1. Abdullah NM, Moness HM, Ali MWE, Abdelsamei EM, Hassan EE, Meshref DA. Role of IL-6 gene polymorphisms in children with autism spectrum disorders. Ital J Pediatr;2026 (Apr 11)

BACKGROUND: Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by impairment in social interaction, and communication skills, along with restricted or repetitive behaviors. The diagnosis of ASD depends on behavioral parameters. Numerous studies have reported immune system abnormalities and proposed a potential role of autoimmunity in the pathogenesis of ASD. This study aims to assess the correlation between specific cytokines, such as interleukin-6 (IL-6), and particular IL-6 polymorphisms, including IL-6-174G/C (rs1800795) gene polymorphism, IL-6-572 C/G (rs1800796) gene polymorphism and IL-6-597G/A (rs1800797) gene polymorphism among children with ASD. METHODS: The current study included 100 children with ASD were recruited during their regular follow up to Pediatric Neuro-Psychiatry Clinic of Minia University Hospital of Children. They diagnosed according to DSM-5 ASD criteria. A another 100 children were recruited as control group by simple randomly selected school (pre & elementary school) in Mina Governate, Upper Egypt, their ages and sex matched with the ASD children, they were apparently neuropsychiatric and developmentally normal and free from any chronic systemic illness. The participants were assessed for serum IL-6 levels and single-nucleotide changes in IL-6-174G/C, IL-6-572 C/G and IL-6-597G/A gene polymorphisms. RESULTS: The prevalence of the GG genotype and G allele of the IL-6-174G/C gene polymorphism was significantly higher in ASD patients compared to healthy control (P value = 0.0002, 0.03 respectively). In contrast, the GC genotype and C allele of IL-6 -174G/C gene polymorphism were significantly elevated in the control group compared to children with ASD, indicating a protective role against ASD in the Egyptian population. The prevalence of the CG genotype, GG genotype, and G allele of the IL-6-572 C/G gene polymorphism was significantly higher in ASD patients compared to control individuals, indicating an increased risk of ASD within the Egyptian population. The IL-6-597G/A gene polymorphism analysis revealed no significant differences between the two groups in GG and GA genotypes or allelic frequencies. Nevertheless, the AA genotype was only found in the autistic group. Furthermore, ASD patients exhibited significantly higher serum levels of IL-6 than the healthy controls. The GG genotype distribution of IL-6-174G/C gene polymorphism was significantly associated with increased serum levels of IL-6. CONCLUSION: The IL-6 (-174G/C) gene polymorphism (GG genotype) was associated with ASD. Moreover, the (CG + GG) genotypes of IL-6-572 C/G gene polymorphism were associated with ASD, and the (AA genotype) of IL-6-597G/A gene polymorphism was detected only in ASD. This indicates their role in the increased incidence of ASD among the Egyptian population. In addition, IL-6 serum level was significantly elevated in ASD.

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2. Agostinho D, Sousa D, Castelo-Branco M, Simões M. Restricted Neural Parametric modulation of emotional arousal in autism reveals a core role for the cerebellum. Soc Cogn Affect Neurosci;2026 (Apr 9)

Understanding how emotional arousal and valence are processed in Autism Spectrum Disorder (ASD) is key to uncovering underlying affective mechanisms. Prior research has yielded mixed results, particularly regarding arousal. Using functional magnetic resonance imaging (fMRI), we examined neural responses to emotional video clips in adults with ASD (n = 20) and typically developing controls (n = 20). Stimuli were designed to elicit controlled emotional responses with standardized visual and narrative features, and parametric modulation analyses assessed neural activation as a function of self-reported arousal and valence. Behavioral ratings confirmed stimulus validity. For arousal, typically developing individuals showed widespread modulation across frontal, parietal, temporal, and subcortical regions, including the cingulate gyrus, insula, caudate, and ventral tegmental area. In contrast, ASD participants exhibited restricted modulation, primarily within the anterior cerebellum. No group differences emerged for valence, with both groups recruiting frontal and limbic regions such as the amygdala and insula. These findings highlight a dissociation between arousal and valence processing in ASD. Reduced cortical engagement and increased anterior cerebellar (including the vermis) involvement during arousal suggest compensatory mechanisms, underscoring the importance of distinguishing emotional dimensions when characterizing neural processes in autism.

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3. Darmi T. From technological innovation to institutional adaptation: Reflections on robot-mediated autism interventions in Asian mental health systems. Asian J Psychiatr;2026 (Apr 8);119:104968.

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4. Gámez Martínez S, Lovatón Romero G, Alcañiz Raya M, Hervás Zúñiga A. An Exploratory Analysis of Eye-Tracking During a Virtual Reality Social Cognition Intervention for Children with Autism Spectrum Disorders. Cyberpsychol Behav Soc Netw;2026 (Apr 11):21522715261439451.

The diagnosis of autism spectrum disorder is based on clinical judgment, as there are no clearly identified markers to determine the presence of this condition. Gaze patterns have been proposed as a potential biomarker for autism. This study aims to conduct an exploratory analysis of the eye-tracking data collected during a virtual reality-based intervention for social cognition in autistic children. Specifically, we evaluated the variations in social orientation toward social stimuli, the association of gaze patterns with autistic traits, theory of mind (ToM) and task performance, and the mediating effect of attentional mechanisms on the relationship between social cognition performance and autism symptomatology. Our findings identified an increase in social orientation time toward social stimuli, but eye-tracking measures did not significantly predict autism symptom severity or ToM ability. The mediation analysis also failed to find a significant mediating effect of gaze patterns on the relationship between task performance and autism severity. This study points to VR as a promising tool for improving social orienting in autistic children, although there is a need to further investigate the potential of eye-tracking measures as a behavioral marker for predicting social cognition performance.

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5. Hart LC, Richardson C, Hanks C. Blood Pressure Trends among Autistic Youth Transitioning to Adult Care: A Retrospective Cohort Study. Am J Prev Med;2026 (Apr 9):108372.

INTRODUCTION: Autistic people have higher rates of cardiovascular disease and its risk factors than non-autistic peers. Transition from pediatric to adult health care is associated with health challenges for autistic people and may exacerbate cardiovascular risk for this population. However, this has not been studied extensively. This study sought to evaluate the relationship between transition to adult health care and blood pressure in a cohort of autistic adolescents and young adults. METHODS: This study used linked electronic medical record (EMR) data from pediatric and adult care from January 2011 to May 2020 for a cohort seen in a medical home for autistic youth to evaluate trends in blood pressures before and after the first visit in adult health care using a linear mixed model. Time-to-event analysis was used to determine the proportion of study subjects with two blood pressures meeting criteria for hypertension. RESULTS: Linear mixed model results showed no immediate significant differences in systolic (-1.1 mmHg, 95% CI -3.5 to 1.2) or diastolic (0.47, 95% CI -1.2 to 2.2) blood pressure related to transition to adult health care. Time-to-event analysis showed that over half the cohort had at least two elevated blood pressures over the study period, with the mean time to event being 2.5 years. CONCLUSIONS: The transition to adult health care was not associated with an increase in blood pressure in this cohort. Nonetheless, many of the youth in this cohort may meet the clinical definition of hypertension and merit closer monitoring and possible treatment of hypertension.

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6. Wang Y, Chan WL, Li F, Cai J, Cheung YT, Lai ETH, Leung OLK, Liang S, Ku DTL, Shing MMK, Fu ECH, Yau JPW, Lee ACW, Lu ER, Leung AWK, Cheng FWT, Ho WWS, Gao Z, Song Y, Liu SKY, Tsang L, Yuen ANY, Lee TMC, Chan GCF, Liu APY, Tso WWY. Neurobehavioral outcomes and associated risk factors in pediatric brain tumor survivors. J Neurooncol;2026 (Apr 11);177(2)

PURPOSE: Survival rates for children with brain tumors improve, highlighting the importance of understanding the long-term neurobehavioral outcomes because of its impact on children’s well-being and quality of life. This study investigated the prevalence of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and emotional/behavioral difficulties in pediatric brain tumor survivors (PBTS), and identified the risks and protective factors on mental well-being. METHODS: A territory-wide retrospective cohort included 274 PBTS registered in the Hong Kong Paediatric Haematology and Oncology Study Group Registry. In addition, a cross-sectional follow-up survey on mental well-being was completed by 107 PBTS during survivorship follow-up. Emotional/behavioral difficulties, health-related quality of life, parental stress, and sleep variables were assessed by the survey and benchmarked against previously published Hong Kong-based reference/community cohorts. RESULTS: Among 274 PBTS, 10.6% had ADHD and 6.9% had ASD, which are significantly higher than the general pediatric population prevalence. They had more emotional/behavioral symptoms, higher parental stress, and poorer quality of life. Younger age at diagnosis, seizure history, and supratentorial tumors were linked to more difficulties. Radiotherapy was associated with reduced quality of life. Better sleep correlated with fewer ADHD and emotional symptoms. CONCLUSION: PBTS had increased risk of ADHD and ASD, and are more vulnerable to peer-relationship difficulties, poorer mental health, and quality of life. Improving sleep could be key to reducing neurobehavioral challenges. Implementing routine neurobehavioral monitoring, including sleep assessments, is crucial for enhancing survivorship care and overall well-being.

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7. Warner JN, Sim LA, Hatley-Cotter A, Long J, Weiss K, Vater L, Iacobone R, Black WR. Group-Based Psychological Interventions for Autistic Youth with Chronic Pain: Narrative Review and Practice Considerations for Intensive Interdisciplinary Pediatric Pain Treatment. J Clin Psychol Med Settings;2026 (Apr 11)

Emerging work characterizing youth with chronic pain increasingly recognizes a large cohort of youth with co-occurring chronic pain and autism. This development has prompted questions about how to adapt Intensive Interdisciplinary Pediatric Pain Treatment (IIPTs) and the group-based treatments commonly used in these settings to improve accessibility, acceptability, and utility for autistic participants. There is a need for clinically oriented literature that IIPT programs and clinical trialists can use to guide adaptation efforts. Given long-term risks of inadequately treated pediatric pain, we argue it is clinically and ethically important to identify reasonable autism-informed adjustments within existing IIPT frameworks, even as more empirical work unfolds to inform nuance. In this narrative review, we synthesize evidence from pediatric pain psychology and autism intervention literatures to identify overlapping mechanisms and opportunities for adaptation, with a specific focus on group-based CBT/ACT-oriented treatments delivered in IIPTs. We summarize emerging clinical characteristics of autistic adolescents enrolled in IIPTs, bridge autism and pediatric pain group treatment literature, map that literature onto pediatric pain targets and autism-informed IIPT group design considerations and provide practical examples of IIPT group modifications extended from the existing data and the authors’ clinical experience delivering group-based pain psychology services to autistic youth in IIPTs. We also highlight constraints of group formats for autistic youth and emphasize flexible pathways of care.

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8. Yuan B, Yuan A, Lu M, Wang X, Song T, Zhang Z, Zhang R, Chen L, Peng B. Maternal immune activation: A critical prenatal risk factor for autism spectrum disorder. Med;2026 (Apr 10);7(4):100967.

Maternal immune activation (MIA) is an important prenatal risk factor for autism spectrum disorder (ASD). This commentary summarizes epidemiological and experimental evidence linking MIA to altered fetal neurodevelopment, highlighting placental mechanisms, long-term immune programming, sex-related risk and resilience, and potential strategies to monitor and manage pregnancies with significant maternal inflammation.

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9. Zhao Y, Yuan B, Ma W, Peng B, Zhang Y, Wang Y. Microenvironment dysregulation in autism spectrum disorder: Immune, epigenetic, synaptic, and gut-brain mechanisms. Med;2026 (Apr 10);7(4):101034.

Autism spectrum disorder is a common and heterogeneous neurodevelopmental condition. Although its etiologies are diverse, converging evidence suggests that genetic susceptibility and environmental exposures intersect across a limited set of biological pathways. We interpret recent advances through a microenvironment dysregulation perspective that connects immune imbalance, epigenetic regulation, synaptic plasticity, and gut-brain interactions. We distinguish mechanistic evidence from experimental models from predominantly correlative findings in human studies and emphasize that these processes may involve multiple entry points across biological subgroups. We propose that early-life immune challenges can, in some individuals, interact with genetic risk to shape epigenetic programs and neural-immune signaling, with downstream consequences for microglial states and synaptic development, potentially reinforced by gut-brain feedback loops. This integrative view highlights testable hypotheses, convergent mechanistic hubs, and a conceptual basis for subgroup-aware biomarker discovery and mechanism-informed interventions.

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