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Tear fluid participates in systemic immunity.

Tong Wu1,2,3, Xiya Wen4, Jiaxin Zhang5

  • 1Department of Ophthalmology, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China. halodenice@163.com.

Zhong Nan Da Xue Xue Bao. Yi Xue Ban = Journal of Central South University. Medical Sciences
|February 9, 2026
PubMed
Summary

Tear fluid analysis reveals its crucial role beyond eye health, impacting systemic immune diseases. Biomarkers in tears offer potential for early disease detection and new treatments.

Keywords:
autoimmune diseaseexosomesimmunitymicroRNAsocular surface immune microenvironmenttear fluid

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Area of Science:

  • Ophthalmology
  • Immunology
  • Biochemistry

Background:

  • Tear fluid is vital for ocular surface health and immune balance.
  • Recent findings show tear fluid's involvement in ocular and systemic immune diseases.
  • This challenges previous scientific understanding of tear fluid's role.

Purpose of the Study:

  • To explore the role of tear fluid's immune components in various diseases.
  • To highlight tear fluid biomarkers for disease screening and therapeutic targets.
  • To emphasize the potential of tear fluid analysis for diagnosing systemic conditions.

Main Methods:

  • Analysis of immune cells (T cells, neutrophils, NK cells, macrophages) in tear fluid.
  • Detection of cytokines and immunoglobulins in tear fluid.
  • Identification of tear fluid biomarkers such as exosomal microRNAs and proteins.

Main Results:

  • Tear fluid immune components are implicated in autoimmune diseases (Sjögren's syndrome, RA, SLE, MS, Graves' ophthalmopathy) and systemic diseases (Alzheimer's, diabetes, GVHD).
  • Changes in tear fluid composition reflect systemic immune imbalance.
  • Specific biomarkers (miR-204, miR-200b-5p, β2-microglobulin) show promise for early detection and treatment strategies.

Conclusions:

  • Tear fluid analysis offers innovative diagnostic tools and therapeutic targets for systemic diseases.
  • Dynamic changes in tear fluid components can indicate systemic immune homeostasis disruption.
  • Further research is needed to standardize tear fluid testing for clinical application.