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1 Division of Ophthalmology (Surgery), Vanderbilt University, School of Medicine, Nashville, Tenn.
This panorama of the immune factors in corneal graft rejection covers a spectrum of mechanisms which play a role in the opacification of corneal grafts. Great emphasis has been accorded to the role of transplantation immunity. The clinical and experimental evidence implicating transplantation immunity in the rejection of corneal grafts has been critically reviewed. In addition, evidence is presented indicating that some immune mechanisms which result in inflammatory sequelas other than classical transplantation immunity can lead to rejection of corneal grafts. Evidence also suggests that certain well-described pseudoimmune or immunomimetic reactions, which are devoid of the classic criteria required for hypersensitivity reactions, contribute to rejection of corneal grafts.
Key Words: corneal graft rejection transplantation immunity inflammation immunomimetic allograft xenograft autograft "second-set" phenomenon keratoplasty chimerism avascularity vascularization afferent and efferent limbs (arcs) central lymphoid tissue response antigen-antibody reaction Shwartzman reaction Auer phenomenon
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