The combination of IL-2Rα and IP-10 significantly improved predictive accuracy within specific age strata, achieving AUCs of 0.949 (35-45 years), 1.000 (45-55 years), and 0.814 (>55 years) when distinguishing symptomatic from asymptomatic neurosyphilis.<h4>Conclusion</h4>In conclusion, IL-2Rα and IP-10 represent promising predictive biomarkers for neurosyphilis progression, with their combined application achieving high diagnostic accuracy for distinguishing symptomatic from asymptomatic disease. Here, IL2RA is linked to neurosyphilis.