VISICORT was strongly represented at the 7th annual congress of EU Cornea – the European Society of Cornea and Ocular Surface Disease Specialists – which was held at the Bella Center in Copenhagen between September 9th and 10th 2016.
In a focus session on “Immunology in Corneal Transplantation”, members of the VISICORT consortium gave individual presentations to congress attendees on key issues related to the project’s goal of increasing understanding of adverse immune responses to corneal allografts.
Prof. Matthew Griffin (NUI Galway, VISICORT Coordinator) presented a Keynote Lecture entitled “What has been learned from immunological profiling in kidney transplantation? “ in which he summarised developments that have occurred over the past 10-15 years in whole-genome microarray and peripheral blood immune cell profiling in the field of kidney transplantation. Emphasising the progress of these discovery-based profiling technologies towards novel diagnostic and prognostic assays for kidney transplant rejection and tolerance, he reflected upon the potential benefits of similar immunological profiling projects to future management of corneal allograft recipients at risk for rejection or chronic graft dysfunction.
Prof. Uwe Pleyer (Charité University Hospital, Berlin), in a presentation entitled “The role of immune-modulatory stromal cell therapy in prevention of corneal graft rejection”, described the emergence of mesenchymal stromal cells (MSCs) as an immunomodulatory therapy of potential value in preventing allograft rejection. He reviewed experimental evidence from animal model studies performed in the laboratory of Prof. Thomas Ritter (NUI Galway) and others that MSCs from unrelated (“third party”) individuals, delivered intravenously around the time of corneal transplantation module the anti-donor immune response to favour graft acceptance. He then presented the current progress of the VISICORT consortium toward a Phase 1 clinical trial at Charité University Hospital of third party MSCs in human corneal allograft recipients at high risk for rejection.
Mr. Derek Tole (University of Bristol and Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, UK) addressed “Immunosuppression in high-risk keratoplasty” with an emphasis on the outcomes and potential adverse effects associated with the use of the potent anti-rejection drugs tacrolimus and mycophenole mofetil in corneal transplant recipients with one or more risk factors for rejection. With reference to 5-year follow-up results from the Bristol Eye Hospital, he demonstrated the value of a dedicated immunosuppression clinic for maximising the long-term safety and efficacy of these agents in keratoplasty recipients.
Prof. John Armitage (University of Bristol and Bristol Eye Bank) summarised the recent results for one of the largest studies of the influence of tissue type (HLA) matching on corneal transplant outcomes in a presentation entitled “Conclusions of high-risk HLA matching study-CTFS II”. In a large cohort of allograft recipients from the UK, this study concluded that there was no clear overall benefit associated with higher degree of HLA matching. Interestingly, a sub-analysis of data for high-risk recipients compared with an historical control cohort suggested a possible benefit for matching at Class I HLA loci. However, as Prof. Armitage pointed out, further prospective research will be needed to determine whether HLA matching could provide a bona fide immunological advantage in high-risk corneal transplantation.
Commenting after the session, Prof. Jesper Hjortdal (EU Cornea Board Member and VISICORT partner, Aarhus University Hospital, Denmark) noted: “Improving corneal transplantation outcomes is one of the key-issues for the European Society of Cornea and Ocular Surface Disease Society (EuCornea). In-depth exploitation of immune profiles and development of new, safe immunolomodulatory therapies are promising ways to do this. Hopefully, the VISICORT project will bring corneal transplantaion significantly further, being able, on a patient level, to predict who will do well and target mechanistically-informed immunomodulatory therapy to those that have a higher risk profile”.