Wednesday, September 3, 2008

NOW is it over?

Since not all of my readers are often aware of all the scientific goings-on in the world of autism study and research, I would be doing a disservice by failing to mention the most recent important study that looked at the hypothesized link between vaccines (in this case the MMR, not to be confused with the now-defunct mercury causation concept) and autism.

More specifically, this study looked at the long-held position that (follow me here) Measles/Mumps/Rubella vaccine causes autism by creating a persistent measles-virus infection in the gut of the affected individual - termed "autistic enterocolitis" - which, in turn, causes the individual to manifest autistic behaviors, perhaps due to the opioid excess theory. This is the entirety, and half of another, of the three causation concepts being advanced in the Autism Omnibus Proceeding currently (and for the past 2 years) underway in the VICP in our nation's capitol.

To offer a brief summary, the study adds to the body of knowledge that the MMR vaccine has no relation to autism.

A couple of things make this study somewhat more palatable to the broader autism community than the numerous others that have arrived at the same conclusion. One is that a major contributor to this study - indeed half of the presenting research team - is one Dr. Mady Hornig. Dr. Hornig is (in)famous for her studies on "SJL Thim" mice in which she supposedly induced autism via thimerosal exposure. The mice literally chewed through each other's skulls, which was construed as being an "animal model" for autism. Go figure.
(Author's note: Neither of my two autistic children have attempted to chew on anyone else's skulls, including each others'. Knock on wood.)
So Mady Hornig - a veritable "celebrity" of the vaccine/autism research pantheon - is now stating with certainty that the MMR is not to be considered a culprit in autism causation. Of course, one hero of the autism/vaccine movement turning to the "dark side" as a result of this study is easy to explain away if the resulting cognitive dissonance is too great to bear. But two?

Yes, two. Rick Rollens was present at the press conference. Although his comments (which I can only reference in a limited context, as I did not have access to the presser itself) do not directly address what the study authors have found to be the most significant findings, they instead are intended to perpetuate the controversial causation hypotheses.
The following quote, a real "study finding", is by study co-author Ian Lipkin of Columbia University:
"We found no difference in children who had GI complaints and no autism and children who had autism but no GI complaints,..."
Rick Rollens' presence - especially considering his personal, political, and financial largesse in directing funding away from needed services and toward the vaccine causation hypotheses - at the press conference certainly implies a tacit approval of the findings. Few people have more personal or emotional investment in the erroneous, yet dominant, theory. As opposed to arguing against the study results, Rick redirects the topic away from vaccines which, frankly, may be the appropriate thing to do - even if it is a dodge.
Let's please remember that this is not "new" information, per se, but instead is a further confirmation of what has already been accepted by the broader scientific community after numerous studies achieving the same (via different methods) result. Here is, in contrast to the above quoted statement by Ian Lipkin, one of Mr. Rollens' statements from the teleconference:

"No longer can mainstream medicine ignore parents' claims of clinically significant GI distress," said Rick Rollens, a parent and autism research advocate.

He commended the researchers for their work but said, "This study by itself does not exonerate the role of all vaccines."

Well, no, this study doesn't exonerate all vaccines - it was not designed to do so. But seeing as the theories espoused by the vaccine/autism crowd have been centered on two theories (MMR or TCV's/Mercury), that not one shred of good science has supported these theories, that little tangible benefit to a single individual with autism has resulted from these theories, and that the whole topic doesn't amount to a hill of beans in the quality of life for my two autistic sons, I am of a mind to continue to focus on whatever will create the best likelihood of positive outcome for all autistics and not let the festering vaccine causation theories prevail.

Lets all understand that this ongoing and falsely contrived crusade against public health, regardless of what is motivating it and who is perpetuating it, is drawing crucial resources and attention away from the truly pressing issues that the autism community should be addressing. Issues such as housing for adults, societal inclusion, promoting ways and means that autistics can be impactful in a positive way in their communities and microeconomies, identifying and implementing appropriate means to ensure physical and mental health at all stages of life for autistic people. So I ask about the autism/vaccine connection - NOW is it over?

Please read here, here, and here for much more through reviews of this important research result.

Edit: And here is a link to some audio from the conference.

10 comments:

María Luján said...

Hi Steve
Are you really really sure? Things are much more complicated that how they have been presented and the questions have not been done properly, IMO, considering what is known today (about RNA virus and host nutritional status to begin with).

Steve D said...

Hi Maria -
On the level at which you tend to analyze these things, I am sure there is much room for remaining complexity.
At the level of public health concerns during a time of decreasing vaccination uptake and a resulting increase in dangerous disease, I think this is a sound finding that simply adds to the existing evidence that MMR and autism are not related.
Are you implying that the study has no value? Do you believe convincing science exists that supports an MMR causation theory?
This study directly contradicts the findings by Wakefield et al. which originated the hypothesis. Since then, that specific study has been discredited and its findings are no longer considered valid. This current research finding simply confirms - with finality - that the original findings were erroneous.
What, then, is left of the MMR/Autism connection, aside from parent-sourced anecdotal evidence?

Mary said...

Hi Steve

I hope your kids are doing well. :) I, too, hope we can cure autism soon.

While I don't feel strongly one way or the other on whether or not MMR has caused autism, I do question the study a bit. I think it was set up well, executed well, but it was severely limited in size. I would love to see it repeated on a much large scale. That would give it finality to me. A sample set of 25 and a control set of 13 is really small, especially given the number of people affected by autism each year. I would have been worried as a researcher that I would find 2 in the sample set and 0 in the control set and suddenly everyone would jump to the opposite conclusion -- that there is a causal link when maybe there isn't.

As for the parental-sourced anecotal evidence, you really can't discount that completely either. Just because science hasn't determined the mechanism of the relationship, doesn't mean no relationship exists. Maybe we just have figured it out yet.

Steve D said...

Hi Mary -
"I, too, hope we can cure autism soon."
Actually, I don't take a position on an autism cure since one does not currently exist. I'll cross that philosophical bridge if I ever come to it. In the meantime, I'll focus on ways to enhance the lived experience of autism for those who are autistic (lots of ways to do that).

"While I don't feel strongly one way or the other on whether or not MMR has caused autism, I do question the study a bit. I think it was set up well, executed well, but it was severely limited in size. I would love to see it repeated on a much large scale. That would give it finality to me."
I don't have a desire for MMR to cause or not cause autism, but I do have a desire that resources are allocated toward fruitful ends. The relentless pursuit of vaccine causation hypotheses passed the point of being fruitful long ago.
As far as sample size, have you considered the challenges in increasing the sample size. Wakefield's original study included, I believe, 8 or 9 kids (without parental consent, I might add). So this is a big improvement. But for ethical reasons, they only used subjects who were already determined to have serious enough GI issues to merit colonoscopy - a highly invasive procedure. So hitting the ideal sample size is a virtual impossibility in this case.

"As for the parental-sourced anecotal evidence, you really can't discount that completely either. Just because science hasn't determined the mechanism of the relationship, doesn't mean no relationship exists. Maybe we just have figured it out yet."
I don't discount anecdotal evidence at all. Neither did the scientific community, as the temporal relationship b/t vaccines and autism as identified by parents are part of what caused vaccines to be questioned - and then studied. The thing is, many studies have now been performed, none of which support the link (except the thoroughly unethical and discredited Wakefield study). Both epidemiological data and "hard" science have failed to validate the theory.
There comes a point when we must understand that the null hypothesis is the correct position and to move on to areas with greater promise.
With the MMR, we have - again - reached that point.

Thanks for commenting on my blog.

Club 166 said...

NOW is it over?


Ha Ha Ha Ha Ha Ha Ha Ha!!!!!

Steve, you're SO funny!

Joe

Sullivan said...

A sample set of 25 and a control set of 13 is really small, especially given the number of people affected by autism each year.

How many are undergoing these invasive procedures in any one area? Ethically, they were limited to only studying those patients where data could be taken "piggyback" to already approved procedures.

Also, the idea of statistical power was addressed at the press conference. They noted that the Wakefield/Uhlman study indicated 77% positives. This Hornig study has the power to clearly say yes or no to that.

Yes, it is a small group. But, it also highly targeted: looking at specifically children with GI disorders and regression. I.e. it is doing exactly what Bernadine Healy said the research community is "afraid" to do: test the kids that got sick.

María Luján said...

Hi Steve-you have an e-mail.
Hi Sullivan
I have several concerns about the questions that the authors wanted to answer with this study.
Well, could you please clarify me what the authors wanted to do for you?
To test for measles Edmonton vaccinal RNA genoma persistence using the primers of vaccinal Edmonton strain injected with the MMR- in selected parts of the gut?
How do you understand persistance- replication of viral genoma and expression of viral proteins?
Do we agree?

AutisticDad said...

Finally a test that seems to have passed the conspiracy test. I wish there were more numbers involved, but it was well done and can be trusted. Time to move onto other ideas, but review this if new scientific information becomes available in the future.

Anonymous said...

The question still stands unanswered.

http://unherdof.wordpress.com/2008/09/05/mmr-exonerated-not-yet/

Pam said...

I think the biggest concern is:
In the current CDC study, only a small subgroup of children was the correct phenotype to study. From page 7, "Only 5 of 25 subjects (20%) had received MMR before the onset of GI complaints and had also had onset of GI episodes before the onset of AUT (P=0.03)." The other 20 autistic children in the study had GI problems but the pathology developed before the MMR vaccine. Additionally, the controls all received the MMR vaccine and had gastrointestinal symptoms. The controls should have been free of exposure to vaccine measles in order to make a comparison relevant for purposes of causation.