Chen Jian, Zhou Qing, Zeng Jin, Xu Jin-tang, Zhao Song-bin, Wang Yan-ping
Department of Ophthamology, First Affiliated Hospital of Medical College of Jinan University, Guangzhou 510630, China.
Zhonghua Yan Ke Za Zhi. 2003 Sep;39(9):550-4.
To evaluate the general cause of limbal allograft transplantation rejection and the effects of the immunosuppressant FK506.
Limbal deficiency models were established in 48 New Zealand rabbits, which were randomized into three groups of 16 rabbits each. Limbal allograft transplantation was performed one month later. After transplantation, the FK506 group, the CsA group and the untreated group were treated with FK506 eye drops (0.5 g/L), 1% CsA eye drops and physiological saline, respectively. Graft survival and ocular surface were observed clinically for 10 weeks. Impression cytology was performed on the central cornea of the rabbit one month after limbal ablation, 1 day before allograft transplantation, and two and four weeks after transplantation. The expression of CD25 in peripheral T cells was identified dynamically one day before and one and eight weeks after transplantation. The expression of CD25 on the limbal allograft and lymphocyte infiltration was also identified dynamically the fourth, eighth and tenth week after transplantation.
Conjunctivalization of corneal epithelium was found in the limbal deficiency model by impression cytology. Two weeks after limbal allograft transplantation, the central corneal epithelium regained corneal phenotype. Four weeks later, the ocular surface of FK506 group and CsA group continued to express corneal phenotype. Epithelium rejection appeared first in the untreated group (P < 0.05), which had the highest level of the lymphocyte infiltration and the expression of CD25 in peripheral blood and allografts after limbal allograft transplantation (P < 0.05). Epithelium rejection occurred next with the CsA group. FK506 group epithelium rejection occurred last and had the lowest level of the lymphocyte infiltration and the expression of CD25 in peripheral T cell and limbal allografts.
Topically administered FK506 eye drops early after limbal allograft transplantation can delay allograft rejection by effectively inhibiting the expression of CD25 in peripheral T cells and limbal allografts. Also, FK506 is more effective than CsA.
评估角膜缘移植排斥反应的常见原因及免疫抑制剂FK506的作用效果。
在48只新西兰兔中建立角膜缘缺损模型,随机分为3组,每组16只。1个月后进行角膜缘移植。移植后,FK506组、环孢素A(CsA)组和未治疗组分别给予0.5 g/L的FK506滴眼液、1% CsA滴眼液和生理盐水。临床观察移植物存活及眼表情况10周。在角膜缘切除后1个月、移植前1天、移植后2周和4周对兔角膜中央进行印迹细胞学检查。在移植前1天、移植后1周和8周动态检测外周血T细胞中CD25的表达。在移植后第4、8和10周动态检测角膜缘移植物中CD25的表达及淋巴细胞浸润情况。
印迹细胞学检查发现角膜缘缺损模型中角膜上皮结膜化。角膜缘移植2周后,角膜中央上皮恢复角膜表型。4周后,FK506组和CsA组眼表持续表达角膜表型。未治疗组最早出现上皮排斥反应(P < 0.05),角膜缘移植后外周血和移植物中淋巴细胞浸润及CD25表达水平最高(P < 0.05)。CsA组其次出现上皮排斥反应。FK506组上皮排斥反应出现最晚,外周血T细胞和角膜缘移植物中淋巴细胞浸润及CD25表达水平最低。
角膜缘移植术后早期局部应用FK506滴眼液可通过有效抑制外周血T细胞和角膜缘移植物中CD25的表达来延缓移植排斥反应。此外,FK506比CsA更有效。