Wang Min, Zhang Xiaozhuang, Zhong Liyan, Zeng Liqin, Li Ling, Yao Paul
Hainan Women and Children's Medical Center, Hainan Medical University, Haikou 570206, PR China.
Department of gynecology, Sun Yat-Sen University Affiliated No.8 Hospital, Shenzhen 518033, PR China.
Brain Res Bull. 2025 Jul;227:111411. doi: 10.1016/j.brainresbull.2025.111411. Epub 2025 May 29.
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition marked by difficulties in social communication, languages, and repetitive behaviors. Its rising prevalence has made it a critical global public health issue. ASD is believed to arise from a combination of genetic and environmental influences. While some gene mutations associated with ASD have been identified, most cases lack clear genetic explanations. Evidence increasingly points to early-life environmental factors as key contributors to ASD, including advanced parental age, maternal diabetes during pregnancy, infections, hormonal imbalances, certain medications, and exposure to air pollution. Currently, ASD diagnosis relies on behavioral assessments, but the absence of specific molecular biomarkers poses significant obstacles to early detection and targeted therapies. Encouragingly, research has identified potential biomarkers, such as neuroimaging classifiers, electroencephalography patterns, eye-tracking data, digital analytics, gene expression profiles, inflammatory and chemokine markers, proteomic and metabolomic profiles, and gut microbiota characteristics. Potential therapeutical strategies under investigation include digital therapies, non-invasive brain stimulation, antioxidants, oxytocin, AVPR1a antagonists, PPAR agonists, and mTOR inhibitors. This review explores ASD across five areas: epidemiological trends, genetic mechanisms, early-life environmental factors and their potential roles, diagnostic biomarkers, and therapeutic approaches.
自闭症谱系障碍(ASD)是一种神经发育疾病,其特征是社交沟通、语言和重复行为方面存在困难。其发病率不断上升,已成为全球关键的公共卫生问题。ASD被认为是由遗传和环境因素共同作用引起的。虽然已经确定了一些与ASD相关的基因突变,但大多数病例缺乏明确的遗传解释。越来越多的证据表明,早期环境因素是ASD的关键促成因素,包括父母年龄较大、孕期母亲患糖尿病、感染、激素失衡、某些药物以及接触空气污染。目前,ASD的诊断依赖于行为评估,但缺乏特定的分子生物标志物给早期检测和靶向治疗带来了重大障碍。令人鼓舞的是,研究已经确定了潜在的生物标志物,如神经影像分类器、脑电图模式、眼动追踪数据、数字分析、基因表达谱、炎症和趋化因子标志物、蛋白质组学和代谢组学谱以及肠道微生物群特征。正在研究的潜在治疗策略包括数字疗法、非侵入性脑刺激、抗氧化剂、催产素、AVPR1a拮抗剂、PPAR激动剂和mTOR抑制剂。本综述从五个方面探讨了ASD:流行病学趋势、遗传机制、早期环境因素及其潜在作用、诊断生物标志物和治疗方法。