{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:10:36Z","timestamp":1788844236096,"version":"build-2803163510"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"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>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the associations among ocular surface oxidative stress, MMP-9\u2013associated barrier dysfunction, and corneal nerve alterations in patients with allergic conjunctivitis-associated dry eye.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study, participants were classified into healthy controls (HC), patients with allergic conjunctivitis (AC), and patients with AC-associated dry eye (AC\u2009+\u2009DE). Ocular surface symptoms and signs, tear film function, corneal fluorescein staining, and\n                      <jats:italic>in vivo<\/jats:italic>\n                      confocal microscopy (IVCM) parameters were evaluated. Tear malondialdehyde (MDA), superoxide dismutase (SOD) activity, and matrix metalloproteinase-9 (MMP-9) concentrations were measured. Spearman correlation analyses were performed in patients with AC and AC\u2009+\u2009DE, and receiver operating characteristic (ROC) curve analyses were used to evaluate the ability of tear biomarkers to distinguish AC\u2009+\u2009DE from AC alone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with patients with AC alone, those with AC\u2009+\u2009DE exhibited higher Ocular Surface Disease Index scores, shorter tear film break-up time, lower Schirmer I test values, and more severe corneal fluorescein staining (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). IVCM further demonstrated reduced corneal nerve parameters and increased dendritic cell density in the AC\u2009+\u2009DE group. Tear MDA and MMP-9 concentrations were significantly higher, whereas SOD activity was lower, in patients with AC\u2009+\u2009DE. Exploratory correlation analyses identified associations among oxidative stress markers, MMP-9, and selected ocular surface parameters. The areas under the ROC curves for MDA, SOD, and MMP-9 were 0.822, 0.730, and 0.789, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with AC\u2009+\u2009DE exhibited greater oxidative stress imbalance, higher MMP-9 levels, impaired tear film function, and more pronounced corneal neuroimmune alterations than patients with AC alone. The observed relationships among oxidative stress markers, MMP-9, and tear film parameters suggest that these abnormalities may be interconnected within the AC\u2009+\u2009DE phenotype. Tear oxidative stress\u2013related biomarkers may also help distinguish AC\u2009+\u2009DE from AC alone and warrant further evaluation in longitudinal studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1942693","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:26:34Z","timestamp":1788841594000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ocular surface oxidative stress, MMP-9, and corneal neuroimmune alterations in allergic conjunctivitis with dry eye: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Kang","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Ophthalmic Center, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, 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Ophthalmic Center, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haole","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmic Center, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmic Center, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"650","DOI":"10.3390\/life14060650","article-title":"Allergic conjunctivitis: review of current types, treatments, 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