engleski

Vascular Endothelial Growth Factor in a Recipient Cornea Acts as a Prognostic Factor for Corneal Graft Reaction Development

Purpose was to evaluate whether the vascular endothelial growth factor A (VEGF-A) in the recipient cornea measured at the time of penetrating keratoplasty (PK) can act as a prognostic factor for corneal graft reaction development. The study included 25 eyes (of 25 patients) scheduled for PK. According to preoperative clinical finding, patients were divided into three groups: inflammatory with neovascularization (n = 11) ; inflammatory without neovascularization (n = 7) ; and non-inflammatory (n = 7). One half of the recipient cornea was analyzed for the levels of VEGF-A protein using a commercial enzyme-linked immunosorbent assay ; the other half was analyzed to determine the loci of VEGF-A production by immunohistochemistry. The frequencies of corneal graft reaction and rejection were recorded, together with the improvement of visual acuity. Twenty-five donor corneas obtained from cadaver eyes represented the control group (n = 25). There was a statistically significant difference in the levels of VEGF-A protein between the recipient corneal buttons obtained from eyes with inflammatory changes and neovascularization, and those from the non-inflammatory group and controls (p < 0.01). The level of VEGF-A was 287.74 pg/ml (standard deviation [SD] =  129.181) in the inflammatory with corneal neovascularization group, 227.64 pg/ml (SD =  85.590) in the inflammatory without neovascularization group, 115.37 pg/ml (SD =  105.93) in the non-inflammatory group, and 142.28 pg/ml (SD = 93.081) in the control group. Graft reaction/rejection rate was 54.5%/45.5% in the inflammatory with neovascularization group, 14.3%/0% in the inflammatory without neovascularization group, and 14.3%/14.3% in non-inflammatory group. Patients who developed clinical signs of graft reaction during the postoperative follow-up had a significantly higher level of VEGF-A (307.4  pg/ml, SD = 100.058) compared with those without any signs of graft reaction (182.8  pg/ml, SD = 124.987). Our results suggest that both graft reaction and final graft rejection occur more often in patients with increased levels of VEGF-A in a recipient cornea at the time of PK.

ELISA; graft rejection; immunohistochemistry; penetrating keratoplasty; vascular endothelial growth factor

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