Wakefield's research

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

By Ann Roser

Updated: June 6, 2006

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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