IL-6 and IL-10 Immune Imbalance Characterizes Autism Spectrum Disorder in Early Childhood

Sunny Mariana Samosir; Prastiya Indra Gunawan; Riza Noviandi; Agung Dwi Wahyu Widodo; Naoval Diza Ananda; Yunias Setiawati

doi:10.23750/abm.2026.18680

Authors

Sunny Mariana Samosir Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Neurology Division, Child Health Department, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Neurology Division, Child Health Department, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia https://orcid.org/0000-0003-3584-6156
Prastiya Indra Gunawan Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Neurology Division, Child Health Department, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0000-0003-3199-2826
Riza Noviandi Neurology Division, Child Health Department, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Neurology Division, Child Health Department, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia https://orcid.org/0000-0002-8266-3099
Agung Dwi Wahyu Widodo Department of Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia https://orcid.org/0000-0002-3449-768X
Naoval Diza Ananda Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia https://orcid.org/0000-0001-9341-5595
Yunias Setiawati Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia https://orcid.org/0000-0002-5920-3676

Keywords:

Autism, IL-6, IL-10, neuroinflammation, early childhood development, mental health

Abstract

Background and aim: Immune dysregulation has been proposed as a contributing mechanism in autism spectrum disorder (ASD). Interleukin-6 (IL-6) and interleukin-10 (IL-10) are key pro- and anti-inflammatory cytokines that may influence early childhood development. This study aimed to compare IL-6 and IL-10 levels between children with ASD and typically developing controls and to assess the association of cytokines level with the severity of autism.

Methods: A case‒control study was conducted among children aged 2–5 years with ASD diagnosed according to the DSM-5 criteria and age-matched typically developing controls in Surabaya, Indonesia. Blood serum IL-6 and IL-10 levels were measured via enzyme-linked immunosorbent assay (ELISA). ASD severity was assessed via the Childhood Autism Rating Scale, second edition (CARS-2). Nonparametric statistical analyses were applied according to the data distribution.

Results: A total of 70 participants were included. Children with ASD (n = 35) presented significantly higher IL-6 levels (1.21 vs 0.60 pg/mL, P < 0.001) than the control group even after adjustment of sex and age. IL-10 levels did not differ significantly between the groups (P = 0.85). The IL-6/IL-10 ratios tended to increase with increasing ASD severity based on CARS-2 score but attenuated after adjustment for age and sex.

Conclusions: Children with ASD exhibit elevated IL-6 levels. The IL-6/IL-10 ratio showed a positive association with ASD severity in unadjusted analyses; however, this relationship was attenuated after adjustment for age and sex. These findings support the role of neuroimmune dysregulation in ASD.

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