{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T16:14:51Z","timestamp":1783613691902,"version":"3.55.0"},"reference-count":65,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the Medical Scientific Research Foundation of Guangdong Province, China","award":["No. A2024245"],"award-info":[{"award-number":["No. A2024245"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Photobiomodulation, Photomedicine, and Laser Surgery"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the clinical efficacy of an intense pulsed light (IPL)-augmented regimen for moderate-to-severe perennial allergic conjunctivitis (PAC) and to elucidate its potential mechanisms through tear inflammatory factor profiling and untargeted metabolomics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective, single-arm, interventional study, 18 patients underwent two IPL sessions at two-week intervals. Outcomes included symptom visual analog scale (VAS) scores and sign scores, bulbar redness index (BRI), tear breakup time (TBUT), and tear inflammatory factors, including immunoglobulin E (IgE), matrix metalloproteinase-9 (MMP-9), and lymphotoxin-alpha (LTA). Untargeted metabolomics of tear fluid was performed using LC\u2013MS\/MS to identify differential metabolites and pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Symptom VAS [median difference: \u201325.0 (95% CI: \u201331.0, \u201321.0);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01] and sign [\u20134.0 (\u20136.0, \u20134.0);\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01] scores improved significantly, with 79.4% symptom reduction, a shift from frequent to occasional itching, and large effect sizes (Cohen\u2019s d: 2.18 symptoms, 2.70 signs). TBUT and BRI showed no significant changes. Tear IgE and MMP-9 tended to decrease and LTA to increase (nonsignificant). MMP-9 positively correlated with posttreatment BRI (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.570,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05), while LTA negatively correlated with baseline BRI (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u20130.573,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05). Untargeted metabolomics identified 65 differential metabolites: purine-related compounds (e.g., adenine, guanine) and stearic acid were downregulated; oleic acid, 9-OxoODE, etc., were upregulated. Purine metabolism was significantly altered (Raw\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0013, false discovery rate [FDR] = 0.104), while unsaturated fatty acid biosynthesis changes were not significant (Raw\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.49, FDR = 1). No serious adverse events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>An IPL-augmented regimen may alleviate moderate-to-severe PAC, which is consistent with the modulation of purine and unsaturated fatty acid metabolism. This modulation is characterized by suppressed purine activity and proinflammatory lipids while enhancing anti-inflammatory and antioxidant unsaturated fatty acids. These changes collectively dampen inflammation and promote immune homeostasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25785478251411050","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:14:41Z","timestamp":1773252881000},"page":"94-108","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intense Pulsed Light for Perennial Allergic Conjunctivitis: A Prospective Interventional Study with Untargeted Tear Metabolomics"],"prefix":"10.1177","volume":"44","author":[{"given":"Qiu","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/life14060650"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.5415\/apallergy.2020.10.e11"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.2011.02272.x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.31662\/jmaj.2022-0218"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.57711"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.64.10.30"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24044236"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.18240\/ijo.2023.11.22"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/ph15050547"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-024-01150-0"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0b013e328364ec3a"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/ICO.0b013e318198384f"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20877"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.13179"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/pho.2014.3819"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/photob.2019.4737"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/02713683.2017.1406525"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.5021\/ad.2009.21.1.12"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.973962"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/aos.15759"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1089\/photob.2020.4826"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-025-04058-z"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1089\/photob.2022.0063"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11306-025-02273-9"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2012.06.002"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1021\/pr2004874"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchromb.2011.10.018"},{"issue":"6","key":"e_1_3_3_29_2","first-page":"409","article-title":"Expert consensus on the diagnosis and treatment of allergic conjunctivitis in China (2018)","volume":"54","author":"Expert Consensus Group for Allergic Conjunctivitis Diagnosis and Treatment","year":"2018","unstructured":"Expert Consensus Group for Allergic Conjunctivitis Diagnosis and Treatment. 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