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New research · Ophthalmology
Frontiers in ophthalmology · 2d
StudyFrontiers in ophthalmology · 2026

Differential tear metabolomics in blepharokeratoconjunctivitis and herpes simplex keratitis: potential biomarkers for clinical differentiation.

Zi-Wen Wang, Zhen-Ning Wu, Hui-Zhen Wang, Shi-You Zhou
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OphthalmologyStudy

A 3-metabolite tear panel accurately distinguished herpes eye infection from blepharokeratoconjunctivitis.

Differential tear metabolomics in blepharokeratoconjunctivitis and herpes simplex keratitis: potential biomarkers for clinical differentiation.

Zi-Wen Wang … Shi-You Zhou
Frontiers in ophthalmology · 2026
Purpose

To characterize tear metabolomic differences between active blepharokeratoconjunctivitis (blepharokeratoconjunctivitis) and herpes simplex keratitis (HSK; epithelial type) and identify diagnostic biomarkers.

Methods

Tear samples were collected from 24 HSK patients, 19 blepharokeratoconjunctivitis patients, and 15 healthy controls from October 2020 to 2021.

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Results
0.79
higher score means the tear test better tells the two infections apart
More results

Compared to healthy controls, HSK exhibited 21 altered metabolites, while blepharokeratoconjunctivitis showed 19 altered metabolites.

After FDR correction, L-isoleucine, L-phenylalanine, pantothenol were significantly expressed lower in both HSK and blepharokeratoconjunctivitis.

More results

Moreover, 4-dodecylbenzenesulfonic acid, carnosol were lower in HSK-specific, and sorbitol was lower in blepharokeratoconjunctivitis-specific than in control.

A combined panel of metabolites 4-dodecylbenzenesulfonic acid, carnosol and sorbitol showed good specificity and sensitivity for differentiation of blepharokeratoconjunctivitis/HSK.

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Conclusion · 1 of 2

The disease-specific differential expression of carnosol, 4-dodecylbenzenesulfonic acid in HSK, and sorbitol in blepharokeratoconjunctivitis provide mechanistic insights into HSV-1 infection and chronic immune-mediated ocular surface inflammation, respectively.

Conclusion · 2 of 2

The combination of clinical signs with nPCR result and a metabolite panel (4-Dodecylbenzenesulfonic Acid+ Carnosol +Sorbitol) may be optimal for HSK/blepharokeratoconjunctivitis discrimination.

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