A License to Kill? Part 3: After Gardasil’s Launch, More Victims, More Bad Safety Analysis and a Revolving Door Culture
Aiding and Abetting Science in Avoiding Legitimate Debate of Parental Concerns

Lorene Amet and Pippa Line Respond to Brian Deer in BMJ

Complete_GI_tract-212x300 By John Stone

For six years Sunday Times journalist Brian Deer has been trying to kid us that three experienced gastroenterologists liaising with other professionals within and beyond the walls of the Royal Free Hospital in North London ordered invasive procedures children without significant GI issues. In this short article, originally published as a letter in BMJ Rapid Responses Lorene Amet and Pippa Line of the UK’s Autism Treatment Trust  demonstrate just how implausible and tenuous Deer’s claims are. (See HERE.)

Brian Deer’s article questions the existence of “autistic enterocolitis” in the ‘Lancet’ children (link: HERE). The letter from Drs McClure and O’Hare (link:HERE) questions the validity of the autism diagnosis of the same children. How long before someone pops up and questions the children’s very existence? It would appear these children are an inconvenience in this heavily charged debate.

Notwithstanding, questioning the accuracy of an autism diagnosis is always very pertinent and needs to be properly addressed. Autism spectrums disorders (ASD) comprise a heterogeneous spectrum of developmental conditions that include autism, Asperger Syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). The diagnosis is based on the detailed assessment of the individual’s communication, social, behavioural and developmental presentation. In the last three decades, however, numerous peer-reviewed studies have shown that ASD can be associated with a great variety of unrelated aetiologies of a genetic and/or environmental nature (1). The psychiatric presentation of individuals is therefore important (2) but insufficient to understand and define this heterogeneous group of developmental disorders.


The questions in autism are a lot broader than those raised by Deer (3). The issues are to provide adequate evaluation of the condition in order to address each individual’s needs as fully as possible (4). The clinical concerns raised by parents are many and should be investigated systematically and in great detail. At the Autism Treatment Trust (ATT) clinic in Edinburgh in a sample of 360 autistic children, 59% presented with chronic clinical gastro- intestinal complaints, characterised by abnormal bowel movements (74%), chronic constipation (31%) and/or diarrhoea (30%), abdominal bloating (30%) and abdominal pain (31%). Commonly, children with affected digestive systems presented with abnormal body posturing (32%), leaning over furniture etc, in order to provide relief to their lower abdomen.
Importantly, children with chronic gut problems are more likely to present with hyperactivity (÷2 (1) = 9.665, p = .002, this is reflected by the odds ratio whereby those with current gut problems were 2.33 times more likely to have hyperactivity than those without), sleep issues (÷2 (1) = 6.649, p = .010, this is reflected by the odds ratio whereby those with gut problems were 1.96 times more likely to have sleep problems than those without) and abnormal fits of crying spells, occurring suddenly and even at night time (÷2 (1) = 5.075, p = .024, this is reflected by the odds ratio whereby those with current gut problems were 1.80 times more likely to have crying problems than those without). Developmentally, these children are also more likely to have experienced regressive autism, characterised by a loss of acquired developmental skills in the areas of communication and socialisation and to present with novel deviant restricted and repetitive behaviours (÷2 (1) = 5.619, p = .018, this is reflected by the odds ratio whereby those with current gut problems were 1.93 times more likely to have regression than those without). In terms of markers, 20% of children presenting with chronic gut issues have abnormal levels of faecal calprotectin, a surrogate marker of Inflammatory Bowel Disease characterised by pathological inflammation of the bowel wall (5). These findings indicate that the gastro-intestinal problems encountered in autism are related to a range of behavioural and developmental abnormalities, and are associated with markers of inflammation, consistent with other reports (6-8). These are therefore likely to be central to the dysfunction experienced by this sub-set of autistic individuals.

Children with autism also commonly present with severe chronic immune problems (observed in 65% of a group of 258 children with autism at the ATT clinic). These include eczema (24%), repetitive chronic and long- lasting infection issues (36%), food and/or inhalant allergies (37%), asthma (7%). A significant association between children presenting with immune problems and those with parental immune problems was found indicating a common genetic susceptibility (÷2 (1) = 5.543, p = .013, this is reflected by the odds ratio whereby those with immune problems were 1.86 times more likely to have parents with immune problems than those without). Additionally, there was also a significant association between immune problems and self- injurious behaviour (÷2 (1) = 4.152, p = .028, this is reflected by the odds ratio whereby those with immune problems were 1.85 times more likely to have self-injurious behaviour than those without). In terms of markers, a surrogate marker for cell immunity called neopterine (9) was found to statistically correlate with isoprostane (10), a marker of oxidative stress (r =0.547, p (one- tailed) <.001. The R2 value of .299 indicates that the markers account for 30% of the variation in the levels of each other). Both immune and oxidative stress-issues have been reported to be centrally associated with a sub-set autism (11-12).
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In conclusion, autism spectrum disorders include a range of syndromes characterised by varying degrees of clinical, developmental and behavioural symptoms. It is essential to provide a systematic evaluation of affected individuals in order to address the range of abnormalities identified. Autistic individuals have suffered greatly due to internal medical politics. It is time to move on.

References:
1. Gillberg, C. and Coleman, M. 2000. The biology of the autistic syndromes. Cambridge University Press.
2. Iain McClure, Anne O'Hare (28 April 2010). How can we be confident that the children with "autistic enterolcolitis" have autism? Rapid response BMJ 2010:340.
3. Deer B. Wakefield’s ‘autistic colitis’ under the microscope. BMJ 2010; 340: 838-41.
4. Buie T, Fuchs GJ 3rd, Furuta GT, et al. 2010. Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs. Pediatrics. Jan;125 Suppl 1:S19-29.
5. Costa F, Mumolo MG, Ceccarelli L, Bellini M, Romano MR, Sterpi C, Ricchiuti A, Marchi S, Bottai M..Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease. Gut. 2005 Mar;54(3):364- 8.
6. Ashwood, P., Anthony, A., Pellicer, A.A., et al. 2003. Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology. Journal of Clinical Immunology, 23:504- 517.
7. Krigsman, A., Boris, M., Goldblatt, A., and 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.
8. Balzola, F., Barbon V., Repici, A., Rizzetto, M., Clauser, D., Gandione, M., and Sapino, A. 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.
9. Sweeten, T.L., Posey, D.J. and McDougle, C.J. High blood monocyte counts and neopterin levels in children with autistic disorder. Am. J. Psychiatry 2003:160, 1691-1693.
10. Wu X, Cai H, Xiang YB, Cai Q, Yang G, Liu D, Sanchez S, Zheng W, Milne G, Shu XO. Intra-person variation of urinary biomarkers of oxidative stress and inflammation. Cancer Epidemiol Biomarkers Prev. 2010 Apr;19(4):947-52. Epub 2010 Mar 23.
11. Vargas, D.L., Nascimbene, C., Krishnan, C., et al. 2005. Neuroglial activation and neuroinflammation in the brain of patients with autism. Ann. Neurol. 57(1):67-81.
12. Sweeten, T.L., Bowyer, S.L., Posey, D.J., Halberstadt, G.M., and McDougle,C.J. Increased prevalence of familial autoimmunity in probands with pervasive developmental disorders. Pediatrics 2003:112(5):e420.

John Stone is UK Editor for Age of Autism.

Comments

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Christina

There is a link on the BMJ website where you can register a complaint against the BMJ (search "complaint"). Also you can complain to the Associated Press at Info@AP.org for AP articles, like its 4/15/10 piece publicizing Deer's BMJ article. The AP's standards and principles are on its website, and are high. I couldn't find the BMJ's. I asked the AP to do a fair, balanced article on Dr. Wakefield. (Maybe it's coincidence, but I started getting a newspaper left at my back door!)

Jenny Allan

Two quotes from Lorene Amit's excellent response:-
'It would appear these children are an inconvenience in this heavily charged debate.'

'Autistic individuals have suffered greatly due to internal medical politics. It is time to move on.'

When I viewed the video of odious Brian Deer's response to two mothers outside the impressive GMC headquarters, I realised just how rotten and corrupt this whole business had become. Mr Deer, who has no medical or scientific qualifications whatsoever and who is entirely responsible for initiating this GMC 'witchhunt' of Dr Wakefield and his two colleagues, told these mothers that their sons 'did not have bowel problems'. One had an ileostomy bag, (leaking). This was diarrhoea in Mr Deer's learned opinion. The other child had a severely impacted bowel. This, according to Mr Deer, was 'just constipation'. It is obvious that neither Mr Deer nor the collective might of the GMC cares a hoot about the welfare of the children who are central to this case.

The Autism Treatment Trust are based in Scotland. They do sterling work with autistic children and are quietly collating their observations and statistics which seem to concur 100% with the observations of Wakefield et al. I am proud of them all.

Benedetta

Thank you Gotgorra and Gammaknows;

I don't know what to do. I seem to have become unable to move except were I have been dircted.

GrammaKnows

Since hallucination of bugs crawling on the skin is a known adverse effect of psychotropics (anyone have any idea how a non-verbal child with autism is supposed to tell us if that is happening?), nightmares and strange or bizarre dreams as well, Benedetta - sometimes issues are not resolved by adding a drug or treatment, but by taking it away, instead. I hope she finds the source of her distress.

Gatogorra

Thank you for sharing more of the "voices of reason" in the debate in the UK. I'm pretty sure that some of the doctors who are currently retorting to Brian Deer's claims are not isolated, though many have been intimidated into silence. I wonder if even the majority of scientists truly follow Deer's marching music.

Gatogorra

Benedetta-- I'm very sorry to hear this and I hope your daughter is okay.

Bear in mind that mania is a listed side effect of Prozac. It also carries warnings of a 40 fold increase in suicidality/violence (when compared to people with the same diagnoses who do not take the drugs).

I know first hand that vaccines (therefore environmental toxins) can cause similar swings in children which are often mislabeled as "pediatric bipolar disorder" (which did not exist fifty years ago). But for adults (and now some children), prime suspects in the rise of BPD are the very drugs which supposedly "treat" mental health disorders.

Benedetta

This inflammatory disease brought on by vaccines can come out as anything, anything!

I was floored this past Sunday (okay some more of me died this weekend, did not know I had anything left to be emotional about, but I was wrong) I discovered my daughter who seemed all right - although she takes prozac for depression but has a job, an RN nurse doing great although she suffered Kawaskai's as a child brought on from a DPT shot -

this Sunday she cut herself with her dissecting kit from a previous biology class. She said it was bots under her skin.

We found out this week she has bipolar.

I think this mannia stuff they talk about is some sort of seizure disorder or maybe inflammation of the brain to the point oxygen is being limited. She is there talking to you but she is not really there. She said it was like some type of dream. No, she had a blood test in the emergency room and- no drugs except what is suppose to be in her blood for depression.

Right before this happened she had had a very busy week. She works only weekends but she had also worked addtionoal 8 days. Right before this happened she came down with diarrhea, fever, pupils of her eyes were large and slow to close to bright light, her legs cramped worse than usual, her blood vessels below the knee were mottled like when she had Kawasaki's years ago.

yes, as a nurse she took three hep B a couple of years back, and on the third she experienced pain and stiffness all over. Blood test says she has high sed rates, and C reactive protein rates. But nothin they can do - except some ultram for leg and muscle aches.

Three circles - Jim maybe four. Immune response in the blood vessels involves the whole body.

This past week - one more thing to pile on top of it all, something is wrong with my husband's spine in his neck - spurs - lab report says severe. Looking up the cause once again inflammation. Yes vaccine injured 20 years back from 2 tetanus shots, and dignosed with mitochondria disorder.

Let me see who have I left out -- hmmmm oh yes my son who suffered a stroke hours after a DPT shot and before that a heart mummur from a DPT shot. Let us not forget the autism, PDD-NOS, aspergers, tourettes, and oh yes that darn bunch of seizures that turned out to be epilepsy finally at age 17.

ANGUS FILES

The tool of Pharma is Deer,and he still has to realise that, he is like the previous used bog roll once flushed forgotten .. an arse wipe for PHARMA like the rest that PHARMA have passed before him (no insult to bog paper meant)

BOG PAPER R.I.P.

Joan Campbell

As our children get older they get sicker. Talking about bowel movements I am obsessed with making sure my son is regular, because if he is not he gets so impacted that it seems to bring on his seizures and makes him very lethargic and not smiling. At the age of 17 he should be in his element and totally enjoying life and all it's experiences as I did and Lorene Amet is a true crusader and pioneer of treating our children/teenagers with MMR/Autism.
My son has been diagnosed wrongly it shopuld be MMR vaccine damage and that a fact.

Robin Nemeth

Call it autism or call it vaccine damage, but whatever you call it, I can guarantee you that anybody who hasn't had a bowel movement in ten days is going to be acting damn weird.

Jim Thompson

(1) Look at the reported data that 59 percent of the 360 autistic children at the Autism Treatment Trust clinic in Edinburgh had chronic clinical gastro-intestinal complaints.

(2) Picture a Venn diagram with two circles. The first circle is autism. The second circle is gastro-intestinal complaints.

(3) Consider that 59 percent of the first circle overlaps the second circle.

Brian Deer should not expect the public to disbelieve that parents sought help for their children because of autism AND gastro-intestinal complaints.

The odds appear greater than 50 percent that Brian Deer is a tool of Pharma persecution.

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