Corneal transplantation—immunologically privileged status

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Abstract
Despite the relatively high success rate and the word 'immunologically privileged site', it has been known that a corneal graft can induce an allograft rejection reaction. This is especially true in the rat where orthotopic penetrating corneal grafts in certain strain combinations are rejected even when transplanted in avascular bed. Reliable microsurgical techniques, together with the availability of inbred or congenic strains and a rapidly developing knowledge of its major histocompatibility complex (MHC) and immune system in general, have made the rat a prime species in which to study the immunological events after corneal grafting. This review describes recent progress in understanding the immunological mechanisms behind corneal graft rejection. The topics discussed include the rat MHC (RT1) antigens and their distribution in the cornea; different responder status in fully allogeneic strain combinations, including the importance of multiple non-MHC antigens; and the role of antigen-presenting cells (APCs) in corneal graft rejection.