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This review brings together comprehensive insights into: *The genetic and epigenetic mechanisms underlying ASD *Prenatal and postnatal exposure to environmental pollutants, including heavy metals *The role of immune dysregulation, mitochondrial dysfunction, and oxidative stress in ASD *Gender-based differences in phenotypic presentation and the unique camouflaging behaviors often observed in females Our goal is to advance the development of more accurate, gender-sensitive diagnostic tools and targeted therapeutic interventions for individuals with ASD

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