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New Research on Autism Points to a Novel 'Gut' Disease in Some Kids

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New York Times Syndicate

By Ann Roser

Sunday, October 31, 2004

AUSTIN, Texas -- A maverick British scientist who now works in

Austin has

completed a new study on autism that links the disease to a novel

intestinal

illness.

The research, which will be published in this month's issue of the

Journal

of Clinical Immunology that is expected to come out today, opens the

door to

testing treatments for some autistic children, including a diet that

forbids

dairy products and certain grains.

Dr. Andy Wakefield, whose earlier work caused a furor by suggesting

an

association between a common childhood vaccine and autism, said he

considers

the latest research groundbreaking.

The study by Wakefield and three collaborators builds on previous

research

connecting autism and the gut.

But it goes several steps further: It identifies a new inflammatory

intestinal disease in some children who appear normal but regress

into

autism; it suggests the intestinal disease is viral, thus giving

clues about

the nature of this type of autism; and it provides new targets for

treating

autism in some children.

" This now gives us the basis of what is driving that disease and

what we can

do to treat many children " who regress into autism, said Wakefield,

who is

setting up a research, education and treatment center for autistic

children

in Austin called the Thoughtful House.

" We hope this will form the basis for a new clinical trial. "

Nationally

known autism expert Dr. Buie, a pediatrician specializing in

gastrointestinal disorders at Massachusetts General Hospital for

Children,

called the research a welcome extension of Wakefield's earlier work

into the

relationship between autism and gastrointestinal symptoms, such as

constipation and diarrhea. Buie is among the researchers studying

bowel

disease and autism, but he said it's too early to gauge the

significance 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 and

interact

with others. Some type of autism is diagnosed in one in 166

individuals,

according to the U.S. Centers for Disease Control and Prevention.

According

to the Autism Society of America, rates are soaring and could rise

from 1.5

million Americans to 4 million in the next decade.

Autism is classified as a neurological disorder, but scientists

don't know

what causes it or how to cure it.

Though the new research expands the understanding of autism in a

select

group of children, " the jury is still out " on whether it extends to

a larger

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 what

is

causing the autism. " Dr. Baskin, a professor of neurosurgery

and

anesthesiology at Baylor College of Medicine in Houston, said the

study

" adds to a growing body of knowledge concerning children with autism

and

poses 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 had

significantly 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. Their

parents

said the children functioned better, physically and mentally,

according to

the study. Those children also had fewer inflammatory chemicals in

their

intestines than those not on restricted diets, the study says.

The study recommends more research on the restricted diet. Autistic

children

across the country have been known to try it.

" It's really rather remarkable the differences I have seen in some

children, " said 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 said

Remicade, used

to treat Crohn's disease and rheumatoid arthritis, merits further

study.

The Food and Drug Administration issued warnings about Remicade

after it was

linked to lymphoma, malignancies and heart failure. Wakefield said

he didn't

want to mention the drug because he didn't want patients clamoring

for it

until it's been thoroughly tested for autism.

The gut's connection to the disorder has gained credence in the last

five to

10 years, Bell said, although people outside the autism community

might not

know that.

Wakefield said the study found that the type of gastrointestinal

illness the

autistic children exhibited, though different than other

inflammatory bowel

diseases, is " similar to what we would see in HIV patients. " " That's

important, " he said, " because it's a rationale for looking for a

viral cause

for autism. " Wakefield received international notoriety following a

1998

article he published in the Lancet, a prestigious British medical

journal,

in which parents reported that they thought the measles, mumps and

rubella

vaccine, known as MMR, could be linked to autism and a bowel disease

in some

children.

Though Wakefield said it was important to report what parents were

saying,

he insists he is a big vaccine supporter. However, he does favor

separating

the MMR into individual shots because the combination might harm some

children.

Earlier this year, 10 of the 13 authors of the Lancet report

disavowed the

interpretation that MMR might cause autism. Wakefield was not one 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 discuss

vaccines.)

The Lancet said it would not have published the 1998 study had it

known that

Wakefield was helping parents of autistic children gather scientific

information for a lawsuit over the MMR vaccine. The Legal Aid Board

in

England had paid the hospital where Wakefield worked $90,000 for his

help.

Wakefield said last week that he didn't get any money and didn't do

anything

unethical. Although some of the same parents in the lawsuit also were

involved in the Lancet study, Wakefield said, the Lancet paper was

not done

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 the

past 18 months, he said, and plans to open the Thoughtful House in

January.

The center will start with clinical services for autistic children

and will

gradually expand to a school. It also will do research studies.

Ann Roser writes for the Austin American-Statesman. E-mail:

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