Association between allergic diseases and autism spectrum disorder: protocol for a systematic review and meta-analysis
- 1Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- 2Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
Abstract
Introduction: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition increasingly linked to immune dysregulation and chronic low-grade inflammation. Allergic diseases, including asthma, atopic dermatitis, allergic rhinitis and food allergy, are generally associated with immune dysregulation and type 2 inflammatory responses predominantly involving T helper 2-related pathways. Epidemiological evidence also suggests a possible association between ASD and allergic diseases. However, existing studies differ in population characteristics, allergic phenotypes, diagnostic definitions, case ascertainment methods and strategies for confounding control. As a result, the available evidence remains fragmented and the findings are not fully consistent. Therefore, an updated and comprehensive synthesis is needed to integrate observational evidence and examine the associations between multiple allergic diseases and ASD.
Methods and analysis: This protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines. We will systematically search PubMed/MEDLINE, Embase, Web of Science, Scopus, the Cochrane Library, CINAHL and APA PsycINFO, supplemented by searches of grey literature sources. We will search for studies published from 1 January 2011 to the date of the final search. Only English-language publications will be eligible for inclusion. Observational studies (cohort, case-control and cross-sectional) evaluating associations between ASD and allergic diseases will be included. Study selection, data extraction, risk-of-bias assessment and certainty-of-evidence assessment will be performed independently by two reviewers. Disagreements will be resolved by discussion, with persisting discrepancies adjudicated by a third senior reviewer. For effect estimates, the most fully adjusted estimates will be prioritised. ORs, risk ratios, HRs and prevalence ratios will be log-transformed. Analyses will be conducted in Review Manager (RevMan, V.5.4). A fixed-effect model or a random-effects model will be selected according to the degree of heterogeneity. Subgroup analyses, sensitivity analyses and publication bias assessment will also be performed. When meta-analysis is not appropriate, the findings will be summarised using a narrative synthesis approach.
Ethics and dissemination: No ethical approval is required as this study is based on published literature only. This protocol has been registered with Prospective Register of Systematic Reviews (CRD420251119984). Findings will be disseminated through peer-reviewed publication and conference presentations.
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BibTeX
@article{yang2026association,
title = {{Association between allergic diseases and autism spectrum disorder: protocol for a systematic review and meta-analysis}},
author = {Yuxuan Yang and Lingling Wang and Dan Ma},
journal = {BMJ Open},
year = {2026},
month = oct,
doi = {10.1136/bmjopen-2025-114099},
url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2025-114099},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Association between allergic diseases and autism spectrum disorder: protocol for a systematic review and meta-analysis
AU - Yuxuan Yang
AU - Lingling Wang
AU - Dan Ma
PY - 2026
DA - 2026/10/23
JO - BMJ Open
DO - 10.1136/bmjopen-2025-114099
UR - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2025-114099
AB - Introduction: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition increasingly linked to immune dysregulation and chronic low-grade inflammation. Allergic diseases, including asthma, atopic dermatitis, allergic rhinitis and food allergy, are generally associated with immune dysregulation and type 2 inflammatory responses predominantly involving T helper 2-related pathways. Epidemiological evidence also suggests a possible association between ASD and allergic diseases. However, existing studies differ in population characteristics, allergic phenotypes, diagnostic definitions, case ascertainment methods and strategies for confounding control. As a result, the available evidence remains fragmented and the findings are not fully consistent. Therefore, an updated and comprehensive synthesis is needed to integrate observational evidence and examine the associations between multiple allergic diseases and ASD. Methods and analysis: This protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 guidelines. We will systematically search PubMed/MEDLINE, Embase, Web of Science, Scopus, the Cochrane Library, CINAHL and APA PsycINFO, supplemented by searches of grey literature sources. We will search for studies published from 1 January 2011 to the date of the final search. Only English-language publications will be eligible for inclusion. Observational studies (cohort, case-control and cross-sectional) evaluating associations between ASD and allergic diseases will be included. Study selection, data extraction, risk-of-bias assessment and certainty-of-evidence assessment will be performed independently by two reviewers. Disagreements will be resolved by discussion, with persisting discrepancies adjudicated by a third senior reviewer. For effect estimates, the most fully adjusted estimates will be prioritised. ORs, risk ratios, HRs and prevalence ratios will be log-transformed. Analyses will be conducted in Review Manager (RevMan, V.5.4). A fixed-effect model or a random-effects model will be selected according to the degree of heterogeneity. Subgroup analyses, sensitivity analyses and publication bias assessment will also be performed. When meta-analysis is not appropriate, the findings will be summarised using a narrative synthesis approach. Ethics and dissemination: No ethical approval is required as this study is based on published literature only. This protocol has been registered with Prospective Register of Systematic Reviews (CRD420251119984). Findings will be disseminated through peer-reviewed publication and conference presentations.
SN - 2044-6055
SN - 2044-6055
ER -