Editor's note: You've really got to check out and connect
people to this interview Andy Wakefield did with Arthur Krigsman, one of the
authors of the new journal article that confirmed unusual bowel disease in
children with autism. That, you no doubt recall, is what the whole
"discredited" Lancet paper was about lo these 15 years, and millions
of autism cases, ago. Sadly, the denial of this reality plays out every day,
including at Loyola hospital in Chicago where a 14-year-old boy is currently
being treated as a psychiatric patient while his mother's pleas to investigate
his GI symptoms have so far gone unheeded. -- Dan Olmsted
Thank you to Bob Moffit for the transcription.
DR. WAKEFIELD: Hi, I'm sitting here with my friend and
colleague, Dr. Arthur Krigsman, who brings us some very exciting news from
pediatric gastroenterology. Arthur, welcome to the show.
DR. KRIGSMAN; Thank you Andy.
DR.W: You've published previously in the area of
inflammatory bowel disease in children with autism. In a nutshell, what
were the findings of that paper?
DR. K: Well, in the initial paper published in early
("Clinical Presentation and Histologic Findings and
lleocolonoscopy in Children with Autism Spectrum Disorders and Chronic
What we were able to show, was that, children with Autism who
had long standing gastrointestinal symptoms, like diarrhea, constipation or
abdominal pain, growth failure .. when those children underwent colonoscopy .. the biopsies showed inflammation. So that,
these children were not just having a bad day, they weren't children with
nervous stomachs, rather, they had a real organic disease that related to the
symptoms parents were complaining about.
DR W: Now that was wonderful news in
a way, because, what it lead to was the potential for new treatments.
If you found nothing, there was nothing to treat. If you found
something, then there was something you could do to help
K: That's a critical point, because, the point of demonstrating there
was inflammation on the biopsies was so that you could then justify treating
them. If you find inflammation, then you have symptoms present. Then
it makes sense to try giving the patient an anti-inflammatory drug .. and ..
seeing if it helps their symptoms. And that has been our experience.
DR W: Clearly, that approach has worked
for many, many children. So that's great news. But now, really
exciting news. You've taken it to a whole new level using the most
sophisticated technology available to do what?
DR. K: We subjected the biopsies, the
inflamed intestinal biopsies of autistic children, we've subjected them to
high-tech analysis, using the technique of "microarray analysis", which studies
the molecular components that are produced by inflammatory cells. We are
now looking for the products, the molecular products of those cells .. and ..
the molecular products of those cells have distinct
DR W: So, the genes that are switched on
or switched off effectively
DR K: Correct, correct. Not so much that
it's a genetic disease.
DR W: That's a very important point to
make, isn't it? A lot of money has gone into pure genetic research.
That is not what this is.
DR K: Right,
DR W: This is saying ..these are those
that are part of the disease, these are the ones that are switched on .. these
are the ones that may be helping to drive the disease process .. and .. these
are the ones turned off .. maybe protective for example.
DR K: Yes, yes. The paper should
not be interpreted as meaning that autism is genetic.
DR W: So, tell me a little bit about the
groups that you looked at?
DR K: We had our study group .. the
children with autism, chronic gastrointestinal symptoms, who underwent
clinically indicated illeo-colonoscopy were found by the pathologist to
have non-specific inflammatory prescence in their illeum or colon. We
compared this group to non-autistic children who underwent colonoscopy and
ultimately were not found to have any diagnosis. The second control
group was non-autistic who had Crohn's disease confirmed on their
biopsy. The third control group was non-autistic children who were
found to have ulcerative colitis.
DR W: So, in other words, is there an
inflammatory bowel disease in these children? Number one. And,
number two .. is it different from the signatures in known inflammatory bowel
disease, such as, Crohn's and colitis? Is that
DR K: Yes, yes.
DR W: A novel
DR K: A novel disease. Either
a novel disease .. or .. an emerging disease .. perhaps ...
DR. W: So, an early stage, for example,
say crohn's disease?
DR K: Yes, exactly.
DR W: What did you
DR K: Using microarray technology ..
what we found was .. the molecular products of the inflammatory cells in
the autistic kids was not normal. The normal patients .. when you took
those bowel biopsies and you took a look at the variety of different molecules
that were produced by those cells on the biopsies, they cluster in one
area. When you took the biopsies of autistic children with G.I. symptoms
and inflammation on biopsies .. they clustered in a second area .. and .. when
you took the bowel biopsies of non-autistic crohn's and colitis patients .. they
tended to cluster in a third area .. over-lapping each other. What was
very interesting was that .. although the autistic children biopsies clustered
in their own region, there was significant overlap with the crohn's and
ulcerative colitis. But, virtually no overlap at all with the normal
non-inflamed, non autistic children.
DR W: Now tell me, did you look at
different areas of the bowel or were you looking at just one
DR K: We were looking at both illeum,
terminal illeum and the colon.
DR W: And you found similar
DR K: Yes, we found the colon biopsies
that were inflamed were just as dissimilar to normal tissue as the inflamed
illeum biopsies were to normal illeo tissue.
DR W VOICEOVER:
"So .. what this is telling us is there is a
large number of genes that are behaving differently, that are switched on or
switched off in children with autism .. when compared to other control
DR W: Fascinating findings. I mean
here we are some fifteen years on from the original work and confirmed beyond
doubt there is an inflammatory disease that may have unique characteristics in
these children with autism.
DR K: The pediatric team at Wake Forest
was exceptionally helpful .. that's what really enabled us to provide data that
is very, very meaningful.
DR W: They must feel immensely
reassured. That the open-minded gastro-enterologists who went into
this, provided the samples you needed to test our hypothesis .. and
.. now a very important publication coming out.
DR K: Correct .. and .. .the parents of
course, the parents of these children who've always been saying this for so
long. They feel very gratified and .. again .. their observations are being
DR W: They's been saying this for years
.. and .. they were absolutely right.
DR K: The issue of bowel disease,
inflammatory bowel disease, got to caught up with political issues, public
health issues and controversies, financial issues .. that it poisoned the
whole concept. The idea there might be an inflammatory bowel disease
that's unique to these children was tossed aside. Primarily by
people in the media that influenced the desire of scientists to pursue this
avenue of thought.
DR W: So Arthur, in summary, fascinating
new finding, confirmation that there's a bowel disease in children with autism,
with gastrointestinal symptoms .. and .. they have all the appearances of being
either new or a precursor of something like crohn's disease or