| There are about 3,000,000 blind patients caused by corneal diseases in China. Corneal transplantation is the most successful form of the organ allograft, and also is the most important operation to regain visual acuity. According to the previous studies, the rejection rate in the so-called low-risk cases is only 10%, yet in the high-risk cases is higher than 65%. The high-risk factors include vascularized cornea, prolonged inflammation, severe chemical injury of the cornea and conjunctiva, large size keratoplasty, and re-keratoplasty. The graft survival rate can not be highly raised by matched HLA, or by systemic or topical application of the habitual immunosuppressive drugs. Nowadays, it is urgent to solve the problem about how to raise the graft survival rate of the high-risk keratoplasty, and the search for high-effective and low-toxic immunosuppressive agent is the point to resolve the above problem.It has been recovered in recent years that cornus officinalis glycosides (COG) is the most effective one in suppressing immunity.Our purpose is to investigate the effect of systemic COG and topical COG eye-drops treatment on the corneal transplantation in rats. We also co-applied COG with other immunosuppressive agent and antineovascular agent in order to prolong the survival timeof the graft, and provide a new combining therapy for clinical treatment. The other character of COG is that its therapeutic dose does not cause any side-effect, which has a very good prospect in clinical using.I The immunosuppressive effect of cornus officinalis glycosides on the corneal allograft rejection in ratsObjectiveTo investigate the immunosuppressive effect of different dosage of cornus officinalis glycosides, CsA, and combining use of cornus officinalis glycosides and CsA on the corneal allograft rejection in rats and to choice the best therapeutic scheme of immunosuppressive agents for clinic.MethodsThe corneal transplantation model of SD-Wistar group on the closed colony rats were set up, and then were randomly divided into 8 groups as follows. Allografts within the group A and D~J were between the Wistar (recipient) and SD (donor) rats colony, Group A (blank comparison), group D (CsA10mg/Kg/d), group E (COG60mg/Kg/d) , group F (COG 120mg/Kg/d), group G (COG240mg/Kg/d), group H (COG60mg/Kg/d + CsAlOmg/Kg/d ) , group I ( COG120mg/Kg/d + CsAlOmg/Kg/d ) , group J (COG240mg/Kg/d+CsA10mg/Kg/d) , Then another two comparison groups B and C were set up, group B (Wistar - Wistar allograft), group C (Wistar - Wistar autograft). Graft fate was assessed clinically by slit-lamp biomicroscope examination. The rejection indexes(RI) that included the corneal clarity, edema and vascularization, and the rejection time of each group were compared with. Besides, histological assessments were done at definite intervals after grafting.Results1. All of three dosages of COG groups (groupE, F, G) were effective against rejection, and the efficiency was increased with dosage. There was no significant difference between the group D and the group E.2. In the combining groups of medication, the group I and the group J were most effective, and there was no significant difference between them.3. The effects of combining groups were better than in the single group. The living time of corneal graft in the control group(group A) was shortest(average 11.33 ± 2.07 days), and that of the group J was longest(average 22.00±1.79 days).4. Pathologic results: On the 15th day after grafting the grafts of the group A were thickened, the epithelial cells were edemaous and there were a lot of infiltrating lymphocytes and neovascularization in stroma in HE staining. The phagocytic cells and the irregular arrangement of stromal cells around the sutures were found. On the 15th day the grafts in the group F were thickened slightly, the epithelial cells were integrated generally, a few lymphocytic cells infiltrated in the stroma, a few neovascularization was found, and keratocytes in stroma arranged regularly. On the 30th... |
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