Immune Dysregulation and Cytokine Imbalance in Children with Autism Spectrum Disorder: A Case-Control Study
Abstract
Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by deficits in social interaction, communication difficulties, and repetitive behaviors. The etiology of ASD is multifactorial and involves genetic, environmental, immunological, and neurological factors. Increasing evidence suggests that immune dysregulation plays an important role in the development and progression of ASD.
Aim of the Study: This study was conducted to evaluate the serum levels of pro-inflammatory (IL-21 and IL-22) and anti-inflammatory (IL-27 and IL-33) cytokines in children with ASD compared with healthy controls and to investigate their potential role in the pathogenesis of ASD.
Materials and Methods: This case-control study included 300 children, comprising 200 patients diagnosed with ASD and 100 healthy controls. Venous blood samples were collected from all participants at the Professor Dr. Arafat Al-Djalili Center in Al-Najaf, Iraq. Serum was separated from 5 mL of venous blood using gel tubes and stored at −20°C until analysis. Serum levels of the pro-inflammatory cytokines IL-21 and IL-22 and the anti-inflammatory cytokines IL-27 and IL-33 were measured using enzyme-linked immunosorbent assay (ELISA). The study protocol was approved by the Medical Ethics Committee of the Ministry of Health, Iraq.
Results: Children with ASD exhibited significant immune dysregulation characterized by markedly elevated serum levels of the pro-inflammatory cytokines IL-21 and IL-22 and significantly reduced serum levels of the anti-inflammatory cytokines IL-27 and IL-33 compared with healthy controls (P < 0.0001 for all comparisons). These findings indicate a pronounced imbalance between pro-inflammatory and anti-inflammatory immune responses in ASD.
Conclusion: The findings of this study demonstrate a significant imbalance in cytokine profiles among children with ASD, characterized by increased levels of IL-21 and IL-22 and decreased levels of IL-27 and IL-33. These alterations support the hypothesis that immune dysregulation contributes to the pathogenesis of ASD. Furthermore, these cytokines may serve as promising biomarkers for ASD, although additional large-scale longitudinal studies are required to confirm their clinical utility.
How to Cite This Article
Kais Khudhair AL Hadrawi, Hassan Akeel M Al-Mulla, Hanan Khalid ALdhalimi (2026). Immune Dysregulation and Cytokine Imbalance in Children with Autism Spectrum Disorder: A Case-Control Study . International Journal of Biological and Biomedical Research (IJBBMR), 2(5), 33-38. DOI: https://doi.org/10.54660/IJBBR.2026.2.5.33-38