
The authors performed a multi‐centre, cross‐sectional analysis of the current immunological status of a human full-thickness (FT) and posterior lamellar (PL) corneal transplant (CT) recipients and control subjects using multiple technology platforms. The primary goal of this study was to define pathways associated with adverse immune responses to corneal transplantation and to generate and compare comprehensive, pathway-based profiles of immune activity in CT acute rejection (AR). The secondary goal was to identify a composite biomarker of CT-AR. Nonetheless, in FT but not PL‐CT recipients, AR was associated with differences in B cell maturity and regulatory CD4+ T-cell frequency compared to stable allografts. The results suggest that, in contrast to solid organ transplants, genetic or cellular assays of peripheral blood are unlikely to be clinically exploitable for predicting or diagnosing AR. However, further investigation of circulating B cell and T cell subpopulations may provide insights into regulating anti-donor immune responses in human CT recipients with differing AR risks.
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