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<p>Growing evidence implicates neuroinflammation in the pathophysiology of autism spectrum disorder (ASD). However, whether anti-inflammatory interventions can ameliorate ASD symptoms and modulate underlying immune dysregulation remains unclear. This systematic review aims to assess the therapeutic potential of anti-inflammatory interventions in ASD.&#xa0;The study protocol was registered in PROSPERO (CRD420250653075). A comprehensive search was conducted in CENTRAL, PubMed, Scopus, Lilacs, Web of Science, and Google Scholar. Data on baseline immune profiles, post-treatment cytokine changes, and standardized behavioral scales were extracted and synthesized.&#xa0;The systematic search identified 886 records, with 172 duplicates, resulting in a total of 5 articles included. Many participants exhibited elevated pro-inflammatory markers at baseline. Omega-3 supplementation was associated with a significant reduction in IL-2, and when combined vitamin D and omega-3 supplementation led to greater improvements in social responsiveness in a subgroup of children with high baseline IL-1β. Probiotic therapy, particularly when combined with oxytocin, improved aberrant behaviors, though with minimal direct modulation of the assessed cytokines. Risperidone treatment resulted in expected behavioral gains but did not alter cytokine or autoantibody profiles. A key observation across studies was that behavioral improvements often occurred without parallel, significant normalization of the measured inflammatory biomarkers.&#xa0;While ASD is frequently characterized by immune dysregulation, current anti-inflammatory and probiotic interventions demonstrate modest or indirect immunomodulatory effects on the commonly assessed biomarkers. The observed dissociation between behavioral improvements and systemic inflammatory marker changes suggests that alternative or more complex mechanisms, such as neuropeptide signaling or localized immune effects, may be involved. Future large-scale, methodologically rigorous RCTs are imperative.</p>

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Evidence and Perspectives on Anti-Inflammatory Treatments in Autism Spectrum Disorder: A Systematic Review

  • 期刊论文

  • 发表日期：

    2025年11月7日

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  • Denner Henrique Isaías Souza,
  • Daniella Georgopoulos Calló,
  • Brayan Jonas Mano-Sousa,
  • Valéria Ernestânia Chaves,
  • Joaquim Mauricio Duarte-Almeida

摘要

Growing evidence implicates neuroinflammation in the pathophysiology of autism spectrum disorder (ASD). However, whether anti-inflammatory interventions can ameliorate ASD symptoms and modulate underlying immune dysregulation remains unclear. This systematic review aims to assess the therapeutic potential of anti-inflammatory interventions in ASD. The study protocol was registered in PROSPERO (CRD420250653075). A comprehensive search was conducted in CENTRAL, PubMed, Scopus, Lilacs, Web of Science, and Google Scholar. Data on baseline immune profiles, post-treatment cytokine changes, and standardized behavioral scales were extracted and synthesized. The systematic search identified 886 records, with 172 duplicates, resulting in a total of 5 articles included. Many participants exhibited elevated pro-inflammatory markers at baseline. Omega-3 supplementation was associated with a significant reduction in IL-2, and when combined vitamin D and omega-3 supplementation led to greater improvements in social responsiveness in a subgroup of children with high baseline IL-1β. Probiotic therapy, particularly when combined with oxytocin, improved aberrant behaviors, though with minimal direct modulation of the assessed cytokines. Risperidone treatment resulted in expected behavioral gains but did not alter cytokine or autoantibody profiles. A key observation across studies was that behavioral improvements often occurred without parallel, significant normalization of the measured inflammatory biomarkers. While ASD is frequently characterized by immune dysregulation, current anti-inflammatory and probiotic interventions demonstrate modest or indirect immunomodulatory effects on the commonly assessed biomarkers. The observed dissociation between behavioral improvements and systemic inflammatory marker changes suggests that alternative or more complex mechanisms, such as neuropeptide signaling or localized immune effects, may be involved. Future large-scale, methodologically rigorous RCTs are imperative.