title: Corneal Immunosuppressive Mechanisms, Anterior Chamber-Associated Immune Deviation (ACAID) and Their Role in Allograft Rejection.
abstract: Corneal transplantation is the most frequently performed transplant procedure in humans. Human leukocyte antigen matching, while imperative for other types of organ transplants, is usually not performed before cornea transplantation. With the use of topical steroid immunosuppressants, which are subsequently tailed off to almost zero, most corneal transplants will not be rejected in recipients with low risk of graft rejection. This phenomenon has been described as immune privilege by Medawar many years ago. However, this immune privilege is relative and can be easily eroded, e.g. by postoperative nonspecific inflammation or other causes of corneal or ocular inflammation. Interestingly, corneas that are at high risk of rejection have a higher failure rate than other organs. Considerable progress has been made in recent years to provide a better understanding of corneal immune privilege. This chapter will review current knowledge on ocular immunosuppressive mechanisms including anterior chamber-associated immune deviation and discuss their role(s) in corneal allograft rejection. Ultimately, this evolving information will be of benefit in developing therapeutic strategies to prevent corneal transplant rejection.
authors.affiliation: College of Medicine, Nursing and Health Sciences, Regenerative Medicine Institute, National University of Ireland, Galway, Ireland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Treacy
authors.affiliation: Department of Ophthalmology, University Hospital Galway, National University of Ireland, Galway, Ireland.
authors.forename: Gerry
authors.initials: G
authors.lastname: Fahy
authors.affiliation: College of Medicine, Nursing and Health Sciences, Regenerative Medicine Institute, National University of Ireland, Galway, Ireland. thomas.ritter@nuigalway.ie.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ritter
authors.affiliation: Orbsen Therapeutics Ltd, Galway, Ireland.
authors.forename: Lisa
authors.initials: L
authors.lastname: O'Flynn
mesh_terms: D000818:Animals; D000867:Anterior Chamber / Q000276:immunology* / Q000378:metabolism; D003315:Cornea / Q000033:anatomy & histology / Q000276:immunology* / Q000502:physiology; D016039:Corneal Transplantation; D006084:Graft Rejection / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007155:Immunologic Factors / Q000276:immunology / Q000378:metabolism; D056747:Immunomodulation; D014184:Transplantation, Homologous
chemical_list: D007155:Immunologic Factors
keywords: ACAID; Cornea; Immunosuppression; Transplantation; Tregs