We studied IL-1alpha level in corneal scars with/without neo-vascularization. A total of 27 patients underwent grafting for corneal scar. Recipients were grouped according to number of vascularized ...quadrants (0 to IV/IV): none (n = 12), one (n = 5), two (n = 4) and four (n = 6). Recipient corneas were collected during surgery and IL-1alpha measured by immunoassay. Controls were donor corneas unsuitable for transplantation. Graft rejection rate was calculated for each group. Mean IL-1alpha concentration in corneal scars was 6 +/- 3.93 pg/mm3; significantly higher as compared to controls (1.25 +/- 2.03 pg/mm3). IL-1alpha correlated well with amount of blood vessels, except in IV/IV scars: 5.17 +/- 3.65 pg/mm3 for 0/IV; 8.02 +/- 2.51 pg/mm3 for I/IV; 8.27 +/- 3.62 pg/mm3 for II/IV and 4.47 +/- 5.03 pg/mm3 for IV/IV corneal scars. Vascularization of corneal scar is associated with increased IL-1alpha level (in all but highly vascularized scars), indicating that IL-1alpha promotes early stages of vascularization. Graft rejection rate increases in patients with higher vascularization, independently of IL-1alpha level.
PURPOSE. Topical interleukin-1 receptor antagonist (IL-1ra) promotes corneal allograft survival in naive hosts by suppressing local antigen-presenting cell function and allosensitization. The purpose ...of these experiments was to test whether IL-1ra could likewise promote transplant survival in pre-sensitized hosts. METHODS. Orthotopic corneal grafts were performed into immunized (N = 65) and naive (N = 40) BALB/c recipients from fully disparate (C57BL/6) or minor H-only disparate (B10.D2) mice. Allograft recipients were randomized to receive treatment with IL-1ra or vehicle only. RESULTS. Immunization to both MHC and minor H alloantigens was associated with accelerated graft rejection. IL-1ra treatment had no significant impact on overall graft longevity or the early incidence of graft rejection in pre-immunized recipients of fully-disparate corneal allografts (P = 0.25). Similarly, although rejection of corneal grafts in hosts immunized to minor H alloantigens occurred more slowly in mice treated with IL-1ra than in controls (P = 0.04), overall graft survival at 8 weeks was comparable (P = 0.07) among the two groups. CONCLUSIONS. The accelerated rejection of corneal allografts in presensitized hosts is not materially affected by IL-1ra, particularly if the host has been immunized to donor MHC alloantigens. These data confirm that the role of IL-1ra in corneal transplantation is primarily limited to downmodulating the afferent, not expression, arm of alloimmunity.
Cystoid macular edema (CME) is the accumulation of extracellular fluid in the outer plexiform and inner nuclear layers of the macula that occurs as the result of the breakdown of the blood-retinal ...barrier. The exact cause of CME is still unclear; the release of inflammatory mediators seems to be the most probable causing factor. It is characterized by cystoid fluid-filled spaces.
To determine pro-inflammatory cytokine secretion from human corneas with different pathology and to establish whether cytokine profile influences corneal graft outcome.
Secretion of both ...proinflammatory cytokine interleukin (IL)-1alpha and tumor necrosis factor (TNF)-alpha was measured after cultivation of 47 corneas collected from corneal graft recipients suffering from different corneal diseases. Non-inflammatory corneal diseases were keratoconus (n=8), keratoglobus (n=2), bullous keratopathy (n=11), and Groenouw stromal dystrophy type II (n=2), whereas inflammatory included vascularized corneal scar (n=14), rejected graft (n=6), and corneal ulcer (n=4). Corneas were cultivated at 37 degrees C for 24 hours and frozen until cytokine detection was measured by immunoassay. Donor corneas unsuitable for transplantation were used as controls (n=7). Corneal graft recipients were followed at least 18 months and rejection rate was calculated for each group.
The median concentration of IL-1alpha secreted from corneas of recipients with non-inflammatory diseases was 2.47 pg/mm(3) (range, 0.13-9.95). In inflammatory corneal diseases, IL-1alpha concentration was significantly higher (median, 5.92 pg/mm(3); range, 0.48-12.68; P=0.005). IL-1alpha production in controls (median, 0.63 pg/mm3; range, 0.36-1.29 pg/mm(3)) was significantly lower than in inflammatory corneal diseases (P<0.001) and non-inflammatory diseases (P=0.008). Low level of TNF-alpha was detected only in 5 cases of vascularized corneal scars, 3 cases of bullous keratopathy, and 3 cases of graft rejection. Rejection rate was significantly higher in inflammatory than in non-inflammatory group (46% vs <10%, respectively, P=0.008). IL-1alpha and TNF-alpha were absent from all patient's sera, confirming its local intra-ocular production.
Increased production of IL-1alpha in corneal recipients with inflammatory diseases suggests its role in corneal graft rejection in humans.
In this study we examined whether immunization with heterotopic corneal graft can be suppressed by usage of cultured corneal tissue. Starting from the hypothesis that the corneal antigenicity might ...change during long-time storage, we compared, in a mouse model, the immunization obtained with fresh and>stored corneas. Heterotopic (chest wall) mice corneal allografts were exchanged between donors and hosts: (1) mismatched at multiple minor H loci and (2) only H-Y mismatched animals. Median survival time (MST) of primary and secondary skin grafts exchanged between mentioned donors and hosts was recorded. Recipient mice were immunized with either: (a) tail-skin graft, (b) fresh cornea graft or (c) corneal graft stored for three weeks in tissue culture. Three weeks later, recipients were challenged with skin graft placed at the opposite side of the chest wall and MST of these skin grafts was recorded. MST of secondary skin grafts in animals that had been immunized by skin served as a control. In case of multiple minor H disparity, MST of a first-set skin graft was 12 days, as compared to 9 days in case of secondary skin graft (P<0·05). MST of secondary skin graft following immunization by both fresh and stored corneas was 10 days. These data suggest that stored corneas don't loose ability to sensitize the multiple minor H disparate host. It also show that both cultured and fresh corneas, when placed in non-privileged site, have same immunizing capacity as skin (MST of 10 and 9 days, respectively;P>0·1). When only H-Y disparate animals were used, MST of a first-set skin grafts was 26 days and of secondary skin graft 11 days (P<0·01). In case of H-Y disparity, MST obtained after immunization with fresh and stored corneal tissue (19 and 18 days, respectively) was significantly longer as compared to skin (P<0·05). However, no significant difference in MST of secondary skin grafts between recipients of fresh (19 days) and stored corneal grafts (18 days) was recorded. According to our results, the ability of corneal tissue to immunize both multiple minor H mismatched, as well as only H-Y mismatched host, was not influenced by storage in a tissue culture.
The authors discussed about the problem of special form in astigmatism classification. This special type of astigmatism is the form of obliquely crossed astigmatism. In which the meridians, major and ...minor, are not right angles. In this astigmatism is not possible to prescribing for cylindrical (toric) spectacle lens. Authors describe the Thompson formula for oblique crossed cylinder and observe that this formula is to complicate for calculation new cylinder power. In this reason, the authors create the new formula and simple procedure for this calculation. This simple formula based on vector analysis and read: DM3 = DM2 ´ cos2 b.
To evaluate the effectiveness of lodoxamide in the therapy and prophylaxis of the ocular allergies.
This prospective study included 64 patients divided in 2 groups. In the first group there were 47 ...symptomatic patients suffering from seasonal allergic conjunctivitis (n = 27), perennial allergic conjunctivitis (n = 16) and giant papillary conjunctivitis (n = 4). The symptomatic patients were examined upon arrival and every 2 weeks until the symptoms were reduced. During the period, lodoxamide drops were administered 4 times a day. In the second group there were 17 patients who had a history of seasonal ocular allergies during previous years but were still not symptomatic upon arrival. In the group of 17 patients who were very likely to develop ocular allergy but up to inclusion into the study had no ocular symptoms, 12 (70%) presented with allergic rhinitis while 5 (30%) had asthma. The symptoms intensity (itching, discomfort, foreign body sensation, pain, tearing) was graded on a 0-3 scale. The clinical signs (follicles, papillae, hyperemia, conjunctival edema, Trantas dots, stromal infiltrates) were detected on a slit lamp examination and graded on a 0-3 scale.
In the group of 47 symptomatic patients 2-4 weeks after lodoxamide administration, 70-80% of symptomatic patients examined clinically had less or no follicles, 60-70% had reduced or no edema, the secretion was stopped or greatly reduced in 50-70% of patients. All of the patients reported reduced or no itching, 60% of patients reported less discomfort, photophobia and reduced tearing. In the asymptomatic group two weeks after the initiation of the prophylaxis 88% of patients were still with no ocular signs of allergy while 12% of patients had a conjunctival hyperemia and follicles. After 4 weeks of the prophylaxis 76% of patients patients were still asympthomatic while only 4 developed a mild form of allergic conjunctivitis (conjunctival hyperemia and papillae), but less severe than during previous episodes.
Lodoxamide was effective in reduction of symptoms and clinical signs of the ocular allergies. The best results were obtained if the drug was administered as a prophylaxis or very early in the course of the disease.
