The immunopathology of keratoconus: tear film biomarkers and immune pathways.

IF 2.6 4区医学 Q2 ALLERGY

Current Opinion in Allergy and Clinical Immunology Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI:10.1097/ACI.0000000000001099

Marco Lombardo, Mario Fruschelli, Sebastiano Serrao

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引用次数: 0

Abstract

Purpose of review: This review explores established risk factors for keratoconus and current insights into tear film immune biomarkers, with a focus on the role of chronic low-grade inflammation in disease pathogenesis and emerging targeted therapies.

Recent findings: Growing evidence supports immune dysregulation as a key driver in the onset and progression of keratoconus. Genetics establish a foundation for a dysregulated inflammatory response in the ocular surface and corneal microenvironment, which sustains and accelerates disease progression. Elevated tear levels of IL-1, IL-6, TNF-α, HMGB1, and MMP9 reflect these inflammatory changes. Chronic inflammation and repeated mechanical trauma from eye rubbing, especially in adolescents and young adults, are major risk factors for disease progression. Timely screening and regular corneal topography in adolescents with allergic or atopic disorders are essential for early diagnosis and prevention of vision loss.

Summary: The tear film and corneal microenvironment contain valuable immune markers that shed light on keratoconus pathophysiology. Advances in precision and predictive medicine hold promise for safer, more effective strategies to halt disease progression.

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圆锥角膜的免疫病理：泪膜生物标志物和免疫途径。

综述目的：本综述探讨了圆锥角膜的已知危险因素和泪膜免疫生物标志物的最新见解，重点关注慢性低度炎症在疾病发病机制和新兴靶向治疗中的作用。最近发现：越来越多的证据支持免疫失调是圆锥角膜发病和发展的关键驱动因素。遗传学为眼表和角膜微环境中失调的炎症反应奠定了基础，这维持并加速了疾病的进展。泪液中IL-1、IL-6、TNF-α、HMGB1和MMP9水平的升高反映了这些炎症变化。慢性炎症和反复揉眼造成的机械性创伤，尤其是在青少年和年轻人中，是疾病进展的主要危险因素。青少年过敏或特应性疾病的及时筛查和定期角膜地形图检查对于早期诊断和预防视力丧失至关重要。泪膜和角膜微环境包含有价值的免疫标记物，揭示圆锥角膜的病理生理。精准和预测医学的进步为更安全、更有效地阻止疾病进展提供了希望。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Allergy and Clinical Immunology 医学-过敏

CiteScore

5.90

自引率

3.60%

发文量

109

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on one to three topics, every issue of Current Opinion in Allergy and Clinical Immunology delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as upper airway disease; mechanisms of allergy and adult asthma; paediatric asthma and development of atopy; food and drug allergies; and immunotherapy.