Dana M R, Olkowski S T, Ahmadian H, Stark W J, Young E M
Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Invest Ophthalmol Vis Sci. 1990 Nov;31(11):2261-8.
Donor rabbit corneal endothelium was pretreated with different doses of ultraviolet (UV-B) irradiation (302 nm) before grafting to test whether allograft survival could be favorably affected in comparison with untreated corneas grafted into the same recipients. Endothelial rejection was observed in 19 of 32 (59%) eyes that received no treatment compared with five of 32 (16%) eyes that received UV-B (P less than 0.001), and increasing doses of UV-B were associated with lower rejection rates (P less than 0.05). Although exposure of donor endothelium significantly reduced endothelial rejection at all doses tested, it resulted in primary graft failure in a substantial proportion of corneas treated at high doses. Class II (Ia) antigen staining of corneal tissue was present in conjunction with clinical evidence of rejection, and the magnitude of staining correlated with the histologic extent of inflammation. Scanning electron microscopy revealed various endothelial cell surface irregularities and membrane defects in high-dose UV-treated corneas. Endothelial cell cultures exposed in vitro to UV-B light showed a dose-dependent loss in cell viability. These data suggest that UV-B pretreatment of donor corneal endothelium prolongs graft survival but that toxic side effects must be carefully controlled.
在移植前，供体兔角膜内皮用不同剂量的紫外线（UV-B，波长302nm）进行预处理，以测试与移植到相同受体的未处理角膜相比，同种异体移植的存活是否会受到有利影响。在32只未接受处理的眼中，有19只（59%）观察到内皮排斥反应，而在接受UV-B处理的32只眼中，有5只（16%）出现内皮排斥反应（P<0.001），并且UV-B剂量增加与排斥率降低相关（P<0.05）。虽然供体内皮暴露在所有测试剂量下均显著降低了内皮排斥反应，但在高剂量处理的相当一部分角膜中导致了原发性移植失败。角膜组织的II类（Ia）抗原染色与排斥反应的临床证据同时出现，并与炎症的组织学程度相关。扫描电子显微镜显示，高剂量UV处理的角膜存在各种内皮细胞表面不规则和膜缺陷。体外暴露于UV-B光的内皮细胞培养物显示出细胞活力的剂量依赖性丧失。这些数据表明，供体角膜内皮的UV-B预处理可延长移植存活时间，但必须仔细控制毒性副作用。
