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Maternal Extracellular Vesicles During Pregnancy and Autism Risk in Children

McGowan, D.; Nencini, S.; Yakah, W.; Vacher, C.-M.; Lacaille, H.; Haas, D. M.; Grobman, W. A.; Silver, R. M.; Reddy, U. M.; Wapner, R. J.; Fifer, W. P.; Penn, A. A.; Firestein, M. R.

2026-07-06 psychiatry and clinical psychology
10.64898/2026.06.25.26355526 medRxiv
Show abstract

Differences in extracellular vesicles (EVs), bioactive nanoparticles involved in intercellular signaling, have been reported in those with autism. However, little is known about the association between maternal EVs during pregnancy and the likelihood of autism in offspring. This study evaluated the association of the concentration and cargo material of EVs in prenatal maternal plasma with childhood autism likelihood. Participants in the Nulliparous Pregnancy Outcomes Study provided maternal plasma at 15 to 23 weeks gestational age. EVs were isolated by ultracentrifugation, and concentration, mean size, CD63 levels, and RNA cargo were assessed by nanoparticle tracking analysis, ELISA, and small RNA sequencing. At 4.5 to 6 years of age, parents completed the Social Communication Questionnaire. Thirty-one children at high-risk for autism were matched to 31 low-risk children on sex, age, and gestational age. Differential RNA transcript analysis and over representation analysis were performed. There were no group differences in CD63 levels, mean particle size, or EV concentration (p>0.1). Nominal bin-level differences were observed at 280 to 290 nm and 430 to 440 nm before multiple-comparison correction. One hundred forty-five RNAs, including protein-coding RNAs, piRNAs, lncRNAs, miRNAs, snoRNAs, snRNAs, and tRNAs, were differentially contained, most of them downregulated in those at high risk of autism. These RNAs mapped to pathways involved in immune/inflammatory signaling, intracellular trafficking, protein turnover, and neurodevelopment. Six of the 62 (9.7%) differentially contained protein-coding RNAs overlapped with genes in the SFARI Gene database. These findings provide preliminary evidence that maternal prenatal EV RNA cargo is associated with childhood autism likelihood.

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