FK-506 delays corneal graft rejection in a model of corneal xenotransplantation

FK-506 is a relatively new immunosuppressant similar in action to cyclosporine A, but is much more potent. Its primary action is against T lymphocytes, the major cellular component in corneal allograft rejection. The purpose of this study was the evaluation of the ability of topical and systemic FK-506 in preventing corneal xenograft rejection in an experimental animal model. Cross-species xenotransplants were used as the most vigorous stimulus to induce corneal rejection. Corneas derived from Hartley guinea pigs were transplanted into the left eyes of 32 male Lewis rats. Topical treatment was administered by using FK-506 0.3 mg/ml in a cyclodextrin suspension or vehicle (cyclodextrin suspension) four times per day. For systemic treatment, 0.5 mg/kg/day of FK-506 or vehicle (saline) was administered intraperitoneally. Treatments were started 60 minutes after surgery and continued for 21 days. The grafts underwent a double-masked examination, and a score was given for clarity, edema, and vascularization. The animals were sacrificed 21 days after transplantation. The control groups had allograft rejection after 6.75 +/- 0.31 (topical vehicle) and after 7.37 +/- 0.32 (systemic vehicle) days. The FK-506-treated groups showed allograft rejection after 14 +/- 0.88 (topical FK-506) or after 16.25 +/- 1.23 (systemic FK-506) days. In addition, FK-506-treated rats manifested less corneal neovascularization than control animals. We conclude that systemic or topical FK-506 is effective in prolonging xenograft survival in the rat keratoplasty model.