Corneal lymphangiogenesis: evidence, mechanisms, and implications for corneal transplant immunology.

Abstract:

PURPOSE:The normal cornea is devoid of blood and lymphatic vessels but can become vascularized secondary to a variety of corneal diseases and surgical manipulations. Whereas corneal (hem)angiogenesis, i.e., the outgrowth of new blood vessels from preexisting limbal vessels, is obvious both clinically and histologically, proof of associated corneal lymphangiogenesis has long been hampered by invisibility and lack of specific markers. This has changed with the recent discovery of the lymphatic endothelial markers vascular endothelial growth factor receptor 3, LYVE-1 (a lymphatic endothelium-specific hyaluronan receptor), Prox 1, and Podoplanin. METHODS:We herein summarize the current evidence for lymphangiogenesis in the cornea and describe its molecular markers and mediators. Furthermore, the pathophysiologic implications of corneal lymphangiogenesis for corneal transplant immunology are discussed. RESULTS:Whereas corneal angiogenesis in vascularized high-risk beds provides a route of entry for immune effector cells to the graft, lymphangiogenesis enables the exit of antigen-presenting cells and antigenic material from the graft to regional lymph nodes, thus inducing alloimmunization and subsequent graft rejection. CONCLUSIONS:Antilymphangiogenic strategies may improve transplant survival both in the high- and low-risk setting of corneal transplantation.

journal_name

Cornea

journal_title

Cornea

authors

Cursiefen C,Chen L,Dana MR,Streilein JW

doi

10.1097/00003226-200304000-00021

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

273-81

issue

3

eissn

0277-3740

issn

1536-4798

journal_volume

22

pub_type

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