Translational vision science & technology · 2026
Tear Fluid Lymphotoxin-Alpha as a Diagnostic Biomarker for the Stratification of Dry Eye Disease.
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Yang Yun, Wang Wushuang, Tan Yue, Feng Changming, Liu Yujia, Wen Xuetian, Lin Tong, Gong Lan
Аннотация
PURPOSE: This study aimed to investigate the diagnostic value of the tear lymphotoxin-α (LTA) concentration for dry eye disease (DED).
METHODS: A total of 160 subjects-75 patients with DED, 55 individuals without DED, and 30 pain-without-stain patients were included. Ocular Surface Disease Index (OSDI), the tear LTA concentration, tear break-up time (TBUT), MMP-9, IL-1ra, IL-1β, IL-6, IL-8, IL-17, and IFN-γ, and MUC5AC levels, corneal fluorescein staining (CFS), conjunctival lissamine green staining (CLGS), conjunctival impression cytology (IC), Schirmer I test, and conjunctival goblet cell counts were determined.
RESULTS: Tear LTA concentration varied among the three groups, being the lowest in the DED group and the highest in the pain-without-stain group. The overall agreement rate between LTA diagnosis and expert consensus diagnose was 83.85%. The kappa coefficient was 0.670 (P < 0.001). Significant differences in tear LTA concentration were observed among all severity groups. Receiver operating characteristic (ROC) curve analysis revealed cutoff values of 105 pg/mL, 855 pg/mL, and 1580 pg.mL as an exploratory stratification thresholds for distinguishing the severe DED (LTA <105 pg/mL), mild DED (LTA 105 pg/mL to 855 pg/mL), non-DED (LTA 855 pg/mL to 1580 pg/mL), and pain-without-stain groups (LTA > 1580 pg/mL). Moreover, significant differences in the OSDI, the TBUT, CFS results, CLGS results, IC results, MMP-9, IL-1ra, IL-1β, IL-6, IL-8, IL-17, IFN-γ, and MUC5AC concentrations were detected among the different LTA groups.
CONCLUSIONS: Throughout the cohort, we explored the potential of tear LTA concentration for the diagnosis and graded classification diagnosis of dry eye.
TRANSLATIONAL RELEVANCE: Tear LTA is a potential biomarker for the graded classification and subtyping of dry eye, and is expected to become a novel biomarker in the diagnosis and management of dry eye.
METHODS: A total of 160 subjects-75 patients with DED, 55 individuals without DED, and 30 pain-without-stain patients were included. Ocular Surface Disease Index (OSDI), the tear LTA concentration, tear break-up time (TBUT), MMP-9, IL-1ra, IL-1β, IL-6, IL-8, IL-17, and IFN-γ, and MUC5AC levels, corneal fluorescein staining (CFS), conjunctival lissamine green staining (CLGS), conjunctival impression cytology (IC), Schirmer I test, and conjunctival goblet cell counts were determined.
RESULTS: Tear LTA concentration varied among the three groups, being the lowest in the DED group and the highest in the pain-without-stain group. The overall agreement rate between LTA diagnosis and expert consensus diagnose was 83.85%. The kappa coefficient was 0.670 (P < 0.001). Significant differences in tear LTA concentration were observed among all severity groups. Receiver operating characteristic (ROC) curve analysis revealed cutoff values of 105 pg/mL, 855 pg/mL, and 1580 pg.mL as an exploratory stratification thresholds for distinguishing the severe DED (LTA <105 pg/mL), mild DED (LTA 105 pg/mL to 855 pg/mL), non-DED (LTA 855 pg/mL to 1580 pg/mL), and pain-without-stain groups (LTA > 1580 pg/mL). Moreover, significant differences in the OSDI, the TBUT, CFS results, CLGS results, IC results, MMP-9, IL-1ra, IL-1β, IL-6, IL-8, IL-17, IFN-γ, and MUC5AC concentrations were detected among the different LTA groups.
CONCLUSIONS: Throughout the cohort, we explored the potential of tear LTA concentration for the diagnosis and graded classification diagnosis of dry eye.
TRANSLATIONAL RELEVANCE: Tear LTA is a potential biomarker for the graded classification and subtyping of dry eye, and is expected to become a novel biomarker in the diagnosis and management of dry eye.