Living tissues and dead objects in the eye: The first description of ocular immune privilege by J.C. van Dooremaal in Albrecht Von Graefe’s Archiv für Ophthalmologie in 1873

BACKGROUND: Immune privilege of the eye is considered to contribute significantly to the excellent survival of transplants in the anterior and posterior segment of the eye. While Sir Peter Medawar proved the existence of this phenomenon scientifically, a prior study by Dr. J.C. van Dooremaal already suggested the existence of ocular immune privilege and was published in this journal in 1873. METHODS: The original 1873 German paper by J.C. van Dooremaal in Albrecht von Graefe's Archiv für Ophthalmologie was translated into English and commented on by immunologist Dr. J. Wayne Streilein and other eye specialists. Family of Dr. van Dooremaal supplied information about the author himself. RESULTS: Dr. van Dooremaal was a military doctor when he was confronted with a severe epidemic of trachoma while serving at the Government Institution of Benevolence in the Netherlands (now a UNESCO heritage site). While finding a solution to fight the epidemic, he became familiar with the eye clinic of professor F.C. Donders in Utrecht. He subsequently trained as an ophthalmologist, and worked on a thesis on implantation of foreign tissues in the anterior chamber of different animals. He observed that a piece of skin of a white mouse placed in the eye of a dog survived amazingly long and was integrated into the tissues of the anterior chamber instead of rejected. According to Dr. J. Wayne Streilein, this was the first experimental demonstration of ocular immune privilege. CONCLUSION: The 1873 paper by Dr. J.C. van Dooremaal can be regarded as the first description of ocular immune privilege, and as Dr. J. Wayne Streilein wrote in 2001: Dr. van Dooremaal is the FATHER of immune privilege - although he could not call it that since immunology had not yet been discovered.