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Immunogenetical Considerations on Corneal Transplantation*

  • L. Gedda (a1) and M. Milani-Comparetti (a1)

Summary

A case of bilateral clouding of corneal homografts in a 24-year-old woman 8 and 9 years after the respective operations, coincidentally with the second month of pregnancy, leads the Authors to a series of considerations and hypotheses on the immunological aspects of keratoplasties.

Differential diffusion of antigens to reach the antibody-forming sites, and of antibodies to reach the antigenic loci on the graft, through the endothelial barriers and the stromal layers, is held responsible for the peculiarities of corneal graft survival, especially in view of the different molecular sizes of antibodies and in connection with primary and secondary immunization. A series of experiments is currently being carried out to test the various hypotheses.

RIASSUNTO

Un caso di opacamento bilaterale di lembi corneali, ad 8 e 9 anni di distanza dai rispettivi trapianti, in una donna di 24 anni, in coincidenza col secondo mese di gravidanza, conduce gli Autori a formulare una serie di considerazioni ed ipotesi sugli aspetti immunologici della cheratoplastica.

Alla diffusione differenziale degli antigeni fino a raggiungere le sedi dell'anticorpopoiesi, e degli anticorpi fino a raggiungere i loci antigenici sul lembo trapiantato, attraverso le barriere endoteliali ed il tessuto stromale, vengono attribuite le peculiarità della sopravvivenza dei trapianti corneali, soprattutto in considerazione delle diverse dimensioni delle molecole anticorpali ed in rapporto alla immunizzazione primaria e secondaria. Una serie di esperimenti è attualmente in corso per verificare le ipotesi formulate.

RÉSUMÉ

Un cas d'opacification bilatérale de greffes cornéennes, 8 et 9 ans respectivement après leur implantation, chez une femme de 24 ans, en coïncidence avec le deuxième mois d'une grossesse, conduit les Auteurs à formuler una série d'hypothèses sur les aspects immunitaires de la greffe cornéenne.

Les péculiarités du comportement des greffes cornéennes sont attribuées à la diffusion différentielle des antigènes jusqu'aux sièges de l'anticorpopoiese, et des anticorps jusqu'aux loci antigéniques sur la greffe. Cela surtout en considération des différentes dimensions moléculaires des anticorps et en rapport avec l'immunisation primaire et secondaire. Une série d'expériences destinées à vérifier les hypothèses formulées est actuellement en cours.

ZUSAMMENFASSUNG

Bei einer Frau von 24 Jahren trat im 2. Schwangerschaftsmonat im Abstand von 8 bzw. 9 Jahren nach Korneatransplantation beiderseits eine Verschleierung von Korneastellen auf. Die Verf. stellen daher einige Überlegungen und Vermutungen bezüglich der immunologischen Seite von Cheratoplastiken an. Die Eigenart des Überlebens von Korneatransplantationen wird, vor allem, wenn man die verschiedene Größe der Antikörpermoleküle und das Verhältnis zur Primär- und Sekundärimmunisierung betrachtet, der differenzierten Diffusion von Antigenen und Antikörpern zugeschrieben, von denen Erstere biszum Sitz der Antikörperpojesis und Letztere bis zu den Antigenloci auf der transplantierten Korneastelle gelangen.

Es werden zur Zeit Untersuchungen angestellt, um diese Hypothesen zu überprüfen.

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Copyright

Footnotes

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*

Based on a paper read at the International Congress on Genetics and Ophthalmology, Brno 1965.

Footnotes

References

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1. Restivo, M. L.: Opacità transitoria delle cornee comparsa in gravidanza in soggetto operato otto anni prima di cheratoplastica bilateralmente, (in press).
2. Basu, P. K., Ormsby, H. L.: Am. J. Ophthal., 44, 477 (1957).
3. Sanna, G., Rivara, A.: Ann. Oftalm., 88. 415 (1962).
4. Ovary, Z., D'Ermo, F.: Boll. d'Ocul., 32, 69 (1953).
5. Maurice, D. M.: The cornea and sclera. In « The Eye », Ed. Dawson, H., Academic Press, New York and London, 1962.

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