Early Expression of Tumor Necrosis Factor &agr; and Nuclear Factor Kappa B After Descemet Stripping Endothelial Keratoplasty in Rabbits

Purpose: To investigate immune rejection after Descemet stripping endothelial keratoplasty (DSEK) compared with that after penetrating keratoplasty (PKP) in New Zealand rabbit eyes and to identify the relationship between tumor necrosis factor alpha (TNF-&agr;) and nuclear factor kappa B (NF&kgr;B) and evaluate their involvement in graft rejection. Methods: Sixty-nine New Zealand rabbits were divided into 3 groups: group A comprised the control group, which did not undergo either of the procedures; group B underwent DSEK; and group C underwent PKP. Twenty-three Chinese rabbits (46 eyes) were used as donors. The corneal transparency, graft placement, and anterior chamber were observed for 28 days. Blood serum, aqueous humor, and corneal samples were obtained on days 7, 14, 21, and 28 after the procedures. TNF-&agr; levels were measured weekly by double-antibody enzyme-linked immunosorbent assay. NF&kgr;B in the cornea was checked by immunofluorescence. Results: There were no graft rejections in group B. Group C showed a 50% rejection frequency with an increase in both the TNF-&agr; concentrations and NF&kgr;B expression observed at 7 days and peak levels observed at 28 days after PKP. TNF-&agr; concentrations did not differ significantly (P > 0.05) between groups B and A. NF&kgr;B expression was slightly increased at 7 days and returned to normal levels by day 14 after DSEK. Conclusion Rabbits with DSEK had a lower rejection rate than rabbits with PKP. NF&kgr;B and TNF-&agr; may contribute to the early rejection of corneal allografts.

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