In Vivo Confocal Microscopy Demonstrates Increased Immune Cell Densities in Corneal Graft Rejection Correlating With Signs and Symptoms

Chirapapaisan, Chareenun; Abbouda, Alessandro; Jamali, Arsia; Müller, Rodrigo; Colón, Clara; Witkin, Deborah; Şahin, Afsun; Dana, Reza; Cruzat, Andrea; Hamrah, Pedram

doi:10.1016/j.ajo.2019.02.013

Cited by 14 publications

(19 citation statements)

References 52 publications

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“…Previously, Chirapapaisan C et al reported that there was a significant increase in immune cell density following corneal graft rejection, along with a correlation between sub-basal layer immune cell density and clinical signs of graft rejection [10]. Of note, the density of immune cells was significantly increased in the sub-basal and endothelial layers in rejected grafts compared with that in nonrejected grafts.…”

Section: In Vivo Confocal Microscopy Evaluation Of Immune Cells In Thmentioning

confidence: 92%

“…It is possible that increased leukocyte maturation and T-cell dysregulation triggered by dry eye disease may participate in the pathogenesis of allograft rejection [16]. Recently, studies have reported that atypical hyper-reflective cells and activated keratocytes in the corneal stroma are crucial biomarkers of corneal allograft rejection [10,11,16].…”

Section: In Vivo Confocal Microscopy Evaluation Of Immune Cells In Thmentioning

confidence: 99%

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Variable Responses to Corneal Grafts: Insights from Immunology and Systems Biology

Zazzo

Lee

Sung

et al. 2020

JCM

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Corneal grafts interact with their hosts via complex immunobiological processes that sometimes lead to graft failure. Prediction of graft failure is often a tedious task due to the genetic and nongenetic heterogeneity of patients. As in other areas of medicine, a reliable prediction method would impact therapeutic decision-making in corneal transplantation. Valuable insights into the clinically observed heterogeneity of host responses to corneal grafts have emerged from multidisciplinary approaches, including genomics analyses, mechanical studies, immunobiology, and theoretical modeling. Here, we review the emerging concepts, tools, and new biomarkers that may allow for the prediction of graft survival.

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Section: In Vivo Confocal Microscopy Evaluation Of Immune Cells In Thmentioning

confidence: 92%

Section: In Vivo Confocal Microscopy Evaluation Of Immune Cells In Thmentioning

confidence: 99%

Variable Responses to Corneal Grafts: Insights from Immunology and Systems Biology

Zazzo

Lee

Sung

et al. 2020

JCM

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“…13 Extensive analyses have been made of a wide variety of information acquired from IVCM, such as corneal structural changes; subbasal nerve morphology and density; and inflammatory reactions including some pathogens of infectious keratitis. 6,12,[14][15][16] The results of those studies have assisted in the prompt diagnosis and timely management of a range of diseases.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Corneal Subbasal Nerves in Different Age Groups: An in vivo Confocal Microscopic Analysis

Chirapapaisan¹,

Thongsuwan²,

Chirapapaisan³

et al. 2021

OPTH

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Purpose: To determine the normative characteristics of corneal subbasal nerves in different age groups using laser scanning in vivo confocal microscopy (IVCM). Patients and Methods: This descriptive observational study recruited healthy subjects (aged 20-60 years) from Siriraj Health-Screening Center. Excluded were individuals who had abnormal ocular symptoms, previous ocular surgery, a history of any diseases related to systemic and/or corneal neuropathy, or abnormal corneal sensitivity. Corneal IVCM (HRT3/ Rostock Corneal Module) was performed at the central cornea to analyze the subbasal nerve plexus. The corneal nerve characteristics, comprising the number and density of nerves (main nerve trunks, branches, and total nerves) were analyzed using the NeuronJ program, and the corneal nerve tortuosity was graded. The correlations between the subbasal nerve density, tortuosity and age were then analyzed. Results: Eighty subjects were enrolled, with twenty in each of four age groups (20-30, >30-40, >40-50, and >50-60 years). Overall, the mean number and density of main nerve trunks were 27.93±0.81/mm 2 and 11.22±0.30 mm/mm 2 , respectively. As of the nerve branches, the average number and density were 103.56±2.37/mm 2 and 9.15±0.30 mm/mm 2 , respectively. The total nerve density was 20.37±0.39 mm/mm 2 . There were no significant differences between subbasal nerve parameters of the four age groups. It is noteworthy that 65% of the subjects aged over 40 years revealed high-grade nerve tortuosity. Conclusion:The corneal subbasal nerve numbers and densities were not significantly different among a healthy population aged 20-60 years. However, there was a trend towards high tortuosity of the corneal nerve in people aged over 40 years.

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“…There are a limited number of published reports on cellular changes of graft rejection by IVCM. 3 4 5 6 7 …”

Section: Introductionmentioning

confidence: 99%

“…Understanding the structural changes of the cornea and the inflammatory process of acute graft rejection at a cellular level could help successful treatment and also prevention of subsequent rejection episodes. 5 6 7 Confocal microscopy helps to understand different aspects of the immunological events that could eventually lead to reversible or irreversible graft damage. In this study, the in vivo characteristics of cornea in acute phase of graft rejection and after the resolution of the episode are evaluated.…”

Section: Introductionmentioning

confidence: 99%

In vivo confocal microscopic evaluation of corneal changes in acute endothelial rejection

et al. 2021

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Purpose: To evaluate the microstructural corneal changes during acute endothelial graft rejection and following treatment using in vivo confocal microscopy (IVCM). Methods: Patients with a clinical diagnosis of severe acute endothelial graft rejection following penetrating keratoplasty were included in this study. IVCM was performed on the 1 st day the patient presented with rejection signs and at the time of clinical resolution. Results: Twenty-three patients were included in this study. Inflammatory cells appeared as dendritic cells (DCs) and less frequently, as non-DCs in basal epithelial and subbasal areas. Activated keratocytes (AKs) (type 1: large cells with visible cytoplasmic processes; type 2: elongated and spindle-shaped keratocytes) were visible in acute phase. Following resolution, type 1 AKs considerably reduced, but type 2 cells were more often persisted. Multiple types of keratic precipitates (KPs) were also visible in acute phase which resolved following resolution of rejection. Conclusions: Acute graft rejection was associated with an increase in the number of DCs, activation of keratocytes, and aggregation of various types of KPs. Inflammatory process subsided in almost all cases, but the IVCM changes did not return to normal early after clinical resolution of rejection.

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In Vivo Confocal Microscopy Demonstrates Increased Immune Cell Densities in Corneal Graft Rejection Correlating With Signs and Symptoms

Cited by 14 publications

References 52 publications

Variable Responses to Corneal Grafts: Insights from Immunology and Systems Biology

Variable Responses to Corneal Grafts: Insights from Immunology and Systems Biology

Characteristics of Corneal Subbasal Nerves in Different Age Groups: An in vivo Confocal Microscopic Analysis

In vivo confocal microscopic evaluation of corneal changes in acute endothelial rejection

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