OBJECTIVE: To identify whether histopathologic and immunoassay biomarkers of inflammation are predictive for allograft rejection after penetrating keratoplasty (PKP) for herpes simplex virus (HSV) keratitis. DESIGN: Retrospective, interventional case series with prospective component of pathologic evaluation of frozen tissue. PARTICIPANTS: Sixty-two consecutive patients with HSV keratitis who underwent PKP. METHODS: A chart review and histopathologic examination of the excised host corneal button was performed to identify associations between clinical data and histopathologic presence of inflammation. Enzyme-linked immunosorbent assay for interleukin (IL)-8 and monocyte chemotactic protein-1 (MCP-1) chemokines and immunohistochemical staining for human leukocyte antigen (HLA)-DR and intercellular adhesion molecule-1 (ICAM-1) antigens was also performed in inflamed and noninflamed specimens. MAIN OUTCOME MEASURES: To determine whether the presence of subclinical inflammation at the time of PKP predicts allograft rejection. RESULTS: Although 81% of patients had clinically quiescent disease, histopathology revealed that 74% had active corneal inflammation, a finding that was associated with the presence of clinical neovascularization (P = 0.01). Allograft rejections were experienced by 34% of the patients in this cohort. The histopathologic presence of inflammation was a risk factor for allograft rejection (P = 0.02). Corneal specimens demonstrating inflammation had significantly increased IL-8 (P = 0.0005) and MCP-1 (P = 0.003) levels, and greater immunoreactivity for HLA-DR and ICAM-1 when compared with specimens without inflammation. Treatment with IL-10 ex vivo significantly inhibited IL-8 (P = 0.006), and MCP-1 (P = 0.01) chemokines, and qualitatively substantially reduced HLA-DR, but not ICAM-1, expression. CONCLUSIONS: Histopathologic inflammation is a risk factor for corneal allograft rejection.
OBJECTIVE: To identify whether histopathologic and immunoassay biomarkers of inflammation are predictive for allograft rejection after penetrating keratoplasty (PKP) for herpes simplex virus (HSV) keratitis. DESIGN: Retrospective, interventional case series with prospective component of pathologic evaluation of frozen tissue. PARTICIPANTS: Sixty-two consecutive patients with HSV keratitis who underwent PKP. METHODS: A chart review and histopathologic examination of the excised host corneal button was performed to identify associations between clinical data and histopathologic presence of inflammation. Enzyme-linked immunosorbent assay for interleukin (IL)-8 and monocyte chemotactic protein-1 (MCP-1) chemokines and immunohistochemical staining for human leukocyte antigen (HLA)-DR and intercellular adhesion molecule-1 (ICAM-1) antigens was also performed in inflamed and noninflamed specimens. MAIN OUTCOME MEASURES: To determine whether the presence of subclinical inflammation at the time of PKP predicts allograft rejection. RESULTS: Although 81% of patients had clinically quiescent disease, histopathology revealed that 74% had active corneal inflammation, a finding that was associated with the presence of clinical neovascularization (P = 0.01). Allograft rejections were experienced by 34% of the patients in this cohort. The histopathologic presence of inflammation was a risk factor for allograft rejection (P = 0.02). Corneal specimens demonstrating inflammation had significantly increased IL-8 (P = 0.0005) and MCP-1 (P = 0.003) levels, and greater immunoreactivity for HLA-DR and ICAM-1 when compared with specimens without inflammation. Treatment with IL-10 ex vivo significantly inhibited IL-8 (P = 0.006), and MCP-1 (P = 0.01) chemokines, and qualitatively substantially reduced HLA-DR, but not ICAM-1, expression. CONCLUSIONS:Histopathologic inflammation is a risk factor for corneal allograft rejection.
Authors: R J Epstein; J A Seedor; N G Dreizen; R D Stulting; G O Waring; L A Wilson; H D Cavanagh Journal: Ophthalmology Date: 1987-08 Impact factor: 12.079
Authors: V M Elner; R M Strieter; M A Pavilack; S G Elner; D G Remick; J M Danforth; S L Kunkel Journal: Am J Pathol Date: 1991-11 Impact factor: 4.307
Authors: Lucia Kuffova; Jared E Knickelbein; Tian Yu; Carlos Medina; Guillermo Amescua; Alexander M Rowe; Robert L Hendricks; John V Forrester Journal: Invest Ophthalmol Vis Sci Date: 2016-04 Impact factor: 4.799