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实验性角膜移植排斥反应。

Experimental corneal allograft rejection.

作者信息

Gebhardt Bryan M, Shi Weiyun

机构信息

Lions Eye Research Laboratories, LSU Eye Center, LSU Health Sciences Center, New Orleans, LA 70112-2234, USA.

出版信息

Immunol Res. 2002;25(1):1-26. doi: 10.1385/IR:25:1:01.

Abstract

The major findings regarding corneal allograft rejection in experimental animals are reviewed. The principal anatomic and biological feature of the cornea that determines the immunologic privilege of this tissue is its avascularity. The surgical trauma of transplantation compromises the immunologic privilege, putting corneal allografts at risk for immune rejection. During the past 50 yr, rabbits, rats, and mice have been used extensively in the study of the process of immunologically mediated corneal allograft rejection. It is clear that the inflammation and neovascularization of the graft that occurs following transplantation predisposes a corneal allograft to the classic cell-mediated immune rejection response. The antigenicity of cornea cells has been studied and has been found to be significantly lower compared to other cells and tissues. Rejection of acorneal allograft is acell-mediated process directed against major histocompatibility complex antigens involving both CD4+ T helper cells and CD8+ cytotoxic cells. The prevention of corneal allograft rejection depends on the development of topically applied compounds that can prevent inflammation and vascularization and inhibit the activation of T lymphocytes. Considerable progress has been made using immunomodulators, including blocking antibodies and soluble coreceptor blocking agents such as CTLA4-Ig. Combinations of antiangiogenic agents and immunomodulators hold great promise for preventing corneal allograft rejection in patients.

摘要

本文综述了实验动物角膜移植排斥反应的主要研究结果。角膜决定其免疫赦免特性的主要解剖学和生物学特征是其无血管性。移植手术创伤会损害这种免疫赦免特性,使角膜移植面临免疫排斥风险。在过去50年中,兔子、大鼠和小鼠被广泛用于免疫介导的角膜移植排斥反应过程的研究。很明显,移植后移植物的炎症和新生血管形成会使角膜移植易于发生经典的细胞介导免疫排斥反应。角膜细胞的抗原性已被研究,发现其与其他细胞和组织相比显著较低。角膜移植排斥是一个针对主要组织相容性复合体抗原的细胞介导过程,涉及CD4 + T辅助细胞和CD8 + 细胞毒性细胞。角膜移植排斥的预防取决于开发能够预防炎症和血管形成并抑制T淋巴细胞活化的局部应用化合物。使用免疫调节剂,包括阻断抗体和可溶性共受体阻断剂如CTLA4-Ig,已经取得了相当大的进展。抗血管生成剂和免疫调节剂的联合应用在预防患者角膜移植排斥方面具有很大前景。

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