Andrew Wakefield has responded to the latest MMR Study showing no link between the vaccine and autism.
Just to recap, the latest Baird et al study looked at whether autistic kids and non-autistic controls showed any variance in their measles antibody response. They don’t.
The measles aspect of the MMR vaccine is what Wakefield’s hypothesis relies on. He says because its a live virus its casing gastric issues and then autism in some kids. This study looked to see if there was any evidence of measles-virus in the blood of these kids. There wasn’t. They looked to see if any of the autistic kids had evidence of gastric issues over and above the average. They didn’t.
But Wakers thinks this isn’t good enough.
The study is severely limited by case definition in the context of the crucial ‘possible enterocolitis’ group………….We have over the last 10 years evaluated several thousand children on the autistic spectrum who have significant gastrointestinal symptoms. Upper and lower endoscopy and surgical histology have identified mucosal inflammation in excess of 80% of these children. Almost none of these children with biopsy-proven enterocolitis would fit the criteria set out above………….The requirement for the current presence of these symptoms, for 14 or more days continuously, shows a singular lack of understanding of the episodic, fluctuating, and alternating (e.g. diarrhea/constipation) symptom profile experienced by these children
Wakers thinks that the criteria for defining enterocolitis that Baird et al used was too strict. He says it will occlude the group he’s identified.
He’s probably right. But not in the way he thinks he is. Could it maybe be that _his_ definition of enterocolitis is too slack? His definition includes:
In our experience, ASD children with histologic enterocolitis typically have 1 to 2 unformed stools per day that are very malodorous and usually contain a variety of undigested foodstuffs. This pattern alternates with that of “constipation” in which the unformed stool is passed after many days of no bowel movements at all, and with excessive straining.
With which he claims is ‘identified mucosal inflammation in excess of 80%’ of his kids.
Thing is, a PubMed search for ‘mucosal autism’ returns 20 results. Of which only one support the idea of inflammation – One of Wakers own papers. In fact the only person I could see using the term ‘histologic enterocolitis’ was (you guessed it) AJ Wakefield.
The question immediately occurs: Of the ‘several thousand children on the autistic spectrum who have significant gastrointestinal symptoms’ why hasn’t there been any published, peer-reviewed, replicated, science written up by Wakefield? Why hasn’t anyone else managed to find 80% positive results and published peer reviewed science about their results?
Could it be that its only the team who have screwed up their results that find what they want to find? I think so. Lets quote Stephen Bustin once more.
Now, these are from samples that should have been discarded according to the SOP from Unigenetics because there was no GAPDH present, i.e., the RNA is degraded. If you look at the Cts for the F-gene which they reported as positive you can see they’re the same. Now, if this is degraded RNA yet I’m getting the same Cts for my F-gene target this can’t be RNA because it would have been degraded.
That’s what the GAPDH showed me. Now, if it isn’t RNA it has to be DNA. If it is DNA it can’t be measles virus it has to be a contaminant.
Plain English – Wakefield scoped kids. Sent samples to Unigenetics. They should’ve told Wakers the samples were rubbish. They didn’t. They analysed rubbish samples which were contaminated. What they found wasn’t measles virus.
A frequent complaint from the Wakefield apologists is that by analysing blood samples rather than gut tissue, science teams are not comparing like-for-like. There are a number of reasons why this is questionable.
Firstly, there has to be a _reason_ for scoping children. It is not a straightforward procedure.
Towards the end of last year, an autistic child who was scoped following a recommendation by Simon Murch, a colleague of Andrew Wakefield’s, was awarded £500,000 damages after his bowel was perforated in 12 places.
An autistic boy has won a £500,000 payout after the hospital at the centre of the MMR scandal carried out an operation that was ‘not clinically justified’.
Jack Piper, then five, was left battling for life after the procedure, which his parents claim was carried out to establish links between his condition and bowel problems.
His bowel was perforated in more than 12 places during surgery at the Royal Free Hospital in North London.
The colonoscopy was suggested by Professor Simon Murch. He is being investigated by the General Medical Council over allegations that he carried out invasive tests including colonoscopies on 11 other children contrary to their best clinical interests.
It is an ethical issue – is a scoping procedure ethically justified? The answer is ‘no’ – that hasn’t stopped Wakers doing ‘thousands’ though apparently.
Secondly, is there any reason why looking blood is not good enough? Awhile ago, I asked a Doctor (who wished to remain anonymous) who told me:
measles is a lymphotropic virus, even more so for the vaccine strain which has been selected to exploit the CD46 cellular receptor. If there is a persistent MV infection the most logical place to detect it is in cells that it is most adept at infecting. Lymphocytes [a type of blood cell]
So, there’s not really any reason why blood cells wouldn’t be suitable to check for measles virus, despite Wakefield’s opinion.
And in fact, at least one team _wanted_ to use Wakefield’s samples but their request was ignored:
The groups of investigators that either had access to original autism specimens or investigated them later for measles virus detection were invited to take part in the study but failed to respond. Similarly, it was not possible to obtain clinical specimens of autism cases from these investigators for independent investigations.
Now I have to wonder why, if Wakefield et al are claiming that only scoped samples are any good, or that blood is no good they didn’t hand over the samples they had harvested with the gratitude of a team expecting to be replicated.
Maybe they didn’t really want another science team looking at these samples. Maybe they feared what another team would find.
And what about this inflammation Wakefield alleges to have found? Turns out that its possible to screen for inflammation without the need for scoping.
A 2002 study Effect of Pentavac and measles-mumps-rubella (MMR) vaccination on the intestine looked at:
if MMR vaccination is associated with subclinical intestinal inflammation, which is central to the autistic “enterocolitis” theory
To do this, the team:
….studied 109/58 infants, before and two and four weeks after immunisation with Pentavac and MMR vaccines, for the presence of intestinal inflammation (faecal calprotectin).
The results were:
There were no statistically significant differences in faecal calprotectin concentrations at any time points (p>0.25) or when assessed in subjects studied before and after Pentavac (p>0.2) or MMR (p>0.3) vaccination
There was no evidence that either Pentavac or MMR vaccination provoked subclinical intestinal inflammation in any of our apparently healthy children during the four week post-vaccination period. This lack of a detectable intestinal inflammatory response suggests that the measles vaccine virus itself is not enterotoxic in healthy infants which argues against the MMR induced autistic “enterocolitis” theory.
And so we come back to the bottom line. What direction does peer reviewed published science take us in? It takes us away from Wakefield.
There are no good reasons to believe that blood samples are not good enough to compare with gut samples and if Wakefield believes otherwise, why didn’t he provide the samples to the Afzal team when asked to?
There is no good reason to justify dangerous, invasive procedures such as the one Wakefield has used on thousands of kids and which left one child fighting for life with a massively perforated bowel. Fecal calprotectin is more than adequate as a marker of intestinal issues and using this method reveals no association between MMR and autism.