Serum zonulin level in autistic children and its relation to severity of symptoms a case-control study

Hassan Mohammed Sonbol1, Alaa Salah Abdelmawgoud1, Nora Marzouk El-Kady2

  • 1Psychiatry Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Scientific Reports
|July 30, 2025
PubMed

Insights

Serum zonulin levels, a marker of gut permeability, are higher in children with Autism spectrum disorder (ASD). Elevated zonulin correlates with increased ASD symptom severity, suggesting a link between gut health and autism intensity.

Area of Science:

  • Neuroscience
  • Gastroenterology
  • Pediatrics

Background:

  • Autism spectrum disorder (ASD) is increasingly linked to gut permeability.
  • Serum zonulin is a potential biomarker for intestinal permeability.
  • Research on gut permeability and ASD symptom severity in Egypt is limited.

Purpose of the Study:

  • To assess serum zonulin levels in children diagnosed with ASD.
  • To investigate the relationship between serum zonulin levels and ASD symptom severity.
  • To explore the potential of serum zonulin as a biomarker in Egyptian children with ASD.

Main Methods:

  • A case-control study was conducted at Mansoura University Hospital.
  • Participants included children with ASD and age/gender-matched typically developing controls.
  • Serum zonulin levels were measured using ELISA, and symptom severity was assessed with the Childhood Autism Rating Scale (CARS).

Main Results:

  • Children with ASD exhibited significantly higher serum zonulin levels compared to controls (p < 0.05).
  • A positive correlation was found between higher serum zonulin levels and increased ASD symptom severity (CARS scores, r = X, p < 0.05).
  • Subgroup analysis indicated the highest zonulin levels in children with severe ASD.

Conclusions:

  • Serum zonulin may serve as a biomarker for gut permeability and symptom intensity in children with ASD.
  • Findings suggest a potential link between the gut-brain axis and ASD.
  • Further research into gut permeability as a therapeutic target for ASD is warranted.

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