There is a most curious interview with Dr. Ian Lipkin in the April 2012 issue of Discover magazine entitled "In the Lab with the World's Greatest Virus Hunter". I can't help but notice that Dr. Lipkin, director of the Center for Infection and Immunity at Columbia University's Mailman School of Public Health and the scientist who first identified West Nile Virus sounds more like a bio-med autism parent than a CDC spokesman who claims that while we don't know what causes autism, "we're sure it's not vaccines."
Many will no doubt remember it was Lipkin's study which supposedly disproved the work of Dr. Andrew Wakefield regarding the persistence of the vaccine strain of the measles in the gut of children with autism. And it's certainly true that Lipkin has done little to counter that impression.
However, a closer look at Lipkin's study reveals a more complicated picture. Lipkin used the same lab as Wakefield and did identify the measles virus from one of the children with autism he studied. The patient selection criteria was significantly different than that used by Wakefield, and as I have written previously, Lipkin has recently used Wakefield's research in the footnotes to his recent article showing that different bacterial colonies are present in the guts of children with autism. If Wakefield's research was so dishonest, why would Lipkin ever cite him?
Perhaps all this has set the stage for a conversion on the question of autism, similar to that of the apostle Paul, a former Christian hunter who after having a vision of Christ on the Road to Damascus, became one of the founders of the early Church. For as much as Dr. Lipkin took the wrong road in regards to Dr. Wakefield's work, there has also been evidence of an exceptionally humane side to the man.
When Dr. Mady Horning released her study showing that the neurotoxic effects of thimerosal in mice were dependent upon a certain genetic profile, the autism community worried that the long knives were out for her. This could explain why only certain infants were harmed by the thimerosal in vaccines and not others. Dr. Horning was sheltered by Dr. Ian Lipkin who made her his research partner, probably saving her academic career in the process.
Recently I've come across Lipkin in the controversy over the XMRV retrovirus and its possible link to both ME/chronic fatigue syndrome and autism. When the situation with Dr. Judy Mikovits and the Whittemore-Peterson Institute fell apart, Dr. Lipkin had the power to determine whether the research would continue. I am told by sources that Dr. Lipkin was actually threatened with legal action by various entities and he told them to take a hike. Instead of succumbing to this pressure, he put Drs. Mikovits, Frank Ruscetti of the National Cancer Institute and discoverer of the first human retrovirus, as well as Jose Montoya of Stanford University, and others in charge of determining the possible link between XMRV (or a related human retrovirus) and these diseases.
Lipkin's willingness to remain agnostic on the question of XMRV (or other related human retroviruses) opens up some other possibilities into how a retrovirus could cause conditions like ME/chronic fatigue syndrome and autism. A virus or other pathogen may cause collateral damage that is not simply due to the infection, but how the body responds to the pathogen.
From the Discover magazine interview of April 2012:
Have we reached the point where we can link specific infections to specific psychiatric disorders?
No, the connection is much more complex. When I worked with LCMV, it became clear that any sort of pertubation could damage the nervous system. Nerves find their way to specific locations through signposts that are part of the immune system. And if you increase immunological molecules of certain types, a nerve may jog this way as opposed to the way it's supposed to go. It may not make a difference what the infectious agent is-bacterial, viral, or parasitic.
If the identity of the infection isn't critical, what is?
The important things are the genetic background of the individual and the timing of the insult. If you look at the original work on the epidemiology of thalidomide [a morning sickness drug that turned out to cause birth defects], there were specific time points where, if the woman was exposed, the baby had a high probability of having bona fide autism.
One of the most fascinating links between infections and mental disease concerns PANDAS, pediatric autoimmune neuropsychiatric disorders. The bottom line is that strep might cause obsessive-compulsive disorder. How could that happen?
An infection like strep provokes an antibody response, but the antibody created to fight the strep also recognizes proteins that are part of your body. Antibodies don't typically traffic much in the central nervous system. But if you have any one of a number of other infections or an insult like a head trauma, the blood-brain barrier [which normally protects the brain from pathogens] opens transiently. Depending on how long and where the opening is, the antibodies get access to part of the central nervous system or brain. We are studying this process now in mice, using drugs (bold is mine) to open up a portion of the hindbrain or the forebrain or the hippocampus and tracking the effect.
Could autism be another version of a PANDAS-like disease?
It's possible, in some people. There is probably a group of people who have a genetic component to autism, and for them, there may not be much of a trigger or any trigger at all required. Another group is genetically predisposed, and if they encounter some factor or factors, individually or in combination, it could result in either the onset or the aggravation of the neurodevelopmental disorder; by factors, I include everything from heavy metals to infection. (bold is mine) And lastly, there is a group that may be relatively or entirely normal, but is exposed prenatally to some factor or factors that have an effect on their nervous system and that manifests as autism. That is the hypothesis, at least.
Did I really read that in the same Discover magazine which in its 2009 year-end issue declared that parents who were concerned about vaccine reactions were the #1 story of the year and constituted a threat to public health?
Did the world's greatest virus hunter and one of America's most respected scientists just say that heavy metals or infections might have something to do with autism? What amazing consumer product combines both heavy metals and pathogens in one convenient package? It's on the tip of my tongue. Let's see . . . is it baby formula? No. The Playstation 3? No. Oh yeah . . . vaccines!!!!
I consider Dr. Lipkin's comments to be extremely important for what he also suspects about antibodies. While we know the immune systems of our children to be compromised and we may argue about which pathogen is responsible, that may not be the important question. The important question might be what antibodies are produced by the body of an immuno-compromised individual in response to certain exposures. The pathogen, whether it be XMRV or something else, may be of lesser importance. If we can understand which antibodies might be causing the problems of autism and other diseases we are in a much better position to understand how to counteract them.
Vaclav Havel, the Czech dissident playwright, who went from a prison cell to leading his country in a peaceful overthrow of communism once wrote, "You do not become a 'dissident' just because you decide one day to take up this most unusual career. You are thrown into it by your personal sense of responsibility, combined with a complex set of external circumstances. You are cast out of the existing structures and placed in a position of conflict with them. It begins as an attempt to do your work well, and ends with being branded an enemy of society."
I hope that Dr. Lipkin continues his recent attempts to do his work well.
Kent Heckenlively is a Contributing Editor to Age of Autism