New technique may prevent graft rejection in high-risk corneal transplant patients

May 1, 2017, Massachusetts Eye and Ear Infirmary

Treating donor corneas with a cocktail of molecules prior to transplanting to a host may improve survival of grafts and, thus, outcomes in high-risk corneal transplant patients, according to a new study led by researchers at Massachusetts Eye and Ear. The findings, published online in Scientific Reports, describe a novel strategy to promote the tolerance of corneal transplants in patients at high risk for rejection by targeting antigen-presenting cells in donor tissues with a combination of two cytokines, TGF-β and IL-10, that work together to promote tolerance of the graft by the transplant recipient's immune system.

"We made use of cytokines that can change the function of immune cells to induce tolerance in corneas" said senior author Reza Dana, M.D., MPH, Director of Cornea and Refractive Surgery at Mass. Eye and Ear and the Claes H. Dohlman Professor of Ophthalmology at Harvard Medical School. "We exposed to a particular cocktail of immunoregulatory cytokines, and we've determined what doses, concentrations and exposure we need for these cytokines to generate tolerance inducing in the cornea."

With more than 150,000 cases performed each year worldwide, is the most common procedure in medicine. Patients may need corneal transplants when the cornea, the transparent, outermost layer of the eye, is no longer able to let light in due to scarring or disease. An ophthalmologist removes a section of the injured or diseased cornea and replaces it with donor .

Many corneal transplants are successful in restoring vision to those with damage to the surface of the eye, with the help of steroids to suppress the body's natural immune response to reject the donor tissue; however, roughly one-third of all cases are considered "high-risk," with increased chance of rejecting even with the use of steroids to suppress the immune system. These patients often show signs of a degeneration of what is known as T cell-immunity.

With the goal of improving survival of cornea grafts for patients in the high-risk category, the authors of the Scientific Reports study developed a technique in preclinical models to make the donor tissue more likely to be accepted by the host, rather than tweaking the immune system of the host to accept the donated tissue.

The team accomplished this by treating donor tissue with the TGF-β and IL-10 cocktail, and then grafting them onto high-risk recipient eyes of a preclinical model. Eight weeks post-transplantation, they noted a significant increase in survival (68.7 percent of treated grafts had survived, while none of the control grafts had survived).

The researchers are hopeful that this novel method of using a combination of cytokines working together to promote tolerance of corneal grafts—by treating the donor tissue rather than the recipient—may transition more easily to the clinical setting.

"By exposing the to these cytokines, we avoid having to expose the transplant recipients themselves to any immunosuppressive," said Dr. Dana. "We're very excited, because it's highly translatable technology. When we grafted the tissue that has been treated that way, we developed active tolerance, which leads to long-term acceptance of the corneal transplant and suppresses all the destructive sides of immunity."

Explore further: Corneal transplants, men and women don't see eye to eye

More information: Maryam Tahvildari et al, Treatment of donor corneal tissue with immunomodulatory cytokines: a novel strategy to promote graft survival in high-risk corneal transplantation, Scientific Reports (2017). DOI: 10.1038/s41598-017-01065-z

Related Stories

Corneal transplants, men and women don't see eye to eye

July 14, 2016
A new study of patients undergoing corneal transplants indicates that subtle differences between men and women may lead to poorer outcomes for a woman who has received a cornea from a male donor.

Ophthalmologists uncover autoimmune process that causes rejection of secondary corneal transplants

April 16, 2015
April 16, 2015 - UT Southwestern Medical Center ophthalmologists have identified an important cause of why secondary corneal transplants are rejected at triple the rate of first-time corneal transplants.

Curing blindness by repairing corneas with invisible films

August 15, 2016
A patented treatment could restore eyesight for millions of sufferers of corneal disease.

Study identifies potential new strategy to improve odds of corneal transplant acceptance

December 30, 2013
For the estimated 10 percent of patients whose bodies reject a corneal transplant, the odds of a second transplant succeeding are poor. All that could change, however, based on a UT Southwestern Medical Center study that ...

Scientists grow eye cells to fix corneas

April 17, 2017
A Stanford University research team has created a potentially powerful new way to fix damaged corneas—a major source of vision problems and blindness.

Recommended for you

Researchers report vision-based neurotransmitter events for the first time

November 27, 2018
How does vision work, and what happens in the brain during the process? As simple as this question may sound, it has yet to be scientifically clarified. Dr. Valentin Riedl of the Technical University of Munich (TUM) and his ...

Minimally invasive retinal detachment has better outcomes, clinical trial findings

November 26, 2018
A minimally invasive treatment for retinal detachment gives patients sharper vision, less distortion and reduced side-effects, according to the findings of a randomized controlled trial performed at St. Michael's Hospital ...

Scientists combine technologies to view the retina in unprecedented detail

November 14, 2018
By combining two imaging modalities—adaptive optics and angiography—investigators at the National Eye Institute (NEI) can see live neurons, epithelial cells, and blood vessels deep in the eye's light-sensing retina. Resolving ...

Eyepatch with dissolvable needles used to treat eye disease

November 12, 2018
A team of researchers affiliated with several institutions in Singapore has developed an eyepatch with dissolvable needles for use in treating eye diseases. In their paper published in the journal Nature Communications, the ...

Calcifications in the eye increase risk for progression to advanced AMD by more than six times

November 8, 2018
Calcified nodules in the retina are associated with progression to late stages of age-related macular degeneration (AMD). Experts from Queen's University Belfast, working in partnership with the University of Alabama of Birmingham ...

Traditional glaucoma test can miss severity of disease

November 8, 2018
The most common tests for glaucoma can underestimate the severity of the condition by not detecting the presence of central vision loss, according to a new Columbia University study.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.