Study On The Changes Of IL-2,IL-4 And IFN-γ Levels In Peripheral Blood Of Progressive Vitiligo With Alopecia Areata Patients

Objective: Both vitiligo and alopecia areata are autoimmune diseases mediated by T lymphocytes,in which Th1/Th2 imbalance plays an important role in promoting the immune mechanism of both.The aim of this study was to compare the levels of IL-2,IL-4 and IFN-γ among peripheral blood of patients with generalized vitiligo progressive,alopecia areata and generalized vitiligo progressive with alopecia areata.The correlation between IL-2,IL-4,IFN-γ and generalized vitiligo progression,alopecia areata and generalized vitiligo progression with alopecia areata was analyzed and studied.To explore the immune mechanism of Th1/Th2 cells in the pathogenesis of patients with progressive generalized vitiligo with alopecia areata.Methods:The patients who visited the dermatology outpatient department of the First Affiliated Hospital of Hebei North University from April 2019 to December 2020 were selected,including 26 patients with progressive vitiligo,14 patients with progressive vitiligo with alopecia areata and 30 patients with alopecia areata without vitiligo were selected,as the research objects.The results were compared with 30 healthy subjects from the physical examination center of our hospital.Divided into A group: clinically diagnosed patients with progressive stage of generalized vitiligo without alopecia areata;Group B: Clinically diagnosed patients with progressive stage of generalized vitiligo accompanied by alopecia areata;Group C: clinically diagnosed patients with alopecia areata without vitiligo;Group D: healthy people.The levels of IL-2,IL-4 and IFN-γ in peripheral blood of group A,B,C and D were determined by multi-microsphere flow free fluorescent luminescence method.SPSS 25.0 statistical analysis software was used for statistical analysis of the data.Result:Serum IL-2 levels in patients with A group were significantly lower than those in healthy subjects(P<0.001),IFN-γ and IL-4 were significantly higher than those of healthy subjects(P<0.001);Serum levels of IL-2,IL-4 and IFN-γ in B group were higher than those in healthy subjects(P<0.001).The levels of IL-2 and IFN-γ in B group accompanied by alopecia areata were between those with progressive vitiligo and those without.IL-4 levels were higher than those of the other groups.The serum levels of IL-2 and IFN-γ in patients with alopecia areata without vitiligo were significantly higher than those in healthy subjects(P<0.001),IL-4 was significantly lower than in healthy subjects(P<0.001).The P values of the 4 groups were approximately 0.000 and P<0.05 in the progressive stage of generalized vitiligo,the progressive stage of generalized vitiligo with alopecia areata,and the healthy patients without vitiligo.The serum levels of IL-2,IL-4 and IFN-γ were significantly different between the two groups.Comparison of serum IL-2,IL-4 and IFN-γ levels between men and women in each group: Except for the P value of IL-4 in group A,which was less than 0.05,the other P values were all greater than 0.05,which could be considered as no significant difference.Therefore,there were no significant differences in IL-2,IL-4 and IFN-γ levels between men and women in each group,and the differences were not statistically significant.The correlation between IL-2,IL-4 and IFN-γ was analyzed by multiple linear regression stepwise method.IL-2,IL-4 and IFN-γ were used as dependent variables for analysis.The established models were statistically significant,with P values less than 0.05,suggesting that there was a linear dependence between IL-2,IL-4 and IFN-γ.Conclusion: In the progressive stage of generalized vitiligo,In generalized vitiligo,IL-2 was significantly decreased and Th1 cells were significantly inhibited.IFN-γ plays a minor role in promoting Th0-to-Th1 cell differentiation by inducing IL-2,and its level may be influenced by IFN-γ secreted by cytotoxic T cells.IL-4 increased,and Th2 cells were dominant,and humoral immunity was dominant.IL-2 and IFN-γ were increased and IL-4 was decreased in alopecia areata.IL-2 was significantly correlated with alopecia areata.Th1 cells were dominant and cellular immunity was dominant.Both Th1 and Th2 cells in the body of progressive of generalized vitiligo with alopecia areata are activated,presenting a dynamic change process with the Balance of Th1/Th2 gradually shifting from left to right.In the early stage,the possibility of left-leaning may appear,Th1 cells dominate,while in the middle and late stage,Th2 cells dominate,and humoral immunity is dominant.Serum levels of IL-2,IFN-γ and IL-4 were linearly dependent.These three factors influence and restrict each other,and jointly participate in the onset of generalized vitiligo progression,alopecia areata and generalized vitiligo progression with alopecia areata.