New Developments in Topical and Systemic Immunomodulation Following Penetrating Keratoplasty

Reis, Alexander; Reinhard, Thomas

doi:10.1007/978-3-540-85544-6_3

Cited by 2 publications

(2 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is mainly due to the immune-privileged status of the eye and the cornea [ 5 ] and holds true for low-risk situations, e.g., keratokonus or Fuchs' dystrophy [ 4 ]. However, even in these patients, topical corticosteroids are essential as a mainstay treatment during the first months following keratoplasty [ 6 ] to reduce corneal inflammation and corneal lymph- and hemangiogenesis [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Compared to low-risk situations, these patients require systemic immunosuppressive therapy with cyclosporin A or mycofenolate mofetile [ 10 , 14 ] in addition to topical corticosteroids. These systemic treatments are associated with severe adverse effects [ 6 ]. Therefore, new formulations and therapeutic strategies to minimize these side effects are currently under investigation [ 16 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Short-Term Azithromycin Treatment Promotes Cornea Allograft Survival in the Rat

et al. 2013

Self Cite

View full text Add to dashboard Cite

BackgroundAny inflammatory response following corneal transplantation may induce rejection and irreversible graft failure. The purpose of this study is to analyze the anti-inflammatory effect of azithromycin (AZM) following experimental keratoplasty in rats.MethodsCorneal transplants were performed between Fisher-donor and Lewis-recipient rats. Recipients were postoperatively treated three times daily with AZM, miglyol, ofloxacin or dexamethasone eye drops. As an additional control, AZM was applied following syngeneic keratoplasty. Furthermore, short-term treatments with AZM for seven days perioperatively or with AZM only three days prior to the transplantation were compared to appropriate controls. All transplants were monitored clinically for opacity, edema, and vascularization. Infiltrating CD45+, CD4+, CD8+, CD25+, CD161+ and CD163+ cells were quantified via immunohistochemistry.ResultsAZM significantly promoted corneal graft survival compared with miglyol or ofloxacin treatment. This effect was comparable to topical dexamethasone. No adverse AZM effect was observed. Histology confirmed a significant reduction of infiltrating leukocytes. The short-term application of AZM for three days prior to transplantation or for seven days perioperatively reduced corneal graft rejection significantly compared with the controls.ConclusionsAlong with antibiotic properties, topical AZM has a strong anti-inflammatory effect. Following keratoplasty, this effect is comparable to topical dexamethasone without the risk of steroid-induced adverse effects. Short-term treatment with AZM three days prior to the transplantation was sufficient to promote graft survival in the rat keratoplasty model. We therefore suggest further assessing the anti-inflammatory function of topical AZM following keratoplasty in humans.

show abstract