The effect of immunological and non-immunological factors on corneal graft survival. A single center study

Knockdown of Long Non-Coding RNA AFAP1-AS1 Promoted Viability and Suppressed Death of Cardiomyocytes in Response to I/R In Vitro and In Vivo

Long non-coding RNA (lncRNA) plays a pivotal role in the development of myocardial infarction (MI). The aim of this study was to investigate the effects of lncRNA actin filament-associated protein 1 antisense RNA 1 (AFAP1-AS1) on cell cycle, proliferation, and apoptosis. RT-qPCR was used to detect the expression levels of AFAP1-AS1, miR-512-3p, and reticulon 3 (RTN3) in rat model of I/R. The simulated MI environment was constructed. MTT assay and flow cytometry were used to detect changes in cardiomyocyte viability and cell cycle/apoptosis after MI by AFAP1-AS1 silencing or RTN3 silencing. The targeting relationship of miR-512-3p and AFAP1-AS1 and RTN3 in cardiomyocytes was verified by dual luciferase reporter assay. The expression levels of AFAP1-AS1 and RTN3 were significantly upregulated in a rat model of LAD ligation (or MI) ligation, while the expression level of miR-512-3p was significantly reduced. Overexpressed AFAP1-AS1 and RTN3 promoted cardiomyocyte apoptosis and inhibited cardiomyocyte proliferation. MiR-512-3p was a direct target of AFAP1-AS1, and RTN3 was a direct target of miR-512-3p. AFAP1-AS1 promoted the progression of MI by targeting miR-512-3p. AFAP1-AS1 promoted the progression of MI by modulating the miR-512-3p/RTN3 axis. AFAP1-AS1 may be a potential therapy target for MI. Graphical Abstract The role of AFAP1-AS1 in regulating MI injury in vivo. (A) Effect of AFAP1-AS1 in MI injury in vivo. (B) The mRNA level of RTN3 in MI injury in vivo. (C) The protein level of RTN3 in MI injury in vivo. (D) Effect of miR-512-3p in MI model group. (E) TUNEL assay. *P < 0.05, **P < 0.01 vs the sham group; #P < 0.05, ##P < 0.01 vs the MI group.

Penetrating Keratoplasty in South East London 1981–1986: Epidemiological Aspects and Demands on Medical Resources

We have compared penetrating keratoplasty at a teaching hospital and a district general hospital (DGH). At the teaching hospital, the pathology was similar to previous reports, but at the DGH the patients were older (P less than 0.01) and had a worse prognosis. The vision in the unoperated eye was also frequently poor. The number of postoperative outpatient visits within a hospital was unrelated to the original disease, and there was no statistically significant difference between the two centres. At the DGH, a corneal transplant patient requires the outpatient resources equivalent to three matched cataract patients. The implications for medical manpower requirements are discussed.

Ocular immune privilege: the eye takes a dim but practical view of immunity and inflammation

The delicate visual axis that makes precise vision possible is highly vulnerable to the destructive potential of immunogenic inflammation. Immune privilege of the eye is the experimental expression of the way in which evolution has coped with the countermanding threats to vision of ocular infections and ocular immunity and inflammation. Ocular immune privilege has five primary features that account for its existence: blood:ocular barriers, absent lymphatic drainage pathways, soluble immunomodulatory factors in aqueous humor, immunomodulatory ligands on the surface of ocular parenchymal cells, and indigenous, tolerance-promoting antigen-presenting cells (APCs). Three manifestations of ocular immune privilege that have received the most extensive study are the intraocular microenvironment, which is selectively anti-inflammatory and immunosuppressive; the prolonged acceptance of solid tissue and tumor allografts in the anterior chamber; and the induction of systemic tolerance to eye-derived antigens. Anterior chamber-associated immune deviation is known to arise when indigenous, ocular APCs capture eye-derived antigens and deliver them to the spleen where multicellular clusters of these cells, natural killer T cells, marginal zone B cells, and gammadelta T cells create an antigen-presentation environment that leads to CD4(+) and CD8(+) alpha/beta T cells, which as regulators, suppress induction and expression of T helper cell type 1 (Th1) and Th2 immune expression systems. The ways the eye influences local and systemic immune responses to ocular antigens and pathogens carry risks to and benefits for mammalian organisms. As loss of sight is a powerful, negative-selecting force, the benefits of ocular immune privilege outweigh the risks.

Medical manpower requirements following penetrating keratoplasty for herpes simplex keratitis

We have compared the post-operative course of patients requiring penetrating keratoplasty for herpes simplex virus keratitis, keratoconus, and Fuchs' endothelial dystrophy with a minimum of two years follow-up. Although some expected differences (age, sex) were found between these three groups, the number of post-operative clinic visits was not different between the three groups. This is contrary to the common belief that patients requiring penetrating keratoplasty for herpes simplex keratitis are high risk, and will make greater demands on medical resources in the post-operative period. The management of our patients with herpes simplex keratitis is not statistically different from a similar group managed at another centre.

Large corneal grafts can be successful

Seventeen grafts of 10 mm in diameter or larger have been performed on 16 eyes of 15 patients. The major indications for surgery were infections or perforations or both. Follow-up has ranged from 8-54 months (mean 26.4). The 4 year survival probability was 0.64. Although the procedure was successful in saving all but one eye and restored useful vision in the majority, complications including cataract, glaucoma, graft rejection episodes and infections were encountered. The management of these complications is described. At final review, 13 eyes had clear grafts including those in whom regraft had been performed. These results have only been achieved by close co-operation between patients and the medical team responsible for their care.

Effect of donor epithelium on corneal transplant survival

Two hundred thirty-two penetrating keratoplasties in 228 eyes were performed with or without the removal of donor corneal epithelium in a prospective, randomized clinical trial to determine the effect of epithelial removal on graft survival. The removal of epithelium did not reduce the likelihood of graft failure, irreversible allograft reaction, or reversible allograft reaction.