Original Article

Elevated Circulating Interleukin-33 in Vitiligo Diagnostic Potential and Clinical Correlates — A Cross-Sectional Study

  • Halima Khatun1, A.T.M. Asaduzzaman2, Lubna Khondker3, Mohammad Abul Kalam Azzad4, Md. Nur Alam Mohim5, Wasi Deen Ahmed6, Shihab Talukder7, Farha Zaman8, Mohammed Saiful Islam Bhuyian9

  • Volume 6, Issue 1, Page No: 2-7

Author Details

1. OSD, Directorate General of Health Services, (DGHS), Dhaka

2. Bangladesh Medical University, Dhaka, Bangladesh

3. Bangladesh Medical University, Dhaka, Bangladesh

4. Bangladesh Medical University, Dhaka, Bangladesh

5. Rupganj Upazilla Health Complex, Narayanganj

6. Dhaka Medical College Hospital, Dhaka, Bangladesh

7. Central Police Hospital, Rajarbag, Dhaka

8. Bangladesh Medical University, Dhaka, Bangladesh

9. Bangladesh Medical University, Dhaka, Bangladesh


Abstract

Background: Vitiligo is an immune-mediated depigmenting disorder in which oxidative stress, innate immune activation and cytokine dysregulation contribute to melanocyte destruction. As an epithelial alarmin released during cellular stress, interleukin-33 (IL-33) is well positioned to participate in this inflammatory interface, although its circulating profile and diagnostic relevance in vitiligo remain to be established.

Aims: To determine serum IL-33 concentrations in patients with vitiligo and to evaluate their diagnostic potential and clinical correlates.

Methods: This cross-sectional study included 36 patients with clinically and Wood's lamp-confirmed vitiligo and 36 age- and sex-comparable healthy controls. Serum IL-33 was quantified by sandwich enzyme-linked immunosorbent assay. Lesional activity was graded using the Vitiligo Disease Activity (VIDA) score. Between-group differences, clinical correlations and receiver operating characteristic (ROC) performance were evaluated.

Results: Serum IL-33 was significantly higher in patients than controls (median 10.60 [IQR 2.32–22.20] vs 3.03 [2.01–4.44] pg/mL; p=0.005). ROC analysis yielded an area under the curve of 0.691 (95% CI 0.563–0.819). At an optimal cut-off of 9.345 pg/mL, sensitivity was 61.1%, specificity 88.9%, positive predictive value 84.6% and overall accuracy 75.0%, with a positive likelihood ratio of 5.50. Serum IL-33 was not significantly associated with sex, age or VIDA grade and showed no meaningful correlation with VIDA score (ρ=0.088; p=0.611).

Conclusion: Circulating IL-33 is elevated in vitiligo and demonstrates moderate discriminatory potential, characterised by relatively high specificity but limited sensitivity. Its lack of association with clinical activity suggests greater value as an exploratory disease-associated biomarker than as a marker of current clinical activity.

Keywords: Vitiligo; Interleukin-33; Biomarker; Clinical correlates; ROC curve.


Keywords: Vitiligo; Interleukin-33; Biomarker; Clinical Correlates; Roc Curve

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