{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T12:49:44Z","timestamp":1772455784967,"version":"3.50.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to investigate tear lymphocytotoxin-<jats:italic>\u03b1<\/jats:italic> (LT-\u03b1) levels in adult keratoconus patients and identify the correlations between LT-\u03b1 and the disease severity of keratoconus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross-sectional study, tear samples from 100 keratoconus patients (KC group) and 67 healthy controls (HC group) were collected. LT-\u03b1 levels were tested immediately after collection using a commercially available point-of-care test (POCT). Visual acuity, corneal tomography, anterior segment optical coherence tomography (AS-OCT), tear film parameters, including non-invasive break-up time (NI-BUT), tear meniscus height (TMH), lipid layer thickness (LLT), and meibomian glands, were also tested. Corneal topography values (K1, K2, K<jats:sub>max,<\/jats:sub> and astigmatism) were derived from the tomography data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The tear LT-\u03b1 levels in the HC group were significantly higher than those in the KC group (<jats:italic>p<\/jats:italic>\u202f=\u202f0.038). The NI-BUT, TMH, and LLT were significantly lower, while the meiboscore was higher in the KC group than in the HC group (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). In the KC group, patients were further divided into preclinical stage, initial stage, and complete stage groups. Significant differences in tear LT-\u03b1 levels were found among the three subgroups. Within the KC group, LT-\u03b1 levels were significantly correlated with various parameters, including thinnest corneal thickness, best-corrected visual acuity (BCVA) (LogMAR), K1, K2, K<jats:sub>max<\/jats:sub>, and astigmatism values. However, no significant correlation was observed between the tear LT-\u03b1 level and tear film parameters. Within the control group, no significant correlation was identified between the tear LT-\u03b1 level and corneal topography or tear film parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data demonstrated an association between tear LT-\u03b1 levels and the severity of keratoconus, implying that immune-related factors may be involved in the pathogenesis and progression of the disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1591159","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T04:10:25Z","timestamp":1749183025000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlations between tear lymphocytotoxin-a (LT-\u03b1) level and disease severity in adult keratoconus"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiuxian","family":"Qin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunrong","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xie","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianwen","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiwen","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xumin","family":"Shang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Lan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huping","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhirong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.clae.2010.04.006","article-title":"Keratoconus: 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