Kirby and the 1 in 50 autism timebomb

[Guest guest]

http://www.huffingtonpost.com/david-kirby/the-next-big-autism-

bomb_b_93627.html

The Next Big Autism Bomb: Are 1 in 50 Kids Potentially At Risk?

Posted March 26, 2008 | 09:30 PM (EST)

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On Tuesday, March 11, a conference call was held between vaccine

safety officials at the US Centers for Disease Control and

Prevention, several leading experts in vaccine safety research, and

executives from America's Health Insurance Plans, (the HMO trade

association) to discuss childhood mitochondrial dysfunction and its

potential link to autism and vaccines.

It was a sobering event for all concerned, and it could soon become

known as the Conference Call heard 'round the world.

Buzz up!on Yahoo!The teleconference was scheduled by a little known

CDC agency called the Clinical Immunization Safety Assessment (CISA)

Network, a consortium of six research centers working

on " immunization-associated health risks, " in conjunction with the

CDC's Immunization Safety Office and the health insurance lobby --

whose companies cover some 200 million Americans.

The hot topic of the day was mitochondria - the little powerhouses

within each cell that convert food and oxygen into energy for use by

the body. Recent news events have implicated mitochondria in at least

one case of regressive autism, following normal development.

Some researchers on the call reported that mitochondrial dysfunction

is probably much more common than the current estimate of 1-in-4,000

people. The potential implications for autism, then, are staggering.

" We need to find out if there is credible evidence, theoretically, to

support the idea that childhood mitochondrial dysfunction might

regress into autism, " one of the callers reportedly told participants.

" THE CLOCK IS TICKING "

One person on the call (those interviewed for this article asked to

remain anonymous) told me that, " the CDC people were informed, in no

uncertain terms, that they need to look into this issue immediately,

and do something about it. " The clock is ticking, they were told, and

if they don't respond, the information will be made public.

Still, the doctor said, he was enormously impressed by

the " seriousness " with which CDC officials treated the possibility of

a link between mitochondria, autism and possibly vaccines as well.

In the recent landmark Hannah Poling case, filed in Federal " Vaccine

Court, " officials conceded that Hannah's underlying mitochondrial

dysfunction was aggravated by her vaccines, leading to fever and

an " immune stimulation that exceeded metabolic reserves. "

But on March 6, CDC Director Dr. Gerberding claimed that

Hannah's case was a rare, virtually one-of-a-kind incident with

little, if any relevance to the other 4,900 autism claims currently

pending in the court -- or to any other case of autism for that

matter.(There were conflicting accounts about whether Gerberding was

on the call or not).

Since then, however, Dr. Gerberding and other CDC officials were made

aware of a Portuguese study, published last October, which reported

that 7.2% of children with autism had confirmed mitochondrial

disorders. The authors also noted that, " a diversity of associated

medical conditions was documented in 20%, with an unexpectedly high

rate of mitochondrial respiratory chain disorders. "

" Apparently, the Portuguese study really got their attention, " one of

the participants said. " It's a highly significant finding. And it's

worrisome enough to definitely look into. I think the CDC people know

that. "

They also know that some reports estimate the rate of mitochondrial

dysfunction in autism to be 20% or more. And the rate among children

with the regressive sub-type of autism is likely higher still.

Vaccine safety officials on the March 11 call may have been open to

discussing mitochondria and autism, but they were probably highly

unprepared for what was to come next.

One doctor reported his findings from a five-year study of children

with autism, who also showed clinical markers for impaired cellular

energy, due to mild dysfunction of their mitochondria.

The biochemistry of 30 children was studied intensively, and in each

case, the results showed the same abnormalities as those found in

Hannah Poling, participants said. Each child had moderate elevations

or imbalances in the exact same amino acids and liver enzymes as

Hannah Poling.

All thirty children also displayed normal, healthy development until

about 18-24 months of age, when they quickly regressed into

clinically diagnosed autism (and not merely " features of autism " ),

following some type of unusual trigger, or stress, placed on their

immune system.

Researchers explained on the call that some data show that

mitochondrial dysfunction can convert into autism " in numbers that

make it not a rare occurrence, " one participant told me. They

explained this as " a distinct syndrome; not a mixed bag at all. Every

kid had mild mitochondria dysfunction and autistic regression. "

Another surprise came when one researcher announced an " inheritance

pattern " that linked each case through the genetics of the father: In

families where two cousins had autism, the genetic link was always

through the father.

This unexpected discovery would clearly implicate nuclear DNA

inheritance, and not mitochondrial DNA, which is inherited only

through the mother.

Gerberding and others had previously insisted that Hannah and her

mother, Teri Poling, both had the same single point mutation in their

mitochondrial DNA. CDC officials asserted that Hannah had a pre-

existing disease, a rare genetic glitch in her mitochondria, that may

well have manifested as " features of autism " on its own, perhaps even

without an environmental trigger.

" It's not in the mitochondrial DNA, and it's not rare, " one

participant confirmed. In fact, he said, many people probably carry

the nuclear DNA mutation that confers susceptibility to mitochondrial

dysfunction, they just don't know it.

1-in-50 GENETIC RISK?

On the call, speculation on the prevalence of a genetic mutation that

could confer mild mitochondrial dysfunction in the general population

ranged from about 1-in-400, to a staggering 1-in-50, or 2% of all

Americans.

There was talk about the urgent need to do mapping studies, and find

the locus of this gene. Some of the researchers said they want to

test all 30 children for the actual DNA mutation. There was some

expectation that they might discover that the mutation goes back

generations, so parents and grandparents might be tested as well.

One belief is that a particular mutated gene may have become

prevalent over the centuries, because of selective advantage. Mild

mitochondrial dysfunction reportedly has been associated with

intelligence, because it can increase activity of the brain's NMDA

receptors. A large number of receptors can produce increased

intelligence, but it can also increase risk of brain disease, one

doctor explained to me. It's possible that increased receptor

activity acts in same way.

But not everyone agrees that mitochondrial dysfunction is a purely

inherited affair. Some researchers believe that, while a

susceptibility gene for mitochondrial problems certainly exists, some

type of environmental trigger, or " adversity, " as one doctor put it,

is needed to turn the mutation into a dysfunction.

The medical literature is replete with studies on mitochondrial

health and the adverse impact of mercury, aluminum and other toxins.

Even AIDS drugs like AZT and prenatal alcohol consumption can damage

mitochondria and impact cellular energy.

The mercury-containing vaccine preservative, thimerosal, for

example, " can definitely kill cells in vitro through the

mitochondria, " one teleconference participant told me. " And some

people are beginning to suspect that the dose of hepatitis B vaccine

given at birth might be interfering with proper mitochondrial

function in certain children. "

While the cause of mitochondrial dysfunction is up for the debate, so

too is its potential effect on regressive autism.

All the researchers I spoke with agreed that, in many cases, there

was an underlying, asymptomatic mitochondrial dysfunction, aggravated

by some other stressful event imposed on the child's immune system,

resulting in autism.

Such " metabolic decomposition " occurs when a child's system

simply " cannot meet the energy demand needed to fight the stress of

illness, " one doctor explained.

But what causes the stress? That is a very big question.

Apparently, in only two of the 30 cases, or 6%, could the regression

be traced directly and temporally to immunizations, and one of them

was Hannah Poling. In the other cases, there was reportedly some type

of documented, fever-inducing viral infection that occurred within

seven days of the onset of brain injury symptoms.

All 30 of the regressions occurred between one and two years of age,

at a time when the still-developing brain is particularly vulnerable

to injury.

But if a significant minority of autism cases was caused by

mitochondrial dysfunction aggravated by common childhood illnesses,

then shouldn't we see fewer cases today than, say, at the beginning

of the 20th Century? And wouldn't developing countries likewise show

far more prevalence of autism than the United States?

Not necessarily, some experts said. They noted that many viral

infections are still quite prevalent in modern-day America, and many

children still get these types of viral infections about once a

month, on average.

If that is the case, then why doesn't every child with " mito "

dysfunction regress into autism? Surely, they must encounter viral

infections during their yearlong window of neurological peril.

Again, not necessarily: Some doctors said it would depend on the

severity of the dysfunction, the type of virus encountered, and

perhaps other factors that are still not understood.

But at least two of the 30 kids with mito deficiencies were pushed

over the edge into autism by their vaccines, and some researchers

feel the number is probably much higher than that in the larger

population.

" Vaccines, in some cases, can cause an unusually heightened immune

reaction, fever, and even mild illness, " one participant said. " A

normal vaccine reaction in most kids would be very different in a kid

with a metabolic disorder. We know it happened to at least two kids

in this study, and I'm certain there are many more Hannahs out there. "

One theory currently in circulation about what happened to Hannah and

other children like her, is an apparent " triple domino effect. "

According to this hypothesis, it takes three steps and two triggers

to get to some types of autism, and it goes like this:

STEP ONE: Child is conceived and born healthy, but with an underlying

nuclear DNA genetic susceptibility to mitochondrial dysfunction,

inherited from dad.

TRIGGER ONE: An early environmental " adversity " occurs in the womb or

during the neonatal period, perhaps caused by prenatal exposure to

heavy metals, pollutants, pesticides and medicines. Or, it occurs in

early infancy, through environmental toxins, thimerosal exposure, or

even the Hepatitis B vaccine " birth dose. " This trigger results in:

STEP TWO: Child develops mild, usually asymptomatic mitochondrial

dysfunction (though I wonder if the ear infections and eczema so

common in these cases might also be symptoms of mito problems).

TRIGGER TWO: Child, now with an underlying mitochondrial dysfunction,

suffers over-stimulation of the immune system beyond the capacity of

his or her metabolic reserves. This stress is either via a viral

febrile infection, or from multiple vaccinations, as in the Poling

case. This trigger results in:

STEP THREE: Acute illness, seizures, encephalopathy, developmental

regression, autism.

Such a scenario might help explain why autism has increased right

along with the addition of more vaccines to the national schedule.

And it might help explain why autism rates are not plummeting now

that thimerosal levels have been significantly reduced in most

childhood vaccines.

It's possible that exposures from the flu shot, and residual mercury

left over in other vaccines -- perhaps in synergistic effect with

aluminum used as an " adjuvant " to boost the immune response -

might " contribute to the toxic mix that causes childhood

mitochondrial dysfunction in the first place, " one of the doctors

said.

But like many hypotheses, this one has competition. Some researchers

believe that the modern American diet is largely to blame for an

increase in the number of children whose underlying mitochondrial

dysfunction is " triggered " into autism by febrile infections.

The answer, they hypothesize, is corn.

The American diet has become extraordinarily dependent on corn oil

and corn syrup used in processing, these experts contend. They say

that corn oil and syrup are inflammatory, whereas fish oil is anti-

inflammatory. Could our diet be a factor in making this mutated gene

become more pathogenic? It's a biochemical defect that leads to

biochemical disease, supporters of this theory say: The gene itself

becomes more of a problem.

WHAT NOW?

This information raises so many questions it makes your head swim.

First and foremost among them: What to do about vaccinating children

with known mitochondrial dysfunction?

In many respects, these kids should be first in line for vaccination,

to prevent some illnesses that might trigger an autistic regression

during the window of vulnerability. On the other hand, with multiple

vaccinations, such as the case with Hannah, there is also a risk of

overtaxing the immune system, and likewise triggering regression into

autism.

What's needed most urgently, if possible, is a quick, affordable and

efficient method of testing children for low cellular energy, perhaps

before vaccination even begins.

There was some discussion on the conference call about altering the

vaccine schedule in some way, to lower the risk of immune over-

stimulation in susceptible children. Certainly, pressure will grow

for a change in the schedule - the question is how, when, and if such

changes will be made.

Some of the suggestions may not be popular among public health

officials. They include:

1) Establishing a maximum number of vaccine antigens to which any

child could be exposed on any given day.

2) Permitting the option of separating out the measles-mumps-rubella

(MMR) live virus combination vaccines into three

distinct " monovalent " shots.

3) Not giving the varicella vaccine (chicken pox) on the same day as

the MMR injection - the CDC recently withdrew is recommendation for

the Pro-Quad MMR+Varicella vaccine because it doubled the risk of

seizures.

Another option is to create new " recommendations for administering

multiple vaccines to children who have fallen behind in the

recommended childhood immunization schedule, " according to the

website of the Institute for Vaccine Safety at s Hopkins

Bloomberg School of Public Health.

Hannah had missed some shots and her doctor decided to " catch up "

with the schedule by administering five shots, containing nine

vaccine antigens, at once. But some autism activists have pointed out

that giving five shots in one day is not that uncommon.

Moreover, they claim, many children regressed into autism following

normal vaccination, when the parents religiously adhered to the

official schedule.

According to the s Hopkins site, " Additional research is needed

to determine if other children with autism, especially those

with 'the regressive form' of autism, have the same or similar

underlying mitochondrial dysfunction disorders. "

It adds that, " the advisory groups who make recommendations regarding

vaccines will undoubtedly examine this case carefully and make

decisions regarding the potential need for changes. "

That day may come sooner than you think. It was just announced that,

on April 11 in Washington, DC, the National Vaccine Program Office at

HHS will convene a meeting of the National Vaccine Advisory

Committee's Vaccine Safety Working Group. The Working Group was

established to go over the CDC's Immunization Safety Office draft

research agenda, and to, " review the current vaccine safety system. "

The meeting is open to the public, and I have my seat reserved. But I

honestly don't envy the Working Group's very tricky task at hand.

It remains to be seen how all this plays out. And many important

questions still lie ahead.

For example, if mitochondrial dysfunction turns out to be as common

as 200-per-10,000, and autism is now at 66 per 10,000, did anything

bad happen to any of the other 134-per-10,000 children, apart from

autism (i.e., ADD, ADHD, speech delay, etc.)?

Moreover, if 10-20% of autism cases can actually be traced to an

underlying mitochondrial dysfunction, then what about the majority of

autism cases where this did not come into play?

And, if 20% of autism cases are mito related, and 6% of those cases

regressed because of vaccines, that would mean that at least 1% of

all autism cases were vaccine related. Some estimates of autism go as

high as a million Americans - that would mean 10,000 people with

vaccine-triggered autism, and billions of dollars in the cost of

lifetime care.

(While we are on the subject, isn't it time to fund a study of

vaccinated and unvaccinated children, to settle this debate once and

for all?)

Finally, the goals of the CISA Network, (which convened the

teleconference) are rather progressive and far reaching. It remains

to be seen how well the Network fulfills its stated mission, which

includes:

Conduct research into " the role of individual variation " on vaccine

injury;

" Empower individuals to make informed immunization decisions; "

Help policy makers " in the recommendation of exclusion criteria for

at-risk individuals, " and;

" Enhance public confidence in sustaining immunization benefits for

all populations "

Let's see how long it takes before Network members hang out the

proverbial banner: " Mission Accomplished. "