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Biomedical subjects

W J Armitage

Publications and source records attributed to W J Armitage.

At least 37 records · Page 2Linked to original sources

Corneal organ culture: effects of serum and a stabilised form of L-glutamine.

AIMS: Organ culture medium for corneas contains labile components, such as L-glutamine, whose loss could be a limiting factor to the length of storage. The medium is also supplemented with fetal bovine serum (FBS), which can vary significantly between different batches. The aim of this study was to establish the need for FBS during corneal organ culture, and to determine whether substitution of L-glutamine by the stable dipeptide L-analyl-L-glutamine was beneficial. METHODS: Porcine corneoscleral discs were suspended in 80 ml of organ culture medium (HEPES buffered Eagle's MEM with Earle's salts, 26 mmol/l NaHCO3, penicillin, streptomycin, and amphotericin B) and kept at 34 degrees C. The medium contained either 2 mmol/l L-glutamine or 2 mmol/l L-analyl-L-glutamine, and was either serum free or contained 2% FBS. At weekly intervals, five corneas from each group were stained with trypan blue and alizarin red S, and the surface area and shape of 100 endothelial cells were determined for each cornea. RESULTS: No differences were observed between corneas in organ culture medium with L-glutamine or L-analyl-L-glutamine. In serum free medium, endothelial cell density remained constant for the first week, but then declined rapidly over the next 2 weeks. With 2% FBS, there was no loss of endothelial cells for the first 2 weeks, but cell density had halved by the fourth week of organ culture. CONCLUSION: The presence of 2% FBS extended the period of endothelial stability, but no advantage was gained from the stabilised form of L-glutamine. The overall loss of endothelial cells was much greater than would be expected for human corneas.

Animals↗

Optimal cryopreservation of human umbilical cord blood.

Cryopreservation techniques for umbilical cord blood (UCB) have been based on methods established for marrow (BM) and peripheral blood progenitor cells (PBPC) with varying degrees of success. The aim of this study was to optimise cryopreservation of UCB haemopoietic cells based on sound cryopreservation principles. UCB samples were cryopreserved with different combinations of DMSO and hydroxyethyl starch (HES) by a variety of freezing protocols. After cooling at 1 degree C/min in solutions containing 4% HES and various concentrations of DMSO there was a dramatic fall in CD34+ recovery from 85.4% (s.d. 28.4) to 12.2% (s.d. 10.0) as DMSO concentration was reduced from 5 to 2.5%. Varying HES concentration in solutions containing 5% DMSO did not have a significant effect on CD34+ cell recovery. Increasing cooling rate from 1 to 10 degrees C/min significantly reduced CD34+ recovery (P < 0.0001) while increasing DMSO concentration up to 10% had little effect (P = 0.8, two-way ANOVA). Good recovery of UCB CD34+ cells can be achieved with 5-10% DMSO at a controlled cooling rate of 1 degrees C/min. There was a significant difference (P < 0.0001) in the apparent recovery of CD34+ cells between paired aliquots thawed in the presence (recovery = 76.8%, s.d. 26.0) and absence (32.5%, s.d. 18.7) of DNase. In conclusion, conditions for cryopreserving UCB for clinical banking that yield optimal recovery of CD34+ cells have been established.

Antigens, CD34↗

Differing effects of various cryoprotectants on intercellular junctions of epithelial (MDCK) cells.

The effects of 30 min exposure to 10% v/v cryoprotectant (glycerol, dimethyl sulfoxide, or propane-1,2-diol) on intercellular junctions were investigated in monolayers of epithelial (MDCK) cells. The cells were grown on microporous membrane filters and transepithelial resistance was monitored as an index of junction integrity. At 22 degrees C, Me2SO had the least effect of the three cryoprotectants, causing a gradual fall in transepithelial resistance of only 17% in 30 min. This compares with falls of 50% in 15 min and 37% over 30 min, respectively, with glycerol and propane-1,2-diol. At 0 degrees C, however, propane-1,2-diol had no effect on transepithelial resistance, whereas the effect of Me2SO was now similar to that of glycerol, viz. a sustained reduction in resistance of approximately 30% throughout the 30-min exposure. The results could not be explained solely in terms of osmotic effects and suggested that the cryoprotectants were directly affecting components of the junctional complex or associated elements of the cytoskeleton. During removal of the cryoprotectants by two-step dilution, changes in transepithelial resistance showed little consistency between the different cryoprotectants. This suggested that the pattern of change was dictated more by the state of the junctions immediately before removal of the cryoprotectants, with each cryoprotectant having affected the junctions to different extents and perhaps by different mechanisms, than by the removal of cryoprotectant itself. Thus, intercellular junctions in epithelial sheets were affected by even modest concentrations of cryoprotectant, but the effect was influenced by the type of cryoprotectant and by temperature of exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Chloride binding in the stroma of cultured human corneas.

In the ox cornea, more than half of the non-diffusible, matrix negative charge is derived from the binding of free chloride ions. Because the magnitude of the net matrix charge is the dominant factor which determines the degree of stromal swelling, we investigated whether this phenomenon, stromal chloride binding, also occurs in human corneal stroma. Intrastromal ion concentrations were measured with radio-isotopes when human (outdated Eye Bank) corneas or (fresh) bovine corneas, physically clamped to maintain a constant hydration, were incubated in buffered 154 mM NaCl. The intrastromal chloride ion concentration was compared to the normalized concentrations of trace quantities of radio-labelled acetate and lactate ions. For human corneas, the intrastromal chloride ion concentration was found to be significantly higher (P < 0.001, t-test) than the normalized concentrations of both acetate and lactate ([Cl]i = 142.5 +/- 0.9 mM, (n = 9); [acetate]i = 131.2 +/- 1.2 mM, (n = 8); [lactate]i = 131.9 +/- 1.5 mM, (n = 5); all values are mean +/- S.E.M.). The sodium ion concentration was elevated ([Na]i = 176.0 +/- 1.8 mM, (n = 9)). These results demonstrate that chloride binding occurs to a significant extent in cultured human corneal stroma and suggest that chloride binding may be evident in the native human cornea.

Animals↗

Influence of donor and histocompatibility factors on corneal graft outcome.

The Corneal Transplant Follow-up Study has followed 2311 penetrating keratoplasties for up to 450 days after transplant. A total of 207 failures were observed, including 65 classical rejections and 35 endothelial decompensations. At 12 months, graft survival was 89%, and survival free from rejection was 87%. For surviving grafts, risk of failure reduced from 4.8% in the first 75 days and stabilized after 5 months at 1.2% in each 75-day interval. Risk of rejection initially followed a similar pattern, but then increased after 12 months. Multifactorial analyses accounted for differences in recipient characteristics and interrelationships of donor factors. Donor age, sex, cause of death, and method of corneal storage were not found to influence significantly either time to graft failure or time to first rejection. Grafts in prospectively tissue-typed donor-recipient pairs were generally considered before surgery to be at increased risk of either graft failure or rejection. With due allowance, increasing risk of rejection was associated with increasing numbers of mismatches at HLA-A and HLA-B broad antigens. The opposite was true at HLA-DR broad antigens, where increased risk of rejection was observed with no mismatches.

Adult↗

Response of epithelial (MDCK) cell junctions to calcium removal and osmotic stress is influenced by temperature.

Intercellular junctions could be targets of injury during both hypothermic storage and cryopreservation. Monolayers of Madin-Darby canine kidney (MDCK) cells, an epithelial cell line, were grown on microporous membrane filters, and junction integrity was monitored by transepithelial electrical resistance (TER). At 37 degrees C, TER was 196 ohm . cm2 (SD 58, n = 59): this rose with falling temperature to 278 (SD 54) and 409 (SD 110) ohm . cm2, respectively, at 22 and 0 degrees C. This initial increase was accounted for solely by the change in conductivity of the bathing medium, which declined with falling temperature. Prolonged exposure to reduced temperature, however, did cause a gradual decline in TER. Removal of calcium at 22 degrees C caused a rapid fall in TER owing to dissociation of calcium-dependent components of the junctional complex. This was followed by a gradual increase in TER over several hours when calcium was restored to the bathing medium. At 0 degrees C, TER declined slowly regardless of the presence or absence of calcium, which suggested that reduced temperature stabilized junctions with respect to their calcium dependence, but that low temperature itself was causing dissociation of junctions. Hypertonic stress (597 mOsmol/kg) caused a reduction in TER both at 22 and 0 degrees C, which, unlike the reduction caused by calcium removal at 22 degrees C, was reversed relatively rapidly on return to isotonic conditions. Hypotonic stress (201 mOsmol/kg) increased TER at 0 degree C, but had no effect at 22 degrees C. The lack of response at the higher temperature might have been the result of a cell volume regulatory mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Improved preservation of human corneal basement membrane following freezing of donor tissue for epikeratophakia.

Current methods for the production of lenticules for epikeratophakia involve rapid freezing, cryolathing, and slow warming of the donor cornea. We have found that this procedure causes structural damage to the epithelial basement membrane in the donor cornea which may subsequently contribute to poor postoperative re-epithelialisation of the implant, leading to graft failure. Endeavouring to overcome these problems, the effects of cryoprotection of donor cornea were investigated, using dimethyl sulphoxide, in conjunction with different cooling and warming rates as part of the protocol for cryolathing. The structural integrity of the epithelial basement membrane zone (BMZ) was then assessed by electron microscopy and by immunofluorescence microscopy using antibodies to types IV and VII collagen, components of the basal lamina and anchoring fibrils respectively, and an antibody to a component of the anchoring filaments. No differences in the pattern of immunostaining for these components were detected, indicating that the composition of the BMZ was unaltered by the different treatment regimens applied. However, electron microscopy showed that preservation of basement membrane ultrastructure was markedly improved when cornea was warmed rapidly rather than slowly, both in cryoprotected and non-cryoprotected tissue. Epithelial cell retention and preservation of stromal architecture appeared superior in cryoprotected samples, while keratocyte structure was heterogeneous throughout the experimental groups. Further work is in progress to assess the efficacy of these protocols in the preservation of keratocyte viability in association with improved basement membrane structure in donor tissue for epikeratophakia.

Basement Membrane↗

Effects of irrigation solutions on corneal endothelial function.

Rabbit corneas were perfused in vitro with an irrigation solution for 90 minutes. This was followed by 6 hours of perfusion with tissue culture medium TC199 during which endothelial function was assessed by monitoring rates of swelling during a period of perfusion in the absence of bicarbonate ions, and subsequent rates of thinning when bicarbonate ions were restored to the perfusate. Corneal thickness (measured with an ultrasonic pachymeter) immediately following excision was 401 microns (SD 19, n = 23). During the 90 minute perfusion at 35 degrees C, corneas exposed to balanced salt solution (BSS), Hartmann's solution or 0.9% NaCl (all initially at room temperature) swelled, respectively, at 14 (SD 2.3, n = 4), 11 (SD 2.6, n = 4), and 70 (SD 4.3, n = 4) microns/h. Cold Hartmann's solution (initially at 4 degrees C) caused corneas to swell at 9 (SD 2.3, n = 4) microns/h. On the other hand, corneas perfused with BSS Plus thinned at 9 (SD 3.4, n = 4) microns/h and TC199 with Earle's salts had little effect on thickness. Rates of swelling and thinning during the following assessment perfusion showed no apparent effects of prior exposure to any of the irrigation solutions on the barrier properties or pump function of the endothelium. Despite this, the increased thickness of corneas exposed initially to BSS, cold Hartmann's solution, or 0.9% NaCl was not fully reversed, even by the end of the 6 hour assessment perfusion. In contrast, the swelling observed in corneas exposed to Hartmann's solution at room temperature was reversed and these corneas had returned to their normal thickness by the end of the assessment period. All corneas, even those exposed to 0.9% NaCl, had an intact endothelial mosaic with no evidence of damage or cell loss, although morphological differences in cell shape and the appearance of cell borders were evident compared with freshly isolated cornea.

Animals↗

Penetrating keratoplasty in the United Kingdom: an interim analysis of the corneal transplant follow-up study.

1. Clinical corneal transplantation has been performed for over a century, but many elements leading to a successful outcome have yet to be identified. 2. Because there are limitless supplies of tissue, the supply of corneas need never fall short of demand. Nevertheless, retrieval rates vary widely among regions in the UK due to uneven organization of services. 3. Organ culture of corneas improves the quality of transplanted tissues because it allows time for substandard material to be discarded. The outcome appears to equal other storage methods. 4. Between 1987 and 1991, 4,560 corneal transplants were performed by 428 surgeons at 216 centers in the UK and were registered with CTFS. Of these, 3,213 were evaluable for graft survival, rejection, and other measures of visual outcome. 5. Unifactorial analysis revealed that the percentage of graft survival at one year was 89% and rejection-free survival was 87%. However, the hazard of rejection appeared to increase at or after the time of suture removal. 6. The percentage of recipients in whom CVA was 6/24 or better (able to read normal text with correction) improved from 16% preoperatively to 59% at 3 and 70% at 12 months postoperatively overall. In patients transplanted purely for visual reasons, improvement was 78% and 83% at 3 and 12 months, respectively. 7. Interim results of multifactorial analysis suggest that the risk of graft failure, rejection, and decreased CVA increased in association with the following factors: surgeons who reported fewer than 50 transplants to the study; recipients under 10 years of age; previously failed grafts (the more failed grafts, the greater the risk); grafting for nonvisual reasons; certain diagnoses; and vascularization of the corneal bed prior to transplantation. 8. Astigmatism was investigated in 880 cases at 3 months postoperatively. Preliminary analysis indicated that the risk of severe astigmatism was influenced by suturing technique and large differences between (> 0.25 mm) donor and recipient trephine size. 9. The effects of HLA matching were evaluated in 542 transplants. HLA-A and B matching reduced the risk of rejection during the first 450 days posttransplant, but HLA-DR matching appeared to increase the risk of rejection. 10. A rat model designed to simulate clinical corneal grafting was used to investigate the interaction between immunosuppression and matching. Whereas MHC mismatching could be overcome with topical dexamethasone, non-MHC mismatching appeared resistant.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Corneal tolerance of vitrifiable concentrations of glycerol.

Equilibration of corneas with sufficiently high concentrations of cryoprotectants to inhibit potentially damaging ice formation during cryopreservation has not yet been achieved. This study examined the effects on the structure and function of rabbit corneal endothelium of the low toxicity cryoprotectant glycerol. Corneas were exposed to concentrations ranging from 2.0 to 6.8 M glycerol in a Hepes-buffered Ringer's solution containing glutathione, adenosine, 5 mM sodium bicarbonate and 6% w/v bovine serum albumin. Endothelial function was assessed by monitoring corneal thickness during perfusion of the endothelial surface at 34 degrees C for 6 h. Endothelial structure was observed using specular microscopy during perfusion and scanning electron microscopy after perfusion. Corneas tolerated exposure to 2.0 and 3.4 M glycerol for 20 min at 4 and -5 degrees C, respectively. Tolerance of 4.8 M glycerol for 10 min at -10 degrees C was improved by decreasing the dilution temperatures. Ten-minute exposure to 6.1 and 6.8 M glycerol was tolerated at -15 degrees C. In all cases corneas initially showed signs of damage but endothelial function was regained following structural repair. Corneas exposed to 6.8 M glycerol and cooled below the glass transition temperature were nonfunctional after warming. Ice formation during warming was believed to be the cause of injury.

Animals↗

Long-term survival of endothelium following transplantation of corneas stored by organ culture.

This study reports corneal graft survival, endothelial cell changes, and visual outcome in 20 patients who received some of the first corneas stored by organ culture in the Corneal Transplant Service Eye Bank in Bristol. Mean donor age was 48 years (SD 15, n = 20) and corneas were stored for an average of 21 days (SD 7, n = 20). Preoperative endothelial cell density was 2334 cells/mm2 (SD 235, n = 18) and this fell by 8% (SD 12) to 2158 cells/mm2 (SD 372) within the first 2 months following transplantation. In 13 patients, endothelial cell density thereafter declined exponentially with a half-life of 41 months (SD 17, n = 12; one patient excluded as an outlier). Corneas that suffered rejection episodes showed the highest rates of loss of endothelial cells. Endothelial cell loss 4 years after transplantation was 46% (SD 16, n = 12), which was similar to the postoperative decline in cell density reported for corneas stored for far shorter periods in McCarey-Kaufman medium at 4 degrees C.

Adult↗

Corneal tolerance of vitrifiable concentrations of propane-1,2-diol.

The merit of corneal cryopreservation by vitrification as opposed to conventional freezing is the avoidance of ice damage which is believed to disrupt the integrity of the corneal endothelium resulting in loss of corneal transparency. The cornea must be equilibrated with high concentrations of cryoprotectant in order to achieve vitrification at practicable cooling rates. In an earlier study, corneas were exposed to 3.4 mol/liter propane-1,2-diol (Rich and Armitage (1990) Cryobiology 27, 42-54). The present study exposed rabbit corneas to concentrations of propane-1,2-diol between 3.4 and 5.4 mol/liter in a Hepes-buffered Ringer's solution containing glutathione, adenosine, 5 mmol/liter sodium bicarbonate, 6% (w/v) bovine serum albumin, and 2.5% (w/v) dextran sulfate. Dextran sulfate was as effective as chondroitin sulfate at improving endothelial tolerance of 3.4 mol/liter propane-1,2-diol. This beneficial effect may be linked to the polyanionic nature of these molecules. Corneas exposed to 5.4 mol/liter propane-1,2-diol were cooled in liquid nitrogen vapor at a temperature of -140 degrees C for 2 h. Warming was achieved by direct transfer to a dilution solution at -10 degrees C. Endothelial function was assessed by monitoring corneal thickness during perfusion of the endothelial surface at 34 degrees C for 6 h. Endothelial structure was observed by specular microscopy during the perfusion and by scanning electron microscopy after perfusion. Corneas tolerated exposure to 3.4 mol/liter propane-1,2-diol for 20 min at 0 degrees C and to 4.1 mol/liter for 10 min at -10 degrees C. Exposure to 4.8 and 5.4 mol/liter for 10 min at -10 degrees C caused endothelial damage, although a degree of endothelial function was retained. Function following exposure to 5.4 mol/liter was improved by reducing the temperature of exposure to -15 degrees C. Corneas cooled after exposure to 5.4 mol/liter propane-1,2-diol for 10 min at -15 degrees C apparently vitrified, but devitrified on warming. The corneas swelled to such an extent during perfusion that the endothelium could not be viewed by specular microscopy, subsequent scanning electron microscopy showed a severely disrupted endothelium.

Animals↗

The potential of an equimolar combination of propane-1,2-diol and glycerol as a vitrification solution for corneas.

Corneas must first be equilibrated with multimolar concentrations of cryoprotectants if the formation of ice during cryopreservation is to be avoided by vitrification at practicable cooling rates. Rabbit corneas were exposed to equimolar mixtures of the cryoprotectants propane-1,2-diol and glycerol in a Hepes-buffered Ringer's solution containing glutathione, adenosine, 5 mmol/liter sodium bicarbonate, and 6% w/v bovine serum albumin. Endothelial function was assessed by monitoring its ability to control stromal hydration during perfusion of the endothelial surface at 34 degrees C for 6 h. Endothelial morphology was observed by specular microscopy during perfusion and by scanning electron microscopy after perfusion. Endothelial pump activity and structural integrity of the endothelial layer were demonstrated after 20 min exposure at 4 degrees C to a total concentration of 1.4 mol/liter cryoprotectant (i.e., 0.7 mol/liter propane-1,2-diol + 0.7 mol/liter glycerol). Exposure to 2.0 and 3.4 mol/liter cryoprotectant for 20 min at 4 degrees and -5 degrees C, respectively, resulted in initial endothelial damage; but this repaired and a functioning endothelial pump was subsequently demonstrated. Although exposure to 4.1 mol/liter cryoprotectant for 10 min at -10 degrees C caused irreparable damage to 2/4 corneas, reduced dilution temperatures together with increased dilution time allowed exposure to 4.8 and 5.5 mol/liter cryoprotectant with retention of endothelial pump activity. Exposure to 6.1 mol/liter cryoprotectant for 10 min at -15 degrees C caused endothelial damage which was not mitigated by the presence of 2.5% w/v chondroitin sulfate. Endothelial function may be improved by further modification of addition and dilution protocols or by exposure to the cryoprotectants at lower temperatures.

Animals↗