Correlation between serum IFN-γ/IL-4 and the disease stage of childhood vitiligo and its predictive value for treatment efficacy

XU Qianru; ZHANG Xiaoru; WANG Le; WANG Dongxue; GUO Yinghui

doi:10.13431/j.cnki.immunol.j.20260018

Abstract：Objective To investigate the correlation between serum interferon-γ(IFN-γ)/interleukin-4(IL-4)and the disease stage of childhood vitiligo,and to evaluate its predictive value for treatment efficacy.Methods In total,125 children with vitiligo admitted from January 2023 to June 2024 were selected as the observation group,including 24 stable-stage patients,53 progressive-stage patients,and 48 rapid-progressive-stage patients.Based on the treatment efficacy at 6 months after treatment,they were divided into an effective subgroup(n=93)and an ineffective subgroup(n=32).Another 125 healthy children during the same period were selected as the control group.The levels of serum IFN-γ,IL-4,and IFN-γ/IL-4 in the observation group and the control group,as well as in children with different disease stages in the observation group,were compared.The correlation between serum IFN-γ,IL-4,and IFN-γ/IL-4 and the disease stage was analyzed.The clinical data and serum IFN-γ,IL-4,and IFN-γ/IL-4 levels of the effective subgroup and the ineffective subgroup were compared to analyze the correlation between serum IFN-γ,IL-4,and IFN-γ/IL-4 and treatment efficacy as well as their value in predicting treatment efficacy.Results The serum IFN-γ and IFN-γ/IL-4 levels in the observation group were higher than those in the control group,while the serum IL-4 level was lower than that in the control group(P＜0.01).The serum IFN-γ and IFN-γ/IL-4 levels showed an increasing trend in stable-stage,progressive-stage,and rapid-progressive-stage patients,while the serum IL-4 level showed a decreasing trend(P≤0.05).Spearman correlation analysis showed that serum IFN-γ and IFN-γ/IL-4 were positively correlated with the disease stage of children with vitiligo,and the serum IL-4 was negatively correlated with the disease stage(P＜0.05).The serum IFN-γ,IFN-γ/IL-4 levels in the ineffective subgroup were higher than those in the effective subgroup,while the serum IL-4 level was lower(P≤0.0l).After adjusting for other factors such as disease duration,lesion area,and disease stage,the restricted cubic spline curve showed a positive non-linear correlation between serum IFN-γ,IFN-γ/IL-4 and treatment efficacy(Ptrend＜0.05,Pnon-linear＜0.05).When serum IFN-γ was ≥66.81 pg/mL and IFN-γ/IL-4 was ≥1.78,the risk of treatment failure gradually increased as the levels of serum IFN-γ and IFN-γ/IL-4 increased;the serum IL-4 showed a negative non-linear correlation with treatment efficacy(Ptrend＜0.05,Pnon-linear＜0.05).When the serum IL-4 was＜40.02 pg/mL,the risk of treatment failure gradually decreased with the increase in serum IL-4 level.Receiver operating characteristic(ROC)curve analysis showed that the area under the ROC curve of serum IFN-γ/IL-4 for predicting the treatment efficacy of children with vitiligo was 0.873,with a sensitivity of 84.37％and a specificity of 77.42％,which was superior to the prediction of IFN-γ and IL-4 alone(Z=2.258,2.165,P=0.024,0.030).Conclusion Serum IFN-γ/IL-4 is significantly correlated with the disease stage of childhood vitiligo and can effectively predict treatment efficacy.