Class I disparate corneal grafts enjoy afferent but not efferent blockade of the immune response

Class I antigens are normally expressed on cells in all three layers of the cornea. In congenic rats that differ only at the single Class I locus RT1 A, central orthotopic corneal grafts were rejected 18% of the time with a mean survival time (MST) of 11.5 days. Pre-immunized recipients always rejected Class I disparate corneal grafts (100% MST = 13.3 days). Surprisingly, the presence of donor Langerhans cells in the cornea at the time of grafting did not increase the rejection of grafts (20% MST = 14.0 days). To determine if long term surviving grafts enjoyed immune privilege in the form of efferent blockade, the recipients were challenged with skin grafts 4 to 6 weeks following corneal transplantation. All of the corneal grafts underwent rejection (100% MST = 14.7 days). A number of important conclusions may be drawn from these studies. A single Class I mismatch is a weak barrier to successful engraftment of corneal grafts. However if the recipient has previously been exposed to donor antigens, a single Class I disparity is sufficient to provoke rejection of all subsequent corneal grafts. The susceptibility of long term surviving grafts to rejection induced by skin grafts indicates the orthotopic corneal grafts are antigenic but not immunogenic.