University of Texas Southwestern Medical Center, Dallas, Texas, 75390, USA.
Ocul Immunol Inflamm. 2010 Jun;18(3):162-71. doi: 10.3109/09273948.2010.486100.
Corneal transplantation has been performed successfully for over 100 years. Normally, HLA typing and systemic immunosuppressive drugs are not utilized, yet 90% of corneal allografts survive. In rodents, corneal allografts representing maximal histoincompatibility enjoy >50% survival even without immunosuppressive drugs. By contrast, other categories of transplants are invariably rejected in such donor/host combinations. The acceptance of corneal allografts compared to other categories of allografts is called immune privilege. The cornea expresses factors that contribute to immune privilege by preventing the induction and expression of immune responses to histocompatibility antigens on the corneal allograft. Among these are soluble and cell membrane molecules that block immune effector elements and also apoptosis of T lymphocytes. However, some conditions rob the corneal allograft of its immune privilege and promote rejection, which remains the leading cause of corneal allograft failure. Recent studies have examined new strategies for restoring immune privilege to such high-risk hosts.
角膜移植已经成功进行了 100 多年。通常情况下，不需要进行 HLA 分型和全身免疫抑制药物治疗，但 90%的角膜移植物可以存活。在啮齿动物中，即使没有免疫抑制药物，具有最大组织相容性抗原差异的同种异体角膜移植物的存活率也超过 50%。相比之下，在这种供体/宿主组合中，其他类别的移植物总是被排斥。与其他类别的同种异体移植物相比，角膜同种异体移植物的接受被称为免疫特权。角膜通过防止诱导和表达对角膜同种异体上的组织相容性抗原的免疫反应，表达有助于免疫特权的因子。其中包括阻止免疫效应细胞和 T 淋巴细胞凋亡的可溶性和细胞膜分子。然而，一些情况剥夺了角膜移植物的免疫特权，并促进排斥反应，这仍然是角膜移植物失功的主要原因。最近的研究已经探讨了为这些高风险宿主恢复免疫特权的新策略。
