Metabolic therapy of predicted complications in immunocompromised recipients before repeated corneal transplantation

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Abstract

One of the topical problems of modern ophthalmotransplantology is the graft engraftment after repeated keratoplasty. During repeated corneal transplantation, the frequency of graft rejection increases significantly. The study included 121 patients aged 19 to 89 years with corneal graft failure, who were scheduled for repeated corneal transplantation. Immunophenotyping of major and small populations of peripheral blood lymphocytes was performed by flow cytometry (CytoFlex BC, USA). The intensity of energy metabolism in lymphocyte populations was determined by the activity of succinate dehydrogenase and NADH dehydrogenase by immunocytochemical method using flow cytometry. An increase in the content of B lymphocytes (p = 0.004) and a decrease in Th17 lymphocytes (p = 0.013) were revealed after the use of a course of metabolic therapy. Against the background of therapy, the activity of SDH in the T lymphocyte population significantly increases (p = 0.034). In addition, in the studied populations of lymphocytes in the recipient group, against the background of metabolic therapy, the normalization of SDH activity is observed: the number of recipients with low and high enzyme activity decreases. After a course of metabolic therapy, a significant decrease in NADHDH activity was revealed (p = 0.034). Indicators of lymphocyte populations and mitochondrial enzyme activity in recipients after a course of metabolic therapy indicated a more favorable prognosis for repeated corneal transplantation. Evaluation of the results of repeated keratoplasty a year after surgery showed that 59 recipients received transparent graft engraftment, and in 62 patients the graft became cloudy in the period from 1 to 8 months after surgery. In the group of patients with transparent graft engraftment, the percentage of recipients receiving metabolic therapy was significantly higher than in the group of recipients with graft opacity (41%±2.05% vs 21%±2.91%, p < 0.001). Conducting metabolic therapy before surgery reduces the number of realized unfavorable prognoses of the result of rekeratoplasty, and monitoring the activity of dehydrogenases and the content of lymphocyte populations allows us to evaluate the effectiveness of therapeutic and preventive measures in immunocompromised recipients.

About the authors

Yu. A. Komakh

S. Fyodorov Eye Microsurgery Federal State Autonomous Institution

Author for correspondence.
Email: komakh@yandex.ru
ORCID iD: 0000-0002-6324-6062

Ph.D., Head of the Transplantology and Cellular Biology Laboratory

127486, Russian Federation, Moscow, Beskudnikovskiy blvd, 59a

Phone: 7 (499) 488-89-39 

Russian Federation

S. A. Borzenok

S. Fyodorov Eye Microsurgery Federal State Autonomous Institution

Email: mdborzenok@yandex.ru
ORCID iD: 0000-0001-9160-6240

M.D., Ph.d., Prof., Head of the Center of Fundamental and Applied Medical and Biological Problems

127486, Russian Federation, Moscow, Beskudnikovskiy blvd, 59a

Russian Federation

S. V. Petrichuk

National Medical Research Center for Children's Health

Email: cito@list.ru
ORCID iD: 0000-0003-0896-6996

PhD, MD (Biology), Professor, Main Research Associate, Laboratory of  Experimental Immunology and Virology

Moscow

Russian Federation

D. G. Kuptsova

National Medical Research Center for Children's Health

Email: dg.kuptsova@gmail.com
ORCID iD: 0000-0001-7771-3314

Research of the Laboratory of Experimental Immunology and Virology

Moscow

Russian Federation

T. V. Radigina

National Medical Research Center for Children's Health

Email: tvradigina@mail.ru
ORCID iD: 0000-0003-4704-6885

Ph.D. (Medicine), Senior Research Associate, Laboratory of Experimental Immunology and Virology

Moscow

Russian Federation

References

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  2. Комах Ю.А., Борзенок С.А., Радыгина Т.В., Петричук С.В., Герасимова Д.Г. Метаболизм популяций лимфоцитов в прогнозе результата повторной трансплантации роговицы // Российский иммунологический журнал.- 2019.- Т. 13 (22).- № 4.- С.1485-1487. https://elibrary.ru/item.asp?id=43166786
  3. Патент 2302635 РФ, МПК G01 № 33/53, G01 № 33/50 Способ измерения митохондриальной активности лимфоцитов / С.В. Петричук, Т.Д. Измайлова, Т.В. Радыгина; заявитель и патентообладатель Государственное учреждение Научный центр здоровья детей РАМН. - № 2005141145/15; заявл. 28.12.2005; опубл. 10.07.2007.
  4. Angajala A., Lim S., Phillips J.B., Kim J.-H., Yates Cl., You Z., Tan M. Diverse roles of mitochondria in immune responses: novel insights into immune-metabolism. Frontiers in immunology, 2018, 9; 1805, 1-19. https://www.frontiersin.org/articles/10.3389/fimmu.2018.01605/full
  5. Kitazava K., Wakimasu K., Kayukawa K., Yokota I., Inatomi T., Hieda O., Sotozono C., Kinoshita S. Moderately long-term safety and efficacy of repeat penetrating keratoplasty // Cornea. - 2018.-Vol. 37.- № 10.- P. 1255-1259. https://pubmed.ncbi.nlm.nih.gov/30052560/

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Copyright (c) 2021 Komakh Y.A., Borzenok S.A., Petrichuk S.V., Kuptsova D.G., Radigina T.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
Свидетельство о регистрации СМИ ПИ № 77 - 11525 от 04.01.2002 выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).


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