Background & Aims: Immune system abnormalities such as inflammation, increased autoimmunity and the skewed expression of soluble mediators, including cytokines have been observed in autistic patients. The present study aimed to compare the effects of vitamin D supplementation and/or aquatic exercise training on the serum level of inflammatory cytokines, including IL-1β and IL-1RA, and stereotypic behaviors (S.B) of children with autism spectrum disorders (ASD). Materials & Methods: We recruited 40 children with ASD (aged 6-14) and divided them into the aquatic exercise (n = 10), vitamin D supplementary (n=10), aquatic +supplementation (n=10), and control (n=10) groups. Participants in the aquatic exercise group performed water-based activities for 10 weeks/2 sessions per week/60 min, while the participants of the supplementary group orally received 50,000 IU vitamin D3/ day, and the combined group received both exercise and supplementation, control group did not get any intervention. We evaluated the participants' serum levels of IL-1β, IL-1RA and S.B scores at baseline and the end of the treatment. Results: Results revealed that all three interventional approaches improved behavioral symptoms and IL-1β serum level; interestingly, only the combined intervention could significantly affect IL-1RA. Conclusions: We concluded that both aqua-based exercise and vitamin D supplements could lead to significant improvement in serum cytokine levels and behavioral problems in children with ASD.
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