Corneal transplantation is the most successful solid organ transplantation performed in humans. The extraordinary success of orthotopic corneal allografts, in both humans and experimental animals, is related to the phenomenon of “immune privilege”. Inflammation is self-regulated to preserve ocular functions because the eye has immune privilege. At present, three major mechanisms are considered to provide immune privilege in corneal transplantation: 1) anatomical, cellular, and molecular barriers in the cornea; 2) tolerance related to anterior chamber-associated immune deviation and regulatory T cells; and 3) an immunosuppressive intraocular microenvironment. This review describes the mechanisms of immune privilege that have been elucidated from animal models of ocular inflammation, especially those involving corneal transplantation, and its relevance for the clinic. An update on molecular, cellular, and neural interactions in local and systemic immune regulation is provided. Therapeutic strategies for restoring immune privilege are also discussed.

角膜移植是人类最成功的实体器官移植。原位角膜同种异体移植在人类和实验动物中都取得了巨大的成功，这与“免疫特权”现象有关。炎症是自我调节的，可保持眼睛功能，因为眼睛具有免疫特权。目前，认为在角膜移植中提供免疫特权的三种主要机制为：1）角膜的解剖，细胞和分子屏障。2）与前房相关的免疫偏差和调节性T细胞相关的耐受性；3）免疫抑制性眼内微环境。这篇综述描述了从眼部炎症的动物模型（尤其是涉及角膜移植的动物模型）中阐明的免疫特权机制，及其对诊所的意义。提供了在局部和全身免疫调节中分子，细胞和神经相互作用的更新。还讨论了恢复免疫特权的治疗策略。