Serum interleukin (IL)-4 and IL-6 may play a role in the pathogenesis of primary immune thrombocytopenia (ITP), according to a new study published in the European Journal of Pediatrics. In addition, IL-4 levels may be a good predictor of response to treatment.

The researchers aimed to predict the course of ITP by evaluating the levels of IL-4 and IL-6, which may serve as markers of impaired cellular immunity.

Read more about the pathophysiology of ITP

They prospectively analyzed 60 children aged 1 to 18 years, of whom 15 were newly diagnosed with ITP, 15 had persistent disease, 15 had chronic disease, and 15 were healthy. 

The researchers measured the serum levels of IL-4 and IL-6 in the children and found that children with newly diagnosed ITP and those with persistent disease had significantly higher levels of IL-4 and IL-6. 

More precisely, the mean levels of IL-4 and IL-6 in the serum of newly diagnosed children were 762 pg/mL and 178.5 pg/mL, respectively. These levels were 741 pg/mL and 164.4 pg/mL, respectively, in the serum of children with persistent disease.

The serum levels of IL-4 and IL-6 were much lower in the serum of children with chronic disease and healthy controls at 364.4 pg/mL and 436.8 pg/mL for IL-4 and 57.9 pg/mL and 88.4 pg/mL for IL-6, respectively. 

Interestingly, serum IL-4 levels were significantly higher in patients who achieved remission than in those whose condition did not improve with first-line therapy.

“We found that IL4 seems to be a good predictor to treatment response and it was a very interesting observation in our study,” the researchers concluded. “To the best of our knowledge, there is no published data about this finding.”


Zakaria M, Beshir M, Hassan T, et al. Role of interleukin 4 (IL4) and interleukin 6 (IL6) in the pathogenesis and prognosis of childhood primary immune thrombocytopenia. Eur J Pediatr. Published online April 25, 2023. doi:10.1007/s00431-023-04945-x