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September 1966

Chemotherapeutic Immunosuppression of the Corneal Graft Reaction: II. Combined Systemic Antimetabolite and Topical Corticosteroid Therapy *

Author Affiliations

From the Howe Laboratory of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston.

Arch Ophthalmol. 1966;76(3):338-344. doi:10.1001/archopht.1966.03850010340007

Several studies have independently demonstrated that systemically administered purine analogues (eg, 6-mercaptopurine, azathioprine) are capable of suppressing immunogenic rejection of corneal grafts.1-4 However, each of these studies has also emphasized that when these drugs are given for extended periods in doses adequate to maintain the cornea in a transparent state, prohibitively toxic side effects are encountered.

On the other hand, short-term administration of optimal doses of the purine analogue, azathioprine, causes no significant toxic side effects.1 Thus, it is possible temporarily to inhibit immune reactions in the cornea with antimetabolites without the occurrence of significant drug-related morbidity or mortality. Unfortunately, termination of antimetabolite therapy in this situation generally results in the occurrence of a corneal immune response soon thereafter.

The present communication reports our experience with the use of a combined therapeutic regimen in the suppression of the corneal xenograft (heterograft) reaction in rabbits. Systemic azathioprine was administered