Abstract:The aim of this clinical study was to examine corneas extracted from the patients during penetrating keratoplasty for the presence of immunoglobulins and inflammatory cells that can be warning for the graft failure. Individual clinical diagnoses were correlated to the presence of the inflammatory signs in corneal tissue. The signs of inflammation in corneal layers were detected especially in group of patients classified as viral keratitis but were also found in corneas of patients with degenerative diseases of the cornea. Depending on the number of keratoplasties no statistical difference in analysed parameters was found. Inflammatory process represented by slight positive presence cellular infiltration and/or immunoglobulins could be present in corneal tissue also in absence of acute manifestation. Histological and immunohistochemical evaluation of corneal tissue from patients undergoing penetrating keratoplasty could improve estimation of correct diagnosis. Subsequently prompt adequate therapy could improve worse prognosis of corneal graft with evident immune process.
Abstract:The presence of corneal antibodies in blood sera was investigated in 130 patients by immunoblotting analysis. Sera were obtained from patients before the first keratoplasty, repeated corneal transplantation or keratoplasty of the other eye. Baseline levels of antibodies in 15 healthy blood donors served to establish a positivity threshold. Patients were divided according to diagnosis and number of keratoplasties. Corneal antigens were prepared from donor corneas not suitable for surgery. Hyperimmune sera obtained by immunization of rabbits were used as positive controls. Significant increase in corneal antibodies specific to epithelial antigens was found in patients (62.5% positive) with keratitis of microbial origin. The presence of circulating antibodies to endothelial or stromal proteins was without significant changes. Depending on the number of keratoplasties no statistical difference in corneal antibodies production was observed. The group of patients with increased anti-corneal antibodies already before transplantation had to take immunosuppressive and anti-inflammatory therapy after keratoplasty.
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