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National Autism Association Can't Defend Andrew Wakefield

Of the groups pushing the vaccines-caused-an-epidemic-of-autism idea, the National Autism Association stands out. In a good way. They are the one group that actually has a non-vaccine segment to their agenda.

They presented recently at the IACC on issues of safety. Unfortunately, they are stuck in the vaccine-causation debates of 10 years ago. Case in point: coincident with the lifting of the embargo on the BMJ’s pieces on Andrew Wakefield (e.g. How the case against the MMR vaccine was fixed) the NAA put out a statement defending Mr. Wakefield. (National Autism Association Says BMJ Article is Yet Another Attempt to Thwart Vaccine Safety Research)

As a part of this defense, they claim that Mr. Wakefield’s research has been replicated. The claim has been made before and upon scrutiny shown to be false. They use 5 references:

(1) Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms, Arthur Krigsman, MD, et al, New York University School of Medicine, Autism Insights, 27 Jan 2010

(2) Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms. Gonzalez L, et al. ArchVenez Pueric Pediatr, 2005;69:19-25.

(3) Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsulenteroscopy: Another piece in the jig-saw of the gut-brain syndrome? Balzola F, et al. American Journal of Gastroenterology. 2005. 100(4):979-981.

(4) Childhood autism and eosinophilic colitis. Chen B, Girgis S, El-Matary W.. Digestion. 2010;81:127-9. Epub 2010 Jan 9].

(5) Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report, Timothy Buie, MD, et al, Department of Pediatrics, Harvard Medical School Pediatrics, Vol. 125 Supplement January 2010

Taking a lead from Catherina at JustTheVax, who showed last year that the “replication” of Mr. Wakefield’s results was not independent nor a replication, I will take a look at the 4 papers which are purported to “confirm” and association between autism and bowel disease.

1) A paper by Arthur Krigsman in Autism Insights. Arthur Krigsman was one of Andrew Wakefield’s partners at Thoughtful House when he wrote this. Both have since left. Autism Insights is an online journal whose editors include Dr. Krigsman himself. At the time Dr. Krigsman’s paper was published, the editorial board also included Andrew Wakefield. (strangely, Mr. Wakefield is no longer listed on the editorial board). Hardly independent. Right now, Autism Insights has 18 editors. They also have 8 published papers. Yes, they have twice the number of editors as papers. One has to question if this is a real journal. The Krigsman paper was timed to come out to support Andrew Wakefield at a time when his press was quite poor. Not a replication.

2) Gonzalez, et al.. From JustTheVax:

Gonzales et al, number 2, has been published in “Arch Venez Pueric Pediatr” which stands for Archivos Venezolanos de Puericultura y Pediatría. It was a bit tricky to get my hands on the paper, especially since the citation was not quite right, but I did manage and was not surprised to find that indeed the authors cannot replicate Wakefield’s 1998 “findings” of a distinct autistic enterocolitis, although they do report a higher incidence of gastrointestinal problems in their autistic group.

3) Balzola, et al.. Again, from Catherina:

Balzola et al, number 3, is a case report of one adult autistic patient with inflammed bowel.

4) Chen, et al.. Here’s the abstract, which spells out a rare association in 2 children, with possible mechanisms that may connect the two.

BACKGROUND/AIMS: The significance of the association between many gastrointestinal pathologies and autism is yet to be discovered. The aim of this report is to highlight an association between autism and microscopic eosinophilic colitis in 2 children. The possible mechanisms that may connect these two conditions are discussed.

METHODS AND RESULTS: A rare association between autism and microscopic eosinophilic colitis in 2 children is reported through retrospective chart review. Common causes of secondary eosinophilic colitis were excluded.

CONCLUSION: This report suggests the possibility of either impaired intestinal barrier function or an aberrant immune system that predisposes autistic children to sensitization to environmental antigens. Large controlled studies are needed to examine this hypothesis.

5) Bui, et al.. Here is the paragraph in that paper discussing Mr. Wakefield’s work:

In 1998, Wakefield et al. reported an association between ileocolitis and developmental regression in 12 children and coined the term “autistic enterocolitis.” From the same uncontrolled study they reported NLH of the ileum and colon as an abnormal finding in most children with ASDs. However, similar findings are known to be present in children with typical development, as well as children with food allergies and immunodeficiencies. The significance of these findings, therefore, is unclear. Wakefield et al. also proposed a causal relation between measles, mumps, and rubella (MMR) vaccination and autism, a suggestion that was later retracted by many of the original authors.

None of these papers is a replication of Mr. Wakefield’s work. And this is the best that the NAA can do to support Mr. Wakefield’s work, given 12 years of research since his paper in the Lancet. It also avoids the very clear problem with trying to “replicate” or “confirm” work that was fraudulent to begin with.

What is even more strange is that the NAA goes on in their piece to discuss the hypothesized link between autism and vaccines. Strange because Mr. Wakefield has been strenuously distancing himself from the impression that his paper “proved” a link between autism and vaccines.

Mr. Wakefield’s work was fraudulent. The BMJ says so in clearly and conclusively. It is time for some autism parent organizations to distance themselves from this man and his work. They are doing themselves and the autism communities as a whole any good by further association with him.

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