{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:41:52Z","timestamp":1793122912295,"version":"4.5.0"},"reference-count":67,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":272,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81170828"],"award-info":[{"award-number":["81170828"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81670837"],"award-info":[{"award-number":["81670837"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>\n                    <jats:italic>Purpose<\/jats:italic>\n                    . To assess the tear levels of inflammatory cytokines in patients with keratoconus (KC).\n                    <jats:italic>Design<\/jats:italic>\n                    . Systemic review and meta\u2010analysis.\n                    <jats:italic>Methods<\/jats:italic>\n                    . The following electronic databases and search engine were searched: PubMed, EMBASE, Web of Science, and Google Scholar. A systematic search of all relevant studies published through January 2021 was conducted, and the standardized mean difference (SMD) and 95% confidence interval (CI) of cytokine levels were calculated to estimate the pooled effects. Sensitivity analysis, subgroup analysis, and metaregression were applied to explore the sources of heterogeneity.\n                    <jats:italic>Results<\/jats:italic>\n                    . A total of 7 studies with 374 participants (374 eyes) from clinical studies were included. The tear levels of interleukin\u20101 beta (IL\u20101\n                    <jats:italic>\u03b2<\/jats:italic>\n                    ), interleukin\u20106 (IL\u20106), and tumor necrosis factor alpha (TNF\u2010\n                    <jats:italic>\u03b1<\/jats:italic>\n                    ) were significantly increased in KC compared with normal controls. The SMD of IL\u20101\n                    <jats:italic>\u03b2<\/jats:italic>\n                    was 1.93 (95% CI 0.22 to 3.65,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.03). The SMD of IL\u20106 was 1.22 (95% CI 0.59 to 1.84,\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). The SMD of TNF\u2010\n                    <jats:italic>\u03b1<\/jats:italic>\n                    was 1.75 (95% CI 0.66 to 2.83,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.002). There was no significant difference between the two groups on interleukin\u20104 (IL\u20104) and interleukin\u201010 (IL\u201010). The SMD for IL\u20104 was 2.36 (95% CI \u20100.28 to 5.00,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.08) and for IL\u201010 was 0.30 (95% CI \u20101.29 to 1.89,\n                    <jats:italic>P<\/jats:italic>\n                    = 0.71). Meta\u2010regression analysis indicated that the heterogeneity maybe significantly correlated with the method of detection, the different ages, and the source of population.\n                    <jats:italic>Conclusions<\/jats:italic>\n                    . Our meta\u2010analysis demonstrated that proinflammatory cytokines IL\u20101\n                    <jats:italic>\u03b2<\/jats:italic>\n                    , IL\u20106, and TNF\u2010\n                    <jats:italic>\u03b1<\/jats:italic>\n                    were increased, indicating that cytokine profile changed in KC tears and inflammation may play an important role in the pathogenesis and development of KC.\n                  <\/jats:p>","DOI":"10.1155\/2021\/6628923","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T15:26:03Z","timestamp":1633015563000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Tear Levels of Inflammatory Cytokines in Keratoconus: A Meta\u2010Analysis of Case\u2010Control and Cross\u2010Sectional 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