Braude L S, Chandler J W
Surv Ophthalmol. 1983 Mar-Apr;27(5):290-305. doi: 10.1016/0039-6257(83)90229-1.
The greater success of corneal transplantation compared to other organ transplants has led to the concept that the cornea is a site of "immunological privilege." Corneal cells possess the antigens of the major histocompatibility complex responsible for allograft rejection in other tissues (i.e., HLA antigens). The avascularity of the cornea accounts for the relative protection of the donor cornea from the immunological surveillance of the recipient. As the roles and functions of the major histocompatibility complex are unravelled, the mechanisms responsible for host sensitization, lymphocyte activation and allograft rejection are becoming better understood. In particular, the HLA-DR antigen in humans is believed to play an integral part in allograft rejection. Langerhans cells in human corneal epithelium have been shown to bear this antigen. Evidence suggests that these cells or similar HLA-DR-bearing cells in the cornea play a major role in corneal allograft rejection. In light of these advances in transplantation immunobiology, new methods of suppressing and possibly preventing allograft rejection in corneal transplantation are presented.
与其他器官移植相比，角膜移植取得了更大的成功，这催生了角膜是“免疫赦免部位”的概念。角膜细胞拥有主要组织相容性复合体的抗原，这些抗原在其他组织中负责同种异体移植排斥反应（即人类白细胞抗原）。角膜无血管的特性使得供体角膜相对免受受体的免疫监视。随着主要组织相容性复合体的作用和功能逐渐被揭示，导致宿主致敏、淋巴细胞活化和同种异体移植排斥反应的机制也越来越为人所理解。特别是，人类的人类白细胞抗原-DR被认为在同种异体移植排斥反应中起着不可或缺的作用。已证明人类角膜上皮中的朗格汉斯细胞带有这种抗原。有证据表明，这些细胞或角膜中类似的携带人类白细胞抗原-DR的细胞在角膜同种异体移植排斥反应中起主要作用。鉴于移植免疫生物学的这些进展，本文介绍了抑制并可能预防角膜移植中同种异体移植排斥反应的新方法。
