.
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Perioperative allergic inflammation has been shown to accelerate the tempo of rejection of corneal allografts; early post-operative treatment with topical corticosteroid extends graft survival in eyes with allergic conjunctivitis. This study examines the effect of allergic conjunctivitis and steroid treatment on the early inflammatory response and lymphangiogenesis in host cornea following corneal transplantation.
Corneal allografts (C57Bl/6 donors) were performed in naïve A/J mice and in A/J mice with active allergic conjunctivitis. Allergic allograft recipients were treated with twice daily saline or dexamethasone 0.1% drops for 2 or for 6 days. Mice were killed at days 2 and 6; corneas were examined by fluorescence immunohistochemistry of frozen sections using anti-CD11b, anti-F4/80, anti-Gr-1 antibodies or by wholemount staining with anti- LYVE-1. Digital images of frozen sections and wholemounts were captured. Cells were counted on cross sections and cumulative lengths of lymphatic ingrowth were measured using image analysis software.
In allergic recipients of allografts there were significantly higher numbers of CD11b+ cells and LYVE-1+ vessels in the host cornea at day 2 compared with naive recipients. There were no differences between naïve and allergic recipients in CD11b+ and LYVE-1+ staining in host cornea at day 6. In allergic eyes, twice daily treatment with topical dexamethasone significantly inhibited both CD11b+ cell infiltration and LYVE-1 expression at days 2 and 6.
The innate immune response to allogeneic corneal tissue is more vigorous in the presence of allergic conjunctivitis than in naive eyes. This is associated with accelerated lymphatic ingrowth to host cornea. Topical dexamethasone inhibits lymphatic ingrowth and this may be one of the mechanisms by which dexamethasone enhances graft survival.
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