{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:14:35Z","timestamp":1785496475347,"version":"3.56.0"},"reference-count":46,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012309","name":"Royal Golden Jubilee (RGJ) Ph.D. Programme","doi-asserted-by":"publisher","award":["NRCT5\u2010RGJ63001\u2010018"],"award-info":[{"award-number":["NRCT5\u2010RGJ63001\u2010018"]}],"id":[{"id":"10.13039\/501100012309","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Autism spectrum disorder (ASD) remains underexplored in Southeast Asia, with limited characterization of its molecular underpinnings and clinical heterogeneity. This study investigated transcriptomic variation and its relationship to clinical diversity in Thai children with ASD using integrated molecular and phenotypic analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Peripheral blood transcriptomic profiling was performed in 150 ASD and 70 typically developing (TD) children to identify differentially expressed transcripts (DETs), followed by pathway enrichment, unsupervised molecular clustering, and integrative multiomics modeling. Clinical data from 200 ASD and 110 TD participants were analyzed in parallel to evaluate screening performance and derive phenotype\u2010based subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Differential expression analysis identified 1,407 DETs with significant enrichment of autism\u2010associated genes. Pathway analysis consistently implicated dysregulation of protein\u2010synthesis machinery. Unsupervised transcriptome\u2010based clustering revealed three molecular subgroups characterized by translational, innate\u2010immune, and interferon\u2010associated signatures, which did not directly correspond to clinical severity, age, or cognitive level, indicating structured biological heterogeneity beyond symptom\u2010based classification. Integration of transcriptomic and phenotypic data demonstrated moderate cross\u2010domain correspondence. Among recurrent molecular signals,\n                      <jats:italic>MBD2<\/jats:italic>\n                      showed consistent upregulation across subgroups and strong associations with social\u2010interaction measures (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.74). In parallel, clinical machine\u2010learning models showed high within\u2010cohort screening performance, while a refined 17\u2010transcript panel achieved robust discriminative accuracy, supporting the complementary role of molecular features in ASD stratification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transcriptomic stratification reveals biologically structured heterogeneity in ASD that is only partially reflected in clinical presentation, supporting a multilayered framework integrating molecular and phenotypic dimensions.<\/jats:p>\n                  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