Peer-reviewed article
Pan-immune-inflammation Value as a Potential Inflammatory Marker in Autism Spectrum Disorder
İrem Aktar-Songür, Ahmet Özaslan, Samet Can Demirci, Murat Yıldırım, Niyazi Samet Yılmaz et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study compared blood-count-based inflammation markers in 87 children aged 2-6 years with autism spectrum disorder (ASD) and 74 children without it. Children with ASD had higher values on all five markers studied (PIV, SII, NLR, NLPR and MLR). The markers separated the two groups only moderately well, and PIV was the strongest independent marker after adjusting for age and sex. Most markers were also linked to autism severity. The authors say these markers could support, but not replace, current diagnosis, and that they need testing in further groups of children.
Key points
- The ASD group had significantly higher NLR, SII, PIV, NLPR and MLR than controls.
- MLR had the highest area under the curve (0.799), followed by PIV (0.775), which is moderate discrimination.
- In age- and sex-adjusted logistic regression, PIV was the strongest independent marker of ASD, followed by NLPR, both with adequate model fit.
- PIV, NLR, SII and MLR were associated with autism severity independent of age, sex, special education attendance and developmental delay; NLPR was not.
- The authors state this is the first study of PIV and NLPR in ASD.
Limitations
It was a single-center retrospective case-control study with moderate marker performance, so it cannot show that inflammation causes autism or that these markers work as diagnostic tools. The abstract does not name the country; Turkey is inferred from the metadata hint and the Turkish assessment tool, and the Azerbaijan hint is not supported by the text.
Abstract
Objective: Neuroinflammation and immune dysregulation are implicated in the etiology of autism spectrum disorder (ASD).This study investigated the relationship between inflammatory markers-pan-immune-inflammation value (PIV), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-lymphocyte-platelet ratio (NLPR), and monocyte-to-lymphocyte ratio (MLR)-and ASD.Methods: A total of 161 children aged 2-6 years were included (87 ASD, 74 controls).Assessments comprised the Childhood Autism Rating Scale, the Ankara Development Screening Inventory, and complete blood count (CBC).Results: The ASD group showed significantly higher NLR, SII, PIV, NLPR, and MLR than controls.Receiver operating characteristic analyses revealed moderate discriminatory performance, with the highest area under the curve for MLR (0.799), followed by PIV (0.775).In age-and sex-adjusted logistic regression, PIV was the strongest independent marker of ASD, followed by NLPR, both with adequate model fit.MLR showed a significant but borderline calibration, whereas NLR and SII demonstrated inadequate goodness-of-fit and should be interpreted with caution.PIV, NLR, SII, and MLR were also associated with autism severity, independent of age, sex, special education attendance, and developmental delay; NLPR was not.Conclusion: To our knowledge, this is the first study to investigate PIV and NLPR in ASD.CBC-derived inflammatory indices, particularly PIV, may have potential as adjunctive markers of case-control differences and clinical severity in early childhood ASD.However, given the moderate performance and single-center retrospective design, these markers should be regarded as candidate adjunctive indicators of immune dysregulation rather than standalone diagnostic tools, requiring prospective validation in independent cohorts before clinical translation.