Forget the MMR vaccine question. The 1998 Lancet paper that was withdrawn was a case study on inflammatory bowel disease in children with autistic spectrum disorders. The paper never claimed to have discovered a link between autism and the MMR vaccine. It merely stated that 8 of the 12 parents noted regression after the MMR vaccine and the onset of regression. The editor of the Lancet, Dr. Richard Horton, stated at the hearing’s that Wakefield’s findings were still clinically valid. It was about bowel disease, I repeat bowel disease, in autistic children.
The fact that, for whatever reason, children with autistic spectrum disorders have lots of gut problems—has been replicated in studies in 5 different countries including Canada.
The sad part is, that the conflation of these two issues, and the ensuing controversy, has made doctors in England afraid to treat children with bowel disease.
For those of you who think Dr. Wakefield is a fraud below are a list of studies, from peer reviewed journals that replicate/support his results vis-a-vis autistic bowel problems: The abstract for one is at the end of the list.
Here is a documentary, that has never to my knowledge, been shown on television. If you think Brian Deer is a legitimate journalist, please watch it. If you think Wakefield abused the children, I beg you to watch it.
If you think Wakefield is not credible, please watch one of his lectures on YouTube. http://www.youtube.com/watch?v=67U0_SUt5NM
(Skeptics were supposedly there to ambush him. I guess he won them over.)
Wakefield has never said not to vaccinate. That’s a joke. He has never said vaccines cause autism. He thinks there might be a link, but it has not been scientifically proven and more studies need to be done. He is concerned about vaccine safety. Watch his lecture and you’ll see why. His reasons are not that of an anti-vaccine fanatic; watch and I think you will find his reasons cogent and well thought out. Most of the lecture deals with bowel disease.
The GMC did not find the research fraudulent scientifically. It was a list of nonsense and pumped up casuistry. If you don’t believe read it here. It’s not that long:
I have no idea how safe vaccines are or are not nor if they have any relation to autism. Asking questions is not a crime.
Refusing to treat bowel problems in Autistic children should be.
This whole Wakefield affair leaves me disgusted with the scientific establishment, the media in general for not doing 15 minutes of research and the “skeptical” community, in particular, who take medical journalism and press releases on science stories as gospel. I thought we applied skepticism to everything; not just tarot card readers. THE PAPER DID NOT PURPORT TO PROVE VACCINES CAUSE AUTISM. “WOW VICTORY, RATIONALITY HAS PREVAILED… VACCINES ARE VINDICATED WE HAD A PAPER ON BOWEL DISEASE WITHDRAWN!”
I think I’ll go ask Richard Dawkins to ask Rebecca Watson back to his room for coffee. In an elevator of course. Yeah skeptics are infallible.
Just found this. I guess Wake Forest University are fraudsters as well: http://www.dailymail.co.uk/news/article-388051/Scientists-fear-MMR-link-autism.html#ixzz1DevpXU1A
The following peer-reviewed papers duplicate Dr. Wakefield’s original findings in five additional countries, including the US, Italy, Venezuela, Canada and Poland:
1) Gonzalez, L. et al., Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms. Arch Venez Pueric Pediatr, 2005;69:19-25.
2) Balzola, F., et al., Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain syndrome? American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.
3) Balzola F et al . Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients. Gastroenterology 2005;128(Suppl. 2);A-303.
4) Krigsman A, Boris M, Goldblatt A, Stott C. Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms. Autism Insights. 2009;1:1—11.
5) Horvath K., Papadimitriou J.C., Rabsztyn A., Drachenberg C., Tildon J.T. 1999. Gastrointestinal abnormalities in children with autism. J. Pediatrics 135: 559-563.
6) Sabra S, Bellanti JA, Colon AR. Ileal lymphoid hyperplasia, non-specific colitis and pervasive developmental disorder in children. The Lancet 1998;352:234-5.
7) Sabra A, Hartman D, Zeligs BJ et al., Linkage of ileal-lymphoid-nodular hyperplasia (ILNH), food allergy and CNS developmental abnormalities: evidence for a non-IgE association, Ann Allergy Asthma Immunol, 1999;82:8
8) Galiatsatos P, Gologan A, Lamoureux E, Autistic enterocolitis: Fact or fiction? Can J Gastroenterol. 2009:23:95-98
9) Jarocka-Cyrta et al. Brief report: eosinophilic esophagitis as a cause of feeding problems in an autistic boy. The first reported case.J. Aut. Dev. Disord. Online July 10, 2010
The following articles support the importance of recognizing and treating gastrointestinal symptoms in autistic children:
1) Buie T, et al. Pediatrics. 2010 Jan;125 Suppl 1:S19-29. Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs.
2) Buie T, et al. Pediatrics. 2010 Jan;125 Suppl 1:S1-18. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report.
The following peer-reviewed papers provide further support for gastrointestinal disturbances involving the immune system in autism.
1) Jyonouchi H., Sun S., Lee H. 2001. Proinflammatory and regulatory cytokine production associated with innate and adaptive immune responses in children with autism spectrum disorders and developmental regression. J. Neuroimmunol. 120(1-2):170-9
2) Jyonouchi H, Geng L, Ruby A, Zimmerman-Bier B. Dysregulated Innate Immune Responses in Young Children with Autism Spectrum Disorders: Their Relationship to Gastrointestinal Symptoms and Dietary Intervention. Neuropsychobiology. 2005;28:5177-85
3) Jyonouchi H, Geng L, Ruby A, Reddy C, Zimmerman-Bier B. Evaluation of an association between gastrointestinal symptoms and cytokine production against common dietary proteins in children with autism spectrum disorders. J Pediatr.2005;146(5):605-10.
4) Jyonouchi H, Sun S, Itokazu N. Innate immunity associated with inflammatory responses and cytokine production against common dietary proteins in patients with autism spectrum disorder. Neuropsychobiology. 2002;46(2):76-84.
5) Vojdani A, O’Bryan T, Green JA, McCandless J, Woeller KN, Vojdani E, Nourian AA, Cooper EL. Immune response to dietary proteins, gliadin and cerebellar peptides in children with autism. Nutr. Neurosci. 2004;7:151-61.
6) Whiteley P, Haracopos D, Knivsberg AM, Reichelt KL, Parlar S, Jacobsen J, Seim A, Pedersen L, Schondel M, Shattock P. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci. 2010;13(2):87-100.
7) Knivsberg AM, Reichelt KL, Høien T, Nødland M. A randomised, controlled study of dietary intervention in autistic syndromes. Nutr Neurosci. 2002;5(4):251-61.
8) Balzola F, et al. Beneficial behavioural effects of IBD therapy and gluten/casein-free diet in an Italian cohort of patients with autistic enterocolitis followed over one year. Gastroenterology 2008;4:S1364.
9) Valicenti-McDermott M., McVicar K., Rapin I., et al., Frequency of Gastrointestinal Symptoms in Children with Autistic Spectrum Disorders and Association with Family History of Autoimmune Disease. Developmental and Behavioral Pediatrics. 2006;27:128-136
10) Chen B, Girgis S, El-Matary W. Childhood Autism and Eosinophilic Colitis. Digestion 2010;18:127-129
11) Sandler R, Finegold SM., Bolte ER., et al. Short-term benefit from oral vancomycin treatment of regressive-onset autism. J Child Neurol. 2000;15:429-435
Wakefield’s Science Proven Valid Again In New Study That Replicates Findings
Read the full study, Clinical presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic spectrum Disorder and Chronic Gastrointestinal symptoms at Autism Insights . View a .pdf HERE.
Arthur Krigsman 1, Marvin Boris 2, Alan Goldblatt 3 and Carol Stott 4
Background: Children with developmental disorders experience chronic gastrointestinal symptoms.
Aims:To examine the nature of these gastrointestinal symptoms and histologic findings in children with autism spectrum/developmental disorders and ileocolonic disease.
Methods: Chart review. 143 autism spectrum/developmental disorder patients, with chronic gastrointestinal symptoms, undergoing diagnostic ileocolonoscopy.
Results: Diarrhea was present in 78%, abdominal pain in 59% and constipation in 36%. Ileal and/or colonic lymphonodular hyperplasia (LNH), defined as the presence of an increased number of enlarged lymphoid follicles, often with hyperactive germinal centers, was present in 73.2%. Terminal ileum LNH presented visually in 67% and histologically in 73%. Colonic LNH was multifocal and presented histologically in 32%. Ileal and/or colonic inflammation presented in 74%, consisting primarily of active or chronic colitis (69%). Ileal inflammation presented in 35%. Presence of LNH significantly predicted mucosal inflammation.
Patients with ileal and/or colonic LNH had lower mean/median age than those without; patients with ileal and/or colonic inflammation had lower mean/median age than those without. There was a significant association between ileo and/or colonic inflammation or LNH, and onset of developmental disorder; plateaued or regressive onset conferred greater risk than early onset.
Conclusions: Patients with autism or related disorders exhibiting chronic gastrointestinal symptoms demonstrate ileal or colonic inflammation upon light microscopic examination of biopsy tissue. Further work is needed to determine whether resolution of histopathology with appropriate therapy is accompanied by GI symptomatic and cognitive/behavioral improvement.
Keywords:ASD ileitis, colitis, lymphonodular hyperplasia
1 Assistant professor of pediatrics, New York University school of Medicine Director of Gastroenterology services, Thoughtful House Center for Children, 3001 Bee Caves Rd, Austin, Texas, 78746, UsA.
2 Associate Clinical professor of pediatrics, New York University school of Medicine, 550 1st Ave., New York, NY 10016, UsA.
3 Adjunct professor Touro College, 27-33 West 23rd st, New York, NY 10010, UsA.
4Thoughtful House Center for Children, 3001 Bee Caves Rd, Austin, Texas, 78746, UsA.