However, this association did not remain significant after multivariate adjustment for confounders variables.<h4>Conclusions</h4>During MG relapse, inflammatory activation may engage the B7-H4 pathway, characterized by increased mB7-H4 and decreased sB7-H4 levels, which may cooperatively contribute to immune suppression and serve as a compensatory protective mechanism. The gene discussed is VTCN1; the disease is myasthenia gravis.