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By
Mary Ann Roser for the New York Times
A maverick British scientist who now works in
Austin has completed anew study on autism that
links the disease to a novel intestinal illness.
The research, which will be published in this
month's issue of theJournal of Clinical Immunology
that is expected to come out today, opens thedoor
to testing treatments for some autistic children,
including a diet thatforbids dairy products and
certain grains.
Dr. Andy Wakefield, whose earlier work caused
a furor by suggestingan association between a
common childhood vaccine and autism, said heconsiders
the latest research groundbreaking.
The study by Wakefield and three collaborators
builds on previousresearch connecting autism and
the gut.
But it goes several steps further: It identifies
a new inflammatoryintestinal disease in some children
who appear normal but regress intoautism; it suggests
the intestinal disease is viral, thus giving clues
aboutthe nature of this type of autism; and it
provides new targets for treatingautism in some
children.
"This now gives us the basis of what is driving
that disease and whatwe can do to treat many children"
who regress into autism, said Wakefield,who is
setting up a research, education and treatment
center for autisticchildren in Austin called the
Thoughtful House. "
We hope this will form the basis for a new clinical
trial."Nationally known autism expert Dr.
Timothy Buie, a pediatrician specializingin gastrointestinal
disorders at Massachusetts General Hospital forChildren,
called the research a welcome extension of Wakefield's
earlierwork into the relationship between autism
and gastrointestinal symptoms,such as constipation
and diarrhea. Buie is among the researchers studyingbowel
disease and autism, but he said it's too early
to gauge thesignificance of Wakefield's findings.
Autism is a complex disorder that usually emerges
during the first three years of life and affects
the ability to communicate, reason andinteract
with others. Some type of autism is diagnosed
in one in 166 individuals, according to the U.S.
Centers for Disease Control andPrevention. According
to the Autism Society of America, rates are soaringand
could rise from 1.5 million Americans to 4 million
in the next decade.
Autism is classified as a neurological disorder,
but scientists don'tknow what causes it or how
to cure it.
Though the new research expands the understanding
of autism in aselect group of children, "the
jury is still out" on whether it extends
to alarger group, said Buie, who also is on the
Harvard Medical School faculty."We're a long
way from saying that these changes at the gut
level are whatis causing the autism." Dr.
David Baskin, a professor of neurosurgery andanesthesiology
at Baylor College of Medicine in Houston, said
the study"adds to a growing body of knowledge
concerning children with autism andposes a number
of important questions to be answered with additional
research." Wakefield and his colleagues studied
86 children in England, including 21 with autism.
They found that the autistic children hadsignificantly
more cells of a certain type in their digestive
tracts associated with an intestinal inflammation
causing them chronic problems. Eleven of those
children were on some dietary restrictions involving
dairy products, gluten (grains, such as wheat
and rye), or both. Theirparents said the children
functioned better, physically and mentally,according
to the study.
Those children also had fewer inflammatory chemicalsin
their intestines than those not on restricted
diets, the study says. The study recommends more
research on the restricted diet. Autisticchildren
across the country have been known to try it.
"It's really rather remarkable the differences
I have seen in some children," said Peter
Bell, executive director and chief executive officer
of Cure Autism Now, an advocacy organization in
Los Angeles that supports autism research. But
Bell said the diet had no effect on his autistic
son, now 11. Wakefield said the study also suggests
that some drugs might help,but the paper does
not recommend any. In
an interview, Wakefield saidRemicade, used to
treat Crohn's disease and rheumatoid arthritis,
meritsfurther study. The Food and Drug Administration
issued warnings about Remicade afterit was linked
to lymphoma, malignancies and heart failure. Wakefield
said hedidn't want to mention the drug because
he didn't want patients clamoringfor it until
it's been thoroughly tested for autism. The gut's
connection to the disorder has gained credence
in the lastfive to 10 years, Bell said, although
people outside the autism communitymight not know
that.
Wakefield said the study found that the type of
gastrointestinalillness the autistic children
exhibited, though different than otherinflammatory
bowel diseases, is "similar to what we would
see in HIVpatients." "That's important,"
he said, "because it's a rationale forlooking
for a viral cause for autism." Wakefield
received internationalnotoriety following a 1998
article he published in the Lancet, a prestigiousBritish
medical journal, in which parents reported that
they thought themeasles, mumps and rubella vaccine,
known as MMR, could be linked to autismand a bowel
disease in some children.
Though Wakefield said it was important to report
what parents weresaying, he insists he is a big
vaccine supporter. However, he does favorseparating
the MMR into individual shots because the combination
might harmsome children. Earlier this year, 10
of the 13 authors of the Lancet reportdisavowed
the interpretation that MMR might cause autism.
Wakefield was notone of them and was singled out
in a "60 Minutes" report on the subject
Oct.24 for fueling anti-vaccine hysteria. (The
new study does not discussvaccines.)
The Lancet said it would not have published the
1998 study had itknown that Wakefield was helping
parents of autistic children gatherscientific
information for a lawsuit over the MMR vaccine.
The Legal AidBoard in England had paid the hospital
where Wakefield worked $90,000 forhis help.
Wakefield said last week that he didn't get any
money and didn't doanything unethical. Although
some of the same parents in the lawsuit alsowere
involved in the Lancet study, Wakefield said,
the Lancet paper was notdone to "propagate
a lawsuit." As the MMR vaccine controversy
raged,Wakefield resigned under pressure from his
job as an assistant professor of experimental
gastroenterology at the Royal Free Hospital Medical
School in London in 2001.
He has been in the process of relocating to Austin
for thepast 18 months, he said, and plans to open
the Thoughtful House in January. The center will
start with clinical services for autistic childrenand
will gradually expand to a school. It also will
do research studies. Mary Ann Roser writes for
the Austin American-Statesman
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