Abstract
Corneal transplantation is one of the most successful forms of solid organ transplantation; however, immune rejection is still a major cause of corneal graft failure. Both innate and adaptive immunity play a significant role in allograft tolerance. Therefore, immune cells, cytokines, and signal-transduction pathways are critical therapeutic targets. In this analysis, we aimed to review the current literature on various immunotherapeutic approaches for corneal-allograft rejection using the PubMed, EMBASE, Web of Science, Cochrane, and China National Knowledge Infrastructure. Retrievable data for meta-analysis were screened and assessed. The review, which evaluated multiple immunotherapeutic approaches to prevent corneal allograft rejection, showed extensive involvement of innate and adaptive immunity components. Understanding the contribution of this immune diversity to the ocular surface is critical for ensuring corneal allograft survival.
Highlights
Corneal transplantation has been proven to be the most effective therapy for corneal disorders such as opacity, keratoconus, corneal degeneration, scarring due to keratitis, trauma, and any physio-pathological changes on the ocular surface [1,2,3]
Corneal immune and angiogenic privilege [7] is crucial to the success of corneal transplantation and is mainly dependent on resident heterogeneous immune cells, including dendritic cells (DCs), Langerhans cells (LCs), mast cells, macrophages, T lymphocytes, and regulatory T cells [8,9,10,11]
In addition to the classic T-cell receptor (TCR) and major histocompatibility complex (MHC) interactions that initiate T cell activation, we investigated the function of several representative costimulatory signaling pathways in corneal-allograft survival [40,47,48,49]
Summary
Corneal transplantation has been proven to be the most effective therapy for corneal disorders such as opacity, keratoconus, corneal degeneration, scarring due to keratitis, trauma, and any physio-pathological changes on the ocular surface [1,2,3]. Corneal immune and angiogenic privilege [7] is crucial to the success of corneal transplantation and is mainly dependent on resident heterogeneous immune cells, including dendritic cells (DCs), Langerhans cells (LCs), mast cells, macrophages, T lymphocytes, and regulatory T cells [8,9,10,11]. Several studies have been conducted on immunotherapy for corneal transplantation focusing on immune checkpoint inhibitors, human leukocyte antigen (HLA)-matching strategy, and immunomodulatory cytokines [20,21,22]. These studies give extraordinary contributions to the management of corneal graft rejections
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