{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:18:11Z","timestamp":1787897891411,"version":"build-2784847793"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Child Adolesc. Psychiatry"],"abstract":"<jats:p>Autism is a heterogeneous neurodevelopmental condition for which a single extracellular vesicle (EV) product is unlikely to match every biological context. We hypothesized that four development-coded EV candidates should be allocated by convergent phenotype, biomarker, and patient-derived functional response rather than diagnosis alone. EXO2, a cord-blood-plasma EV candidate, was tested only in an immune-inflammatory endophenotype characterized by regression or severe irritability along with objective inflammatory activity, after excluding pain, sleep disorder, epilepsy, infection, and other mimics. EXO3, a dental-pulp mesenchymal-stromal-cell EV candidate, was tested in a synaptic-developmental endophenotype with prominent language impairment or intellectual disability, but only if the patient-derived neurons show improved neurite, synaptic, and network function. EXO1, a Wharton-jelly mesenchymal-stromal-cell EV candidate, was tested in a circuit-plasticity endophenotype dominated by abnormalities in social communication, sensory, and repetitive behaviors using a concordant neuronal-network assay. R-EXO, an umbilical-cord-tissue mesenchymal-stromal-cell EV candidate, remained an exploratory option for a neurovascular-barrier\/extracellular matrix endophenotype. Regression, language delay, or behavior alone are not selection biomarkers. Each lot must pass identity, purity, safety, and phase-specific potency gates. Sequential use of EXO2, followed by EXO1, EXO3, or, in exceptional cases, R-EXO is predicted to outperform ungated or simultaneous use when inflammation masks a residual developmental mechanism. This is a falsifiable preclinical framework and does not support clinical administration.<\/jats:p>","DOI":"10.3389\/frcha.2026.1942419","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:35:44Z","timestamp":1787895344000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A phenotype- and potency-gated extracellular vesicle allocation hypothesis for autism"],"prefix":"10.3389","volume":"5","author":[{"given":"Burak","family":"Tatl\u0131","sequence":"first","affiliation":[{"name":"Prof. Dr. Burak Tatl\u0131 Private Practice","place":["\u0130stanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim","family":"Kamer","sequence":"additional","affiliation":[{"name":"Prof. Dr. Burak Tatl\u0131 Private Practice","place":["\u0130stanbul, 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