Algorithm for immunological examination of children with immune-dependent diseases to predict the effectiveness of biological therapy

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Introduction. The emergence of a wide range of genetically engineered biological products (GEBP) opens up opportunities for a personalized approach in the treatment of immune-dependent diseases. The development of methods for predicting the effectiveness of biological therapy for timely treatment correction is of particular relevance. Laboratory and clinical biomarkers are being studied.Materials and methods. A laboratory examination was conducted on 486 children aged of 3.5 to 18 years with inflammatory bowel diseases (IBD), 182 children with psoriasis (PS), and 147 children with multiple sclerosis (MS). The study included a set of quantitative and functional indicators: the content of basic (T, B, NK cells) and small populations of lymphocytes (Th17 lymphocytes, regulatory T cells (Treg), activated T helper cells), populations of memory T cells, populations of myeloid suppressor cells (MDSCs), Treg with CD39 ectonucleotidase expression, succinate dehydrogenase (SDH) activity in lymphocyte populations, and nuclear factor kB (NF-kB) activity in lymphocyte populations. The comparison group consisted of 100 conditionally healthy children of comparable age. The diagnostic and prognostic significance of immunological parameters and the level of threshold values (cut-off) were evaluated using the method of characteristic curves (ROC analysis).Results. A high probability of predicting (> 70%) the effect of GIBP therapy was obtained for the Th17/Treg index, regardless of the form of pathology and duration of therapy; for the absolute content of regulatory cells (Treg and MDSCs), regardless of the form of pathology during the maintenance course of GIBP; the activity of ADHD in Treg — in IBD and PS, regardless of the duration of therapy; the combination of ADHD activity in Treg and the Th17/Treg index in IBD, PS and MS, regardless of the duration of therapy; memory T cell subpopulations in IBD, PS and MS during the maintenance course; the relative Treg content with ectonucleotidase CD39 expression in IBD and MS after the induction course. Exceeding the threshold values for NF-κB levels in NK cells has been shown to predicts the activation of the inflammatory process in children with IBD, PS, and MS with a high probability (> 70%).Conclusion. A 2-stage algorithm for immunological examination of children with IBD, PS, and MS has been developed based on informative immunological indicators, which allow for a high probability of predicting the effect of biological therapy and the activity of the inflammatory process before the administration of GIBPs and during the maintenance course.Contribution: Radygina T.V., Petrichuk S.V. — research concept and design; Radygina T.V., Petrichuk S.V., Kuptsova D.G., Kurbatova O.V., Anushenko A.O., Opryatin L.A., Abdullaeva L.M., Freidlin E.V. — collection and processing of material; Radygina T.V., Petrichuk S.V. — writing the text; Fisenko A.P., Potapov A.S., Murashkin N.N., Kuzenkova L.M. — editing the text. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.Acknowledgment. The study was supported by a state assignment from the Russian Ministry of Health, № 119013090093-2, 122040800220-9.Conflict of interest. The authors declare no conflict of interest.Received: November 10, 2025Accepted: November 27, 2025Published: December 25, 2025

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