{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:00:15Z","timestamp":1789988415639,"version":"4.0.1"},"reference-count":65,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004045","name":"Karadeniz Technical University","doi-asserted-by":"publisher","award":["THD-2025-16689"],"award-info":[{"award-number":["THD-2025-16689"]}],"id":[{"id":"10.13039\/501100004045","id-type":"DOI","asserted-by":"publisher"}]},{"award":["THD-2025-16689"],"award-info":[{"award-number":["THD-2025-16689"]}],"id":[{"id":"https:\/\/ror.org\/03z8fyr40","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Increasing evidence suggests that inflammatory processes may be involved in the pathophysiology of attention-deficit\/hyperactivity disorder (ADHD). However, clinical data regarding TLR4, NF-\u03baB and NLRP3 in children with ADHD remain limited. This study aimed to compare serum TLR4, NF-\u03baB, and NLRP3 levels between children with ADHD and healthy controls and to examine the associations between these inflammatory markers and ADHD symptom severity. Methods: A total of 42 children with ADHD and 40 age- and sex-matched healthy controls were enrolled. ADHD symptoms were assessed using the Conners\u2019 Parent Rating Scale\u2013Revised Short Form (CPRS-RS) and the Conners\u2019 Teacher Rating Scale\u2013Revised Short Form (CTRS-RS). Serum TLR4, NF-\u03baB, and NLRP3 levels were measured using enzyme-linked immunosorbent assay (ELISA). Between-group comparisons were performed after adjustment for age, sex, and body mass index (BMI), and correlations between inflammatory markers and symptom severity were evaluated. Results: Serum NF-\u03baB and NLRP3 levels were significantly higher in children with ADHD than in healthy controls, whereas serum TLR4 levels did not differ between groups. Serum NF-\u03baB levels showed a moderate positive correlation with teacher-rated hyperactivity scores, while no significant associations were observed between TLR4 or NLRP3 levels and ADHD symptom severity in the ADHD group. Conclusions: Our findings provide preliminary clinical evidence of altered NF-\u03baB and NLRP3 levels in children with ADHD. The absence of a significant difference in serum TLR4 levels, despite increased NF-\u03baB and NLRP3 levels, suggests that these inflammatory components may be differentially altered in ADHD. Further longitudinal and mechanistic studies are needed to clarify the relevance of these inflammatory alterations to ADHD pathophysiology.<\/jats:p>","DOI":"10.3390\/children13091278","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:01:38Z","timestamp":1789981298000},"page":"1278","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum TLR4, NF-\u03baB, and NLRP3 Levels in Children with Attention-Deficit\/Hyperactivity Disorder: A Case\u2013Control Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0090-1389","authenticated-orcid":false,"given":"Esra","family":"Ho\u015fo\u011flu","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-5935","authenticated-orcid":false,"given":"Z\u00fcleyha","family":"Ulusoy","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Ministry of Health, Siverek State Hospital,  63600 \u015eanl\u0131urfa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8913-8692","authenticated-orcid":false,"given":"Nihal","family":"Turkmen Alemdar","sequence":"additional","affiliation":[{"name":"Department of Medical Services and Techniques, Vocational School of Health Services, Recep Tayyip Erdo\u011fan University, 53100 Rize, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9474-4307","authenticated-orcid":false,"given":"Y\u00fcksek","family":"Aliyaz\u0131c\u0131o\u011flu","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-2370","authenticated-orcid":false,"given":"Volkan","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1190-9589","authenticated-orcid":false,"given":"Bahad\u0131r","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University, 61080 Trabzon, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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