Tag Archives: Andrew Wakefield

Autism is linked to gut problems (so sorry, Andy Wakefield)

Of all the persecuted Brave Maverick Doctors in WDDTY’s pantheon, none is more Brave or indeed more Maverick than Saint Andrew of Wakefraud.

Put simply, WDDTY desperately wants Wakefield to have been right, and will miss no opportunity to rewrite history in the service of this delusion.

As much as the medical community likes to discredit Andrew Wakefield for his theory about the MMR link to autism, research keeps supporting his central argument: autism is somehow related to the gut.

The medical community doesn’t like to discredit Wakefield. It doesn’t like discrediting anybody. Wakefield is discredited because he published fraudulent research with an undeclared conflict of interest, and because he conducted invasive tests on vulnerable children without proper ethical approval.

These are not small things. In any other doctor, they would cause WDDTY to lead the march with pitchforks and burning torches. Wakefield gets a free pass for these gross ethical violations only because his research serves the anti-vaccine agenda of WDDTY.

The latest has discovered that children with persistent gastro-intestinal (GI) symptoms are more than twice as likely to be autistic.

While this may be accurate, it is evidence of correlation not causation and it does not validate Wakefield’s fraudulent research, because Wakefield’s fraudulent research was designed to provide support for a legal action claiming that the MMR vaccine was the cause of autism, whereas the new research has nothing to do with vaccines.

The purported link between vaccines and autism – “the most damaging medical hoax of the last 100 years” – is refuted. This paper not only doesn’t overturn that, it doesn’t even address it.

It is extremely unlikely that any new research will prove a causal link between gut problems and autism, because autism has a strong genetic component, so gut problems are more likely to be co-morbid.

The risk dramatically increases in children who suffer from regular constipation, or food intolerance or diarrhea between the ages of six months and three years, say researchers from Columbia University’s Mailman School of Public Health.

Did you notice how this refutes the Wakefield claim that autism is caused by “measles enterocolitis” due to the MMR vaccination? The first MMR dose is at 12-15 months.

WDDTY “forgot” to mention that. They also “forgot” to mention that the paper has no mention of measles.

Although the connection is apparent, not all children with GI problems will go on to develop autism, any more than autistic children will necessarily have gut issues, cautions lead researcher Michaeline Bresnahan.

Well, duh. Most children will have at least brief periods of GI symptoms at some point, after all.

In this large prospective cohort, maternally reported GI symptoms are more common and more often persistent during the first 3 years of life in children with ASD than in children with [typical development] or [developmental delay].

No mention of a causal relationship, even speculatively.

Nonetheless, it was one of the key discoveries of Andrew Wakefield, who surmised that the MMR vaccine could be triggering the GI problems in the first place.

It wasn’t a “discovery” and this paper doesn’t say it’s a trigger.

Even Faux News did better, with the headline “frequent gastrointestinal issues may be early sign of autism”.

But you know WDDTY: any facts have to be beaten into compliance with their editorial agenda.

(Source: JAMA Psychiatry, 2015; doi: 10.1001/jamapsychiatry.2014.3034)

Note that any substantive finding of a causal link would not come form a psychiatry journal.

WDDTY repeats hysterical anti-abortionist propaganda. Again.

WDDTY appear to be losing their marbles – perhaps they should nip down to the homeopath for some 30C Batshittium?

Back in October 2014 they ran “Autism ‘caused by MMR using human fetal cell lines’“, an entirely credulous repetition of a paper written and funded by a rabid anti-abortionist group, “showing” that foetal cell lines in MMR caused autism. Never mind that studies totalling over twenty million subjects fail to show any correlation, let alone cause, and please, oh please, don’t “follow the money” to the ideology-driven funding.

January 2015 contains the same story. It uses the same hyperbolic description – “major new study”, even though it’s no longer new and never was major. I tried to find out how often it had been cited, but drew a blank because the paper is not indexed on PubMed, and it’s not indexed on Google Scholar either, other than sowing up on “Liberation Chiropractic”.

Why is this “major new study” not showing up in the indexes?

The answer is right there in plain sight on the journal’s About page:

Manuscript Handling Fee
The manuscript handling fee for JPHE is $650 (USD).

Yup. JPHE is a predatory open access journal. The ideology-driven authors paid to have their ideology-driven conclusion-first research published. That’s why Orac found it so easy to shoot it full of holes.

The explosion in cases of autism has been caused by the introduction of human foetal cell lines in the manufacture of MMR (measles-mumps-rubella) vaccines, a major new study has concluded. Before 1987, when the vaccines were produced using animal cell lines, autism cases were relatively low. Today, it’s been estimated that one in 50 children has autism.

That would be significant if it were true. But the authors are Catholic fundamentalist anti-abortionists who run a group whose stated aim is to oppose the use of foetal cell lines, and it’s in a journal where you pay to get published, which is not indexed in PubMed. It is a junk study with massive and disqualifying conflicts of interest in a junk journal, and WDDTY have trotted it out not once but twice. Why?

Oh wait: Deisher has also spoken at Autism One, the anti-vax love-in where Wakefield is the saint du jour for every jour.

Stem cell researcher Theresa Deisher and others say that the correlation between the sudden explosion in autism cases and the introduction of the new MMR vaccines is too strong to ignore – although, as the old maxim goes, correlation doesn’t prove causation.

The “others” are all associated with the same fundamentalist group. There is literally no evidence at all of any independent support for this conjecture.

Meanwhile, even Catholics have a problem with this ideologically motivated tripe.

The “change point” – when the numbers of autism cases rose sharply – happened in the UK in 1987, just when the new MMR vaccine, using human foetal cells, was introduced. A similar correlation was seen at around the same time in Denmark, while the autism change point in the US was in 1980-1981, after the introduction of the new Meruvax and M-M-R II vaccines in 1979 – both of which used human foetal cells for the first time.

Has autism prevalence changed? Not in two decades it hasn’t. So what has changed?

In December 2014, Andrew Wakefield’s vexatious lawsuit against Fiona Godlee, the BMJ and Brian Deer ran out of time, after Wakefield failed to provide evidence for its continuation.

SO it’s likely that dear Lynne, bless her black antivaccinationist heart, is keeping the flame alive by promoting the only thing on her desk that had anything close to credulibility.

A happy new year to all our readers. May it be WDDTY’s last.

h/t @LennyLaw for the tipoff. Thanks!

Wakefield was right! Or not

Autism-bacteriaAndrew Wakefield is a figure who polarises opinion.

To quacks, cranks, and especially antivaccinationists, he is a Brave Maverick Doctor who blew the whistle on the vaccine industry and found the One True Cause of autism.

To the reality-based community he is an unethical quack, struck off for dishonesty and conducting invasive experiments on vulnerable children without proper consent or ethical oversight, reviled for publishing fraudulent research without declaring massive conflicts of interest, and demonised as a significant cause of a resurgence in measles leading to permanent harm and even death.

You might be able to guess which camp we fall into.

Antivaccinationists desperately want Wakefield to be right, even though he wasn’t. So any study showing any kind of link between intestinal disorders and autism is portrayed as vindication, regardless of the actual facts.

In this short piece WDDTY seek to vindicate Wakefield by reference to a study, Reduced Incidence of Prevotella and Other Fermenters in Intestinal Microflora of Autistic Children, Kang et. al., PLoS ONE, 2013; 8: e68322.

“We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described” – Wakefield et. al, 1998

The first thing to note is that the PLoS ONE article does not cite Wakefield’s work. Some will think this is because Wakefield is a pariah, others will know that his work has been retracted so won’t be cited, but the real reason is that the finding has absolutely nothing to do with Wakefield’s hypothesis.

Say it quietly, but the first part of maligned doctor Andrew Wakefield’s theory about the MMR (measles–mumps–rubella) vaccine and autism has been proved right: autistic children do have low levels of three critical bacteria in their gut.

No! Not even close. Wakefield’s claim was that autism is caused by “autistic enterocolitis” triggered by the MMR vaccine. You don’t have to take my word for it, the full text is available on The Lancet website (free registration required). No part of Wakefield’s paper is in any way supported by the new work!

Doctors know that autistic children usually have a range of gut problems, so researchers at Arizona State University decided to find out if it was more than a coincidence. They analyzed the gut flora of 20 autistic children aged between three and 16 years and compared them with samples from 20 typical non-autistic children. The autistic children had fewer types of gut bacteria in general and were also low in three critical varieties: Prevotella, Coprococcus and members of the Veillonellaceae family. Of these, Prevotella species are the most important as they play a vital role in gut interaction.

This is entirely unrelated to Wakefield’s claims, which in any case were admitted in the paper (though not by implication in his grossly irresponsible press statement) not to be provably causal:

“We identified associated gastrointestinal disease and developmental regression in a group of previously normal children, which was generally associated in time with possible environmental triggers.”

The triggers were identified as MMR in eight cases and measles infection in one. And the claims were quite specific:

Onset of behavioural symptoms was associated, by the parents, with measles, mumps, and rubella vaccination in eight of the 12 children, with measles infection in one child, and otitis media in another. All 12 children had intestinal abnormalities, ranging from lymphoid nodular hyperplasia to aphthoid ulceration. Histology showed patchy chronic inflammation in the colon in 11 children and reactive ileal lymphoid hyperplasia in seven, but no granulomas. Behavioural disorders included autism (nine), disintegrative psychosis (one), and possible postviral or vaccinal encephalitis (two). There were no focal neurological abnormalities and MRI and EEG tests were normal. Abnormal laboratory results were significantly raised urinary methylmalonic acid compared with agematched controls (p=0·003), low haemoglobin in four children, and a low serum IgA in four children.

The research was funded by a payment of £55,000 to the Royal Free Hospital by a firm of lawyers engaged in preparing a suit against the manufacturers of the MMR vaccine. It subsequently emerged that a further £400,000 had been paid to Wakefield himself. The lawyers also recruited some of the children in the study. None of this was declared in the published output.

It has also subsequently emerged that the PCR tests that Wakefield claimed identified measles virus in the gut of autistic children, was the result of contamination.

So Wakefield’s thesis was:

  • Autism is caused by enterocolitis
  • This enterocolitis is triggered by the measles virus

Both of these claims are wrong. And the PLoS ONE study does not in any way challenge that. In fact even Wakefield’s own original paper does not support it, it contains the following statement:

“We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described”

The PLoS ONE paper does not find evidence of measles virus in the gut, or of a form of enterocolitis. It doesn’t use the term enterocolitis. the signature features claimed by Wakefield et. al include lymphoid nodular hyperplasia and aphthoid ulceration. Neither of these is mentioned in the PLoS ONE paper. The PLoS ONE paper mentions PrevotellaCoprococcus, and unclassified Veillonellaceae. Wakefield et. al. make no mention of these, its only mention of bacteria is screening for evidence of campylobacter, salmonella, shigella and yersinia – in other words specifically ruling out bacteria as a cause of the purported enterocolitis. No mention is made of the level or makeup of gut flora.

It does not claim to find a causal relationship, in fact it states that:

[T]he direction of causality among interconnected pathophysiological factors (e.g., autistic symptoms, diet patterns, GI symptoms, and gut microbiome profile) is still unclear

It does not identify a distinct “autistic enterocolitis”, but a “relatively low level” of gut flora, specifically a reduction in diversity.

It concludes:

In summary, we demonstrated that autism is closely associated with a distinct gut microflora that can be characterized by reduced richness and diversity as well as by altered composition and structure of microbial community. Most notably, we also discovered that the genera PrevotellaCoprococcus, and unclassified Veillonellaceae were significantly reduced in autistic children. Unexpectedly, these microbial changes were more closely linked to the presence of autistic symptoms rather than to the severity of GI symptoms and specific diet/supplement regimens. Despite limited information on the direction of causality among autism, diet, GI problems, and microbiome profiles, the findings from this study are stepping-stones for better understanding of the crosstalk between gut microbiota and autism, which may provide potential targets for diagnosis or treatment of neurological as well as GI symptoms in autistic children.

To infer from this that Wakefield is in any way vindicated, is to engage in wishful thinking of the most fanciful kind. The two are related only in as much as they both involve the gut – and given the drivers for Wakefield’s work this is almost certainly pure coincidence.

What Doctors Don't Tell You
Why don’t doctors tell you that new research vindicates Andrew Wakefield?

Because it doesn’t.

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Andrew Wakefield was right, autism is linked to gut problems

The Wakefieldites, with WDDTY of course in the vanguard (though of course they are not in the least bit anti-vaccinationist), are crowing like mad things, thanks to a paper that appears to link autism to gastro-intestinal problems.

Wakefield was right, autism is linked to gut problems, is the crowing headline in WDDTY.

Does it stand up to scrutiny?

As the discredited Andrew Wakefield observed years ago, children with autism are far more likely to suffer gastro-intestinal (GI) problems such as constipation, diarrhea and food sensitivities. In fact, autistic children are eight times more likely to suffer from a gut upset, researchers report this week.

No, he didn’t observe this, he set out to find a link between measles and autism; I believe he used the term “measles enterocolitis”, also “autism enterocolitis”, a medically unrecognised term then as now.

Although Wakefield mooted that the MMR vaccine could be triggering GI problems—and was struck off for his troubles—researchers from the University of California are more non-committal, and say they don’t know the cause.

No, he was struck off for three dozen violations including four counts of dishonesty and 12 counts involving the abuse of developmentally challenged children.

The GMC panel ruled that Wakefield had “failed in his duties as a responsible consultant”, acted both against the interests of his patients, and “dishonestly and irresponsibly” in his published research.

Nonetheless, the association is there, as the researchers found when they examined a thousand autistic children. The children were six to eight times more likely than a non-autistic child to have a GI problem, which is linked to autistic behaviour such as social withdrawal, irritability and repetitive behaviour.
(Source: Journal of Autism and Developmental Disorders, 2013; doi: 10.1007/s10803-013-1973-x)

Source: Journal of Autism and Developmental Disorders November 2013 Gastrointestinal Problems in Children with Autism, Developmental Delays or Typical Development Virginia Chaidez, Robin L. Hansen, Irva Hertz-Picciotto

Wakefield claimed to have found measles “DNA” in the gut of the children whose samples he took (without proper consent), but measles is an RNA virus and his claimed link was stated in court by the appropriate experts to be evidence of contamination.

Was Wakefield right? No. If there is a link, this paper does not show it to be the one he proposed, and the offences for which he was struck off were ethical, not related to the validity of his research anyway.

It remains the case that an enormous statistic exercise has consistently failed to show any link between MMR and autism. Autism diagnosis rates vary independently of MMR vaccination rates.

As usual, the anti-vaccinationists are adapting facts to fit their pre-existing hypothesis. As usual, science will adapt its consensus view to the new information. This early finding does give some grounds for thinking that autism and persistent GI problems may share a common cause, possibly an autoimmune syndrome, but that is speculation at this stage.

What Doctors Don't Tell You
Why don’t doctors tell you that new research vindicates Andrew Wakefield?

Because not only does it not vindicate his claims, it cannot vindicate his unethical and fraudulent behaviour.

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