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By
Liz Fink for the Spectator
The past 20 years have seen a surge in the number
of children with autism but few corresponding
funding increases to study the disorder. But thanks
to an October 2003 grant, the Autism Birth Cohort,
a joint project of Columbia University and the
Norwegian government, is now one of the largest
research studies on autism in history.
The number of children with autism--a chronic
neurological disorder
that impairs communication and social interaction--has
increased from
approximately one in 1,000 to one in 150, and
no one can conclusively say
why.
"The frequency of this disorder is likely
to be increasing ... it's an area that has deserved
a great deal more emphasis than it has had for
a long time," said Dr. Ian Lipkin, director
of the Autism Birth Cohort and a professor at
the School of Public Health.
The Cohort is a broad-based epidemiological study
that uses new
technology to identify how genetics, environment,
and timing combine to
cause autism.
A government attempt to free chemical companies
from liability for
chemicals linked to autism inadvertently attracted
major publicity.
Preliminary research indicated a relationship
between prenatal and infant
exposure to thimerosal, present in several vaccines,
and autism. In
November 2002 an unknown senator embedded deep
within a 475-page homeland security bill a provision
removing the liability of manufacturers of thimerosal.
While the ensuing scandal caused the provision
to be scrapped in January 2002, thimerosal's relationship
to autism remains unclear.
"People just want this issue to go away,"
said Dr. Mady Hornig, an
associate professor of epidemiology whose research
corroborates the
connection between autism and thimerosal. She
also works with the Autism
Birth Cohort.
Thimerosal is one of the many possible toxic and
infectious agents whose effects the Autism Birth
Cohort will examine. The Cohort will follow over
75,000 Norwegian expectant mothers and their children,
analyzing their medical records, blood samples,
and survey questionnaires in order to
trace specific agents to the onset of the disease.
New technology will allow for intensified study
into gene expression
of study participants. Hornig said that one of
the most revolutionary
aspects of the Autism Birth Cohort is its access
to funds to buy a certain
type of test tube.
"I know that sounds very trivial, but this
is basically the turning
point that turns this birth cohort into one that
is unique in the world,"
she said, because the test tubes allow for the
collection of the genetic
material RNA.
Early DNA collection is nothing revolutionary
because an
individual's DNA remains constant throughout their
lifetime. According to Hornig, RNA differs because
it "tells you which genes are turned on and
off at a particular point in time ... [and provides
a] look at gene expression at a
particular point in time."
Hornig's research with mice helped demonstrate
a link between
thimerosal and autism worth pursuing in the Autism
Birth Cohort.
Research on mice is less complex than on humans
for many reasons,
including the presence of a specific gene group,
H-2S, which can cause
autism-like behavior in mice. In humans no specific
genes indicating a
predisposition to autism have been identified.
Finding a conclusive single specific cause of
autism is extremely unlikely despite Hornig's
initial findings about thimerosal.
"We think it is unlikely to be a singular
environmental factor" that causes autism,
Hornig said. Autism itself is understood to be
a spectrum of disorders, increasing the "difficulty
in teasing out this complexity."
Despite the lack of a definite link, Hornig's
findings in mice have caused her to question the
use of thimerosal in vaccines. Thimerosal is not
actually a necessary component of vaccines: it
serves only as an anti-microbial preservative
for multi-dose vials. Today it is largely found
in flu shots and older vaccinations.
"There is no legitimate reason other than
cost" to use this additive, Hornig said,
adding that at an additional cost of approximately
four dollars a vial manufacturers could simply
produce single-dose packages and eliminate thimerosal
entirely.
The issue is hotly political, however, and it
is unlikely policy and health officials will reach
a consensus on thimerosal in the near future.
Rejecting research like Hornig's, the Center for
Disease Control Web site states, "No harmful
effects have been reported from thimerosal at
doses used in vaccines, except for minor reactions
like redness or swelling at the reaction site."
Despite the clarity of their conclusions, the
CDC does say no vaccines used on preschool children
against infectious diseases contain thimerosal.
This is significant because children generally
begin exhibiting signs of
autism between the ages of 12 and 15 months. Prenatal
exposure to
different triggers like thimerosal is a major
focus of autism research.
In looking to further study the possible effects
of thimerosal, the Autism Birth Cohort will focus
its research on the prenatal and infancy stages
of development. The project, however, will continue
for the long term, which Lipkin hopes will allow
researches studying other chronic diseases such
as asthma, diabetes, and schizophrenia to be able
to use the data as well.
"This is the Autism Birth Cohort project,
but it's really much, much
more. It's the paradigm for any sort of efforts
to investigate" the normal
trajectory of disease, Lipkin said.
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