title: Immune Cells on the Corneal Endothelium of an Allogeneic Corneal Transplantation Rabbit Model.
abstract: Corneal endothelial cell density undergoes a progressive decrease for many years after transplantation, eventually threatening patients with late endothelial failure. The purpose of this study was to investigate the possibility of an immunologic response in successfully grafted corneal endothelium.
  
  
  
  The corneal endothelium of patients who had undergone corneal transplantation was evaluated by specular microscopy. Rabbit models were subjected to penetrating keratoplasty (PK) with either syngeneic or allogeneic corneal transplants and Descemet's stripping endothelial keratoplasty (DSEK) with allogeneic corneal transplants. The presence of immune cells and expression of proinflammatory cytokines were determined by immunostaining. The corneal endothelium and immune cells were also evaluated by scanning electron microscopy.
  
  
  
  Scanning slit contact specular microscopy of patients with no features of graft rejection revealed cell-like white dots on the grafted corneal endothelium. The corneal endothelium of the allogeneic PK and DSEK rabbit models displayed the presence of immune cells, including CD4+ T-helper cells, CD8+ cytotoxic T cells, CD20+ B lymphocytes, CD68+ macrophages, and neutrophils, but these immune cells were rarely observed in the syngeneic PK model. These immune cells also produced proinflammatory cytokines. Notably, some of the corneal endothelial cells situated near these immune cells exhibited features of apoptosis.
  
  
  
  T lymphocytes, B lymphocytes, macrophages, and neutrophils are present on the grafted corneal endothelium in both PK and DSEK allogeneic rabbit models. The potential involvement of immune cells as an underlying pathophysiology for late endothelial failure deserves further examination.
authors.affiliation: Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
authors.forename: Elena
authors.initials: E
authors.lastname: Koudouna
authors.affiliation: Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan 2Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.affiliation: Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Okazaki
authors.affiliation: Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Nakano
authors.affiliation: Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Inoue
authors.affiliation: Division of Biomedical and Life Sciences, Lancaster University, Lancaster, United Kingdom.
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Fullwood
authors.affiliation: Department of Ophthalmology, Nippon Medical School, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Hori
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan 5Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
authors.affiliation: Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Koizumi
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D016207:Cytokines / Q000378:metabolism; D057111:Descemet Stripping Endothelial Keratoplasty / Q000379:methods*; D004195:Disease Models, Animal; D018450:Disease Progression; D004728:Endothelium, Corneal / Q000276:immunology* / Q000648:ultrastructure; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000378:metabolism / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D007111:Immunity, Cellular; D008264:Macrophages / Q000276:immunology / Q000648:ultrastructure; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology / Q000648:ultrastructure; D011817:Rabbits; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous
chemical_list: D016207:Cytokines