A new model of corneal transplantation in the miniature pig: efficacy of immunosuppressive treatment

Gross anatomy, histological, and histochemical analysis of the eyelids and orbital glands of the neonate pygmy hippopotamus (Suina: Choeropsis liberiensis or Hexaprotodon liberiensis, Morton 1849) with reference to its habitat

The pygmy hippopotamus is phylogenetically related to members of both the Suidae and Cetacea. However, differences in their habitats may have resulted in variation in the anatomy and physiology of the ocular adnexa between these species. Therefore, this study focuses on the identification of accessory organs of the eye, which are typical for the pygmy hippopotamus and are comparable to organs present in mammals related to it. Moreover, the secretions produced by the superficial gland of the third eyelid, the deep gland of the third eyelid and the lacrimal gland were examined, as they ensure eyeball protection. In the upper and lower eyelids, numerous serous glands where identified, which were typical for the pygmy hippopotamus and similar as in the Cetacea. This study enabled to identify additional folds in the eyelids of the pygmy hippopotamus. Lymphoid follicles and diffuse lymphocytes were not found in the lymphoid region in the upper or lower eyelids and the third eyelid, which was most likely caused by the age of the studied hippopotamuses. An accurate histochemical analysis revealed that the secretions of the pygmy hippopotamus are very similar to the Sus scrofa. The structural differences between the pygmy hippopotamus and representatives of Cetacea are most likely caused by the fact that most of Cetacea live in saltwater and are exposed to more frequent fluctuations in water temperature compared to the pygmy hippopotamus, which lives in fresh water and does not lead a migratory lifestyle like the Cetacea.

Anatomic Studies of the Miniature Swine Cornea

The domestic swine eye resembles the human eye both anatomically and physiologically. Xenotransplantation of the swine cornea to humans in need of full keratoplasty shows promise as a potential therapeutic strategy to restore vision in individuals with advanced corneal disease, especially those residing in developing nations. That said, we characterized the morphology of corneas from miniature swine, which are smaller in size, easier to handle, and more cost-effective compared to domestic swine. Eyes (N = 15) were harvested from miniature swine from different age groups: 1 month (N = 3), 2 month (N = 3), 4 month (N = 3), 8 month (N = 3), as well as 24 month old adult domestic swine (N = 3). They were immediately submerged in fixative and processed for histological examination at the light and transmission electron microscopic level. Gross anatomic measurements of the cornea were significantly less (P value ≤ 0.05) in miniature swine versus domestic swine. Corneal strata exhibited morphological characteristics similar to the domestic swine cornea. Adult miniature swine corneas show similar overall corneal thickness at 8 months of age versus domestic swine. Miniature swine exhibit similar corneal morphology with the domestic pig and humans, with the exception of Bowman's layer, which is absent in pigs. Therefore, miniature pigs may be a useful resource of corneal tissue for humans in need of full keratoplasty, as well as serve as a large eye model for ophthalmology residents to develop surgical skills and for development and testing of ocular therapeutic strategies that translate to humans. Anat Rec, 301:1955-1967, 2018. © 2018 Wiley Periodicals, Inc.

Adipose-derived mesenchymal stem cell administration does not improve corneal graft survival outcome

The effect of local and systemic injections of mesenchymal stem cells derived from adipose tissue (AD-MSC) into rabbit models of corneal allograft rejection with either normal-risk or high-risk vascularized corneal beds was investigated. The models we present in this study are more similar to human corneal transplants than previously reported murine models. Our aim was to prevent transplant rejection and increase the length of graft survival. In the normal-risk transplant model, in contrast to our expectations, the injection of AD-MSC into the graft junction during surgery resulted in the induction of increased signs of inflammation such as corneal edema with increased thickness, and a higher level of infiltration of leukocytes. This process led to a lower survival of the graft compared with the sham-treated corneal transplants. In the high-risk transplant model, in which immune ocular privilege was undermined by the induction of neovascularization prior to graft surgery, we found the use of systemic rabbit AD-MSCs prior to surgery, during surgery, and at various time points after surgery resulted in a shorter survival of the graft compared with the non-treated corneal grafts. Based on our results, local or systemic treatment with AD-MSCs to prevent corneal rejection in rabbit corneal models at normal or high risk of rejection does not increase survival but rather can increase inflammation and neovascularization and break the innate ocular immune privilege. This result can be partially explained by the immunomarkers, lack of immunosuppressive ability and immunophenotypical secretion molecules characterization of AD-MSC used in this study. Parameters including the risk of rejection, the inflammatory/vascularization environment, the cell source, the time of injection, the immunosuppression, the number of cells, and the mode of delivery must be established before translating the possible benefits of the use of MSCs in corneal transplants to clinical practice.

The immunobiology of corneal transplantation

Corneal allotransplantation is highly successful in the short term, but much less successful in the longer term. Many corneal grafts in recipients with corneal neovascularization or the sequelae of ocular inflammation undergo irreversible rejection, despite topical immunosuppression with glucocorticosteroids. Sensitization to cornea-derived alloantigen proceeds by both direct and indirect routes, but the anatomic location of sensitization remains unclear. Multiple and redundant mechanisms operate in the effector phase of corneal graft rejection, which is largely cell-mediated rather than antibody-mediated. Human leukocyte antigen matching may improve outcomes in high-risk patients but systemic immunosuppression is frequently ineffective and is seldom used.