Depletion of donor-derived Langerhans cells promotes corneal allograft survival.

A mouse model of penetrating keratoplasty was used to evaluate the efficacy of ultraviolet radiation (UVR) and hyperbaric oxygen (HBO) treatments in depleting corneal Langerhans cells (LC) and promoting corneal allograft survival. The presence of donor-derived LC dramatically increased the immunogenicity and rejection rate of corneal allografts. Rejection increased from 40% in LC- corneal grafts to 80% in grafts containing donor-derived LC. Pretreatment with either HBO or UVR resulted in a sharp decrease in both the incidence and tempo of rejection for grafts containing donor LC, but neither procedure affected the fate of LC- corneal allografts. UVR-treatment abolished the immunogenicity of LC+ grafts. UVR-treated orthotopic grafts failed to elicit either cytotoxic T lymphocyte (CTL) or delayed-type hypersensitivity (DTH) responses that were any greater than naive control mice. The results suggest that purging corneal allografts of stray donor-derived LC might improve corneal allograft survival in high-risk patients without jeopardizing the functional integrity of the graft.