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Can we predict corneal graft rejection based on proangiogenic cytokines level at the time of transplantation?

PURPUSE: To evaluate the quantity of vascular endothelial growth factor (VEGF) and its receptors (VEGFR) in the recipient cornea at the time of penetrating keratoplasty (PK). METHODS: Study included 20 eyes scheduled for PK. Quantity of angiogenic growth factors and their receptors: VEGF, sVEGFR1 and sVEGFR3 were analysed using an enzyme‐linked immunosorbent assay. Postoperatively patients were followed‐up for 3 years. Frequency of corneal graft reaction and degree of corneal neovascularisation were recorded. Donor corneas obtained from cadaver eyes were controls (n=20). RESULTS: Overall quantity of VEGF‐A was 287.74 pg/ml (SD=129.181) in the inflammatory group, 115.37 pg/ml (SD=105.93) in non‐inflammatory group and 142.28 pg/ml (SD=93.081) in controls. sVEGFR1 and sVEGFR3 were significantly higher in non‐inflammatory as compared to inflammatory group. Eyes with graft reaction had significantly higher VEGF‐A (307.4 pg/ml, SD= 100.058) as compared to those without graft reaction (182.8 pg/ml, SD=124.987). Statistical analysis was done by t‐test. CONCLUSION: Graft reaction occurs more often in corneas with increased VEGF‐A. Elevated sVEGFR may act as a sink for VEGF and thus as suppressors of angiogenesis and graft reaction.