Video of Dr Wakefield speaking at the annual meeting of the Association of American Physicians and Surgeons. This story IS going to come out.

[Beachcomber]

Video of Dr Wakefield speaking at the annual meeting of the Association of American Physicians and Surgeons. The story is coming out in the US.

Issues that come up of particular note;

The UK government's decision to use Urabe strain MMR despite information showing it to be unsafe.

Information showing Deer's BMJ articles to be defamation.

Info on how the single mumps Urabe vaccine did not cause meningitis in the way the Urabe MMR did - clear evidence of viral interference in combined live vaccines. Posing a serious question over the safety of the MMR vaccines.

How Professor Walker Smith alerted the government to the work at the Royal Free and the potential problem with the MMR in 1996.

How Dr Wakefield wrote a 250 page report on the inadequate safety data on the MMR, to highlight the problem and argue the case for single vaccines.

A copy of the ethics committe approval for the Lancet case report.

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

More studies on more sick children to discount because they don't fit it with one's world view and what Brian Deer has told you about Dr Wakefield.

Sorry forgot the link.

I'm afraid it is from a website set up by those pesky parents who will insist that their children are sick.

They made up this helpful list of science that relates to their children's condition.

My BG comment was a flippant one, but it did refer to the fact that you do not seem prepared to address Wakefild's conflict of interest, while any possibly conflict of interest in his opponents is examined in a positively forensic manner.

"I'm afraid it is from a website set up by those pesky parents who will insist that their children are sick. "

I will read them. But that is a cheap shot.

seeker - your BG comment did not hold becuase the issue with BG was that he did not declare any CoI (perceived)

Wakefield did declare his CoI - repeatedly. and was judged, by his peers, to be able to continue participating in the research. he did not insist, he did not hide anything.

he brought it up, several times. and was tld it was ok.

to hold over him the possible error of judgement of other peopel is a bit much, no?

but then, so is blaming him (as often happens) for things he did not say, things he did not do, and the whole media shitstorm, which could have been averted if that question had not been directed to Wakefield to answrr (he did not jump in and answer, it was directed to him, by Horton, to answer; before the press conference, he had indicated that he woudl answer in that way, if asked. he was the only one who said he would. why did Horton direct the question to him?)

Um, on the subject of Dr Wakefield's declared involvement in the litigation - did nobody notice the fax reproduced in the article by the editor of The Autism File.

A fax adressed to Horton dated 3rd April 1997 from Dawburns solicitors clearly stating that Dr Wakefield was working with them.

Horton knew of the litigation and he published the Lancet paper with that knowledge.

There is nothing wrong with a doctor working as an expert witness. It happens all the time (Rutter has done it on numerous occasions although he isn't so good as to declare it - the Honda paper being a notable example. Rutter was a paid expert witness for GSK in the UK MMR litigation. I don't see MN posters getting outraged about that.)

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.

My Spanish is a bit rusty, but I understand this paper such that the authors do not replicate Wakefield?s 1998 ?findings? of a distinct autistic enterocolitis, although they do report a higher incidence of gastrointestinal problems in their autistic group. Lenny Gonzales was conducting research paid by Thoughtful House, although I have not looked into whether the above was that research.

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.

This is a case report of one adult autistic patient with inflammed bowel.

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.

This is a meeting abstract that never saw the light of day as a peer reviewed study.

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.

Arthur Krigsman was the clinical director of Thoughtful House, which happens to be the same Texas Clinic out of which Andrew Wakefield used to practise. One editor of ?Autism Insight?, the journal in which this ?independent confirmation? was published, is Andrew Wakefield (another one the senior author of the study, Carol Stott).

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.

This study looks at gastrointestinal (GI) malabsoption as an underlying mechanism for autism. It does not appear to have controls with autism & without GI symptoms OR controls without autism & with similar GI symptoms. Most children with autism & GI symptoms had upper GI problems such as reflux (see also 9)).

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.

A letter to the Editor (in response to the withdrawn Wakefield paper) - they do not report autistic enterocholitis.

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

This is not a peer reviewed paper, but another conference abstract. It has not been published as a proper paper since 1999.

8. Galiatsatos P, Gologan A, Lamoureux E, Autistic enterocolitis: Fact or fiction? Can J Gastroenterol. 2009:23:95-98

This is mostly a review preceded by a case report, featuring two adult patients with gastrointestinal problems and an ASD diagnosis.

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, 201

She reports reflux as a problem for feeding problems. That 1. has nothing to do with Wakefield's claims and 2. is not unique to autistic children - reflux can be very nasty, take ages to be properly diagnose and may even require surgery.

Catherina why does the idea that children with autism often present with GI disturbances and digestive issues, bother you so much?

This particular bit of the autism puzzle that the 1998 Lancet paper described, is accepted science in the US now. The FDA has fast tracked a drug to treat aspects of the problem.

Get with the programme will ya and stop denying evidence that the children are sick. It doesn't look good.

Children with autism and GI disturbaces grow up to be adults with autism and GI disturbances. (Particularly if treatment is witheld by people denying that they are sick.)

HTH.

A drug to improve protein digestion and fix neurotransmitter deficiency is not even remotely related to Wakefield's inflammatory enterocolitis hypothesis.

That is to say (for I am learning to be precise in these matters ), I cannot conceive of a way the two things link up. But as ever, I am willing to be enlightened.

Of course it is related to Dr Wakefield's work.

Dr Wakefield et al treated children with autism and GI disturbances, not only with anti-inflammatory drugs, but also with diet, notably a GFCF diet (casein free gluten free).

From the Lancet paper;

The "opioid excess" theory of autism, put forward first by Panksepp and colleagues7 and later by Reichelt and colleagues8 and Shattock and colleagues9 proposes that autistic disorders result from the incomplete breakdown and excessive absorption of gut-derived peptides from foods, including barley, rye, oats, and caesin from milk and dairy produce. These peptides may exert central-opioid effects, directly or through the formation of ligands with peptidase enzymes required for breakdown of endogenous central-nervous-system opioids,9 leading to disruption of normal neuroregulation and brain development by endogenous encephalins and endorphins.

The paper was ridiculed for this and the GFCF diet was ridiculed for a long time too.

The fast tracked FDA drug aids the breakdown of proteins (gluten and casein are proteins).

Here you go for a more detailed explanation

Some background on immediate and delayed gluten sensitivity

That's what I'm saying; the theory of gut damage => peptide permeability => central opioid effects; is very different from poor protein digestion => neurotransmitter deficiency.

Ah get you. I didn't quote enough of the paper. This part follows on from the previous quote;

One aspect of impaired intestinal function that could permit increased permeability to exogenous peptides is deficiency of the phenyl-sulphur transferase systems, as described by Waring.10 The normally sulphated glycoprotein matrix of the gut wall acts to regulate cell and molecular trafficking.11 Disruption of this matrix and increased intestinal permeability, both features of inflammatory bowel disease,17 may cause both intestinal and neuropsychiatric dysfunction. Impaired enterohepatic sulphation and consequent detoxification of compounds such as the phenolic amines (dopamine, tyramine, and serotonin)12 may also contribute.

Boulevard have you read the Lancet paper?

Catherina why does the idea that children with autism often present with GI disturbances and digestive issues, bother you so much?

It doesn't - shoddy science and unsupported claims do.

This may be of interest Boulevard.

www.autismfile.com/science-research/sulphation-and-autism-what-are-the-links

Without the sulphation process to trigger the release of pancreatic proteases such as trypsin and chymotrypsin, the complete digestion of proteins to their amino acid building blocks (proteolysis) cannot take place, so that peptides, rather than amino acids, are found in the gastrointestinal tract.

Which is I imagine they mean in the news article when they say this;

Zoe takes the study medication mixed in her food. It helps her digest protein. Doctors believe many children with autism can't digest protein, which would cause them to lack amino acids that are critical in producing neurotransmitters for the brain.

Although the sulphation mechanisms and patterns in children with autism appear much more complicated than just that. They appear to also lead to an imbalance of neurotransmitters with overly high levels of dopamine, for example, in the body.

Autism is a like a biological puzzle.

So what are we talking about- are we talking about MMR or about whether different diets are helpful in cases of bowel disease?

I do not have a view either way on vaccination, however I was professionally involved with the main character in the Andrew Wakefield witch hunt, and I can tell you that the lengths to which they went to to discredit him were nothing short of criminal.

I honestly don't think you can post something like thwt without substantiation.

Who, me?

Yes.

Oh right. Well, I know that a certain professor of community medicine lied on oath. I also know that he was cautioned for colluding with a colleague whilst under strict instructions not to have any contact with him whilst the proceedings were ongoing. The lies that he told were shocking. He was caught out on those lies, but this was never told to the public or the press.

Should add that I am not a Wakefield supporter. As I said, I don't really have a view, suffice to say that my kids are vaccinated.

So are you saying that Wakefield should not have been struck off?

I am not sure. I just don't know enough about the issues to hold a view either way. However, if there was enough evidence to strike him off, then why did they go to so much trouble to fabricate information?

Again, I must stress that I am not a Wakefield supporter. Just someone who was frankly quite horrified at the behaviour of some very senior medical people at the time.