Autism Omnibus – Vas Aposhian

16 May

Vas Aposhian is – like Sander Greenland – an expert witness for petitioners (the families) and a professor of molecular and cellular biology as well as a professor of pharmacology.

On Day 2 and 3 he testified as to what seemed to be the main hypothesis behind the whole thiomersal/autism idea.

The basic idea is that some people are genetically predisposed to something called _mercury efflux disorder_ (plain english, they can’t get rid of mercury as well as most people can, it crosses the blood brain barrier and triggers autism). Mercury Efflux Disorder is itself an unproven hypothesis but Aposhian passionately believes in it.

He came under heavy cross exam (I won’t go through his performance whilst testifying to his own ‘side’ – we all know the basic hypothesis), that compromised a lot of day two and most of the morning of day three (the audio is released slowly so I’m a couple of days behind). The part I’m writing about today starts about an hour and a half into day three (NB: I’ve downloaded all the MP3′s and stitched them into one file).

Aposhian says that the mercury efflux hypothesis is supported by six papers:

…each piece of evidence alone leaves some doubt but taken all together the evidence implicates thimerosal/ethylmercury as the likely precipitating agent in the etiology of some of the autism spectral disorders.

Respondent counsel referred to these six papers as ‘pillars’ supporting the hypothesis. Aposhians’s pillars are:

First, Adams et al. (2007) demonstrated that teeth from autistic children contain more mercury than those from non-autistic children.

Respondent counsel asked Asphosian what he thought he could criticize about these papers he says ‘implicate thiomersal’. Regarding Adams et al, Asphosian said (and I’m paraphrasing slightly after scribbling notes furiously):

1) The number of controls should’ve been increased.
2) There were too few test subjects
3) When asked if raised mercury level was an indicator of toxicity, Asphosian answered “I don’t know”.
4) When asked if he would’ve expected mercury concentrations to vary depending on gender, Asphosian answered “Yes”.
5) When asked if Adams controlled for gender Asphosian answered, “No, he doesn’t control for gender”.
6) When asked if lead concentration of a tooth affected mercury concentration of a tooth, Asphosian answered, “I don’t know”.
7) Asphosian was asked, given the fact that the thiomersal hypothesis depended on the role of _ethyl_ mercury, what type of mercury did Adams et al measure in the teeth? Asphosian’s answer was “…did not do speciation” – in other words, he didn’t separate the types of mercury out. He recorded it all.
8) When asked if mercury levels in teeth tell you anything about amounts of mercury in the brain Asphosian replied that he didn’t know as no one had ever done that study.

These are fairly damning failings in what Asphosian’s assumptions were regarding the quality of that study. Of course, there is more wrong with the Adams paper than just the above, but these points are pretty damning. The failure to control for gender, the paucity of subjects and the fact Adams et al didn’t concentrate on ethyl-mercury raise serious questions over what exactly this study can add to the so-called Mercury Efflux Disorder.

I’ll keep appending to this post as I work through the rest of the audio.

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17 Responses to “Autism Omnibus – Vas Aposhian”

  1. Kelli Ann Davis May 16, 2008 at 22:02 #

    pssttt…Kev,

    Heads up.

    You may want to go over to Age of Autism to check out the latest study regarding thimerosal and mmr and the overall vaccination schedule.

    Kelli Ann Davis

  2. Kev May 16, 2008 at 22:13 #

    Study? You mean the amusing monkey poster presentations at IMFAR?

    You do know what a poster presentation is, right? Or more accurately, what it isn’t?

  3. Kev May 16, 2008 at 22:21 #

    LOL…I just went and read it!

    Poster presentations must go through a form of peer review before they are presented at the conference.

    Uh, no they don’t. They’re presentations, in the form of a poster. You put your poster up and hope people stop and talk to you.

    …and looky who’s involved in all three…..Andy Wakefield. Shocking.

    Thanks Kelli Ann – this _definitely_ deserves a post all of its own :D

  4. Regan May 16, 2008 at 22:38 #

    Selecting whether or not something is going to be presented as a talk or poster is not peer review and is not considered the equivalent to peer-reviewed publication.

    IMFAR 2008 submission criteria
    http://imfar.confex.com/imfar/2008/cfp.cgi

  5. Kelli Ann Davis May 16, 2008 at 22:43 #

    I’m glad you find this “so amusing”…

    Thankfully, the Secretary’s Science Advisor didn’t share your sentiments…

    Oh, but then again, he is focused on the science…thank God.

    Kelli Ann Davis

  6. Sullivan May 16, 2008 at 22:54 #

    Hmmm,

    Conference abstracts usually tend to be ‘approved’, but that isn’t a ‘peer review’ process at all.

    I’ve never heard of a conference where they actually read the poster and approved it before it went up, much less had the poster go through ‘peer review’.

    That all said, someone is now going to have to do a Berman to this Hornig.

    I find it odd that they are using a blog for their media outlet on this. What I find it more interesting is that blog needs to use your blog to make sure this gets out to the autism community.

  7. Ms. Clark May 16, 2008 at 23:03 #

    If I remember correctly, Aposhian was asked if Adams controlled for dietary intake of mercury, and the answer was no.

    He said you just couldn’t depend on being able to get two urine samples or two blood samples for autistic kids because they are just so hard to deal with.

    For some reason they (Bradstreet for one) were consistently able to get post provocation urine samples but not any “baseline” tests.

    You’d think that if they would at least try to get a pre- and post-provocation urine sample that would be better than not trying at all. It seems like for every kid they wanted to get a post-provocation test from they got one.

    At any rate not being able to get a before and after sample of anything from autistic kids is a cheap excuse. In real toxicology they wouldn’t make a judgment on the state of heavy metals in a person without a baseline test. It’s quack medicine that avoids baseline tests and goes straight for provoked tests, and even worse, compares the results of provoked tests with unprovoked norms.

    Aposhian basically ended up saying that all kinds of mercury at any point in a child’s development before or after birth could cause autism.

    It seems to me that they have sunk their case. Especially where all the witnesses keep going on about how they never ate any fish, ever, and they didn’t have amalgams ever, and they didn’t live near a mercury mine or coal fired power plant… but Aposhian lets loose this scary bombshell about how scary the levels of mercury are in chicken.

    So it’s likely that all the moms and all the kids ate chicken, and possibly very large amounts of it over time, and if that’s a possible source of mercury and if any mercury can cause autism, then how could they know it was the tiny measured dose of ethyl mercury that is in vaccines?

    It would be sort of like saying, “I ate 60 cartons of ice-cream and drank 50 gallons of milk and ate lots of other food with unspecified amounts of milk in them over 3 months time, then I took an aspirin that had 2 mcg of lactose in it and ate another 60 cartons of ice-cream and drank another 50 gallons of milk and ate lots of other food with unspecified amounts of milk in them, over the next three months, but for a fact, I know that my lactose intolerance problems come from that aspirin pill.”

    Then they have the guts to pull out quack laboratory results that show that they are comparing provoked urine samples to non-provoked norms. Why not just advertise, “we don’t know what we are doing” or “we are not only unethical but we’re also committing highway robbery”?

    It will be interesting to read Aphoshian’s comments. To my ear, on the audio he sounds frustrated, angry, sad, confused and tired during different points of his testimony which makes me think that his testimony is less credible, but it might look better in writing.

    Kinsbourne, Mumper and Deth didn’t said what seemed to be unscientific or illogical things sometimes, but they were professional sounding as far composure.

  8. Kev May 16, 2008 at 23:06 #

    All monkey related commenting – here please.

  9. Ms. Clark May 16, 2008 at 23:10 #

    I find Kelli Ann’s “psst” thing to be hysterical. I’m guessing that their traffic was so low that they got desperate.
    (monkey portion of comment moved to appropriate blog entry)

  10. Sullivan May 16, 2008 at 23:23 #

    On cross, Dr. Aposhian did not sound too confident. Rather than answer questions directly, he seemed to be spending a lot of time trying to figure out where the questions might be leading. He pretty much said so in responses that were on the order of, “I don’t know why you are asking that”.

    He did a lot of ‘don’t answer the question posed, answer the question you know the answer to’. Whether this was due to a lack of understanding or not is up to interpretation.

    One big problem in the “first theory of causation” trial (Cedillo) was that Dr. Aposhian (and others) avoided making real definitive comments. They did so here as well, but to a lesser degree. By this, I mean, questions like, “so, how many of your pillars do you need for this to hold up”. Dr. Aposhian at first acted like she was asking ‘papers’ rather than ‘pillars’. Then he refused to state. Since his thesis is that ‘when taken all together’ his pillars add up to causality, the idea that even one isn’t solid would be serious damage. In reality, many of the pillars were, at best, weak.

    One coming up–the Hornig study. Dr. Aposhian relied on a study where others tried to replicate it and showed it couldn’t be done. In defense, Dr. Aposhian relied on “the grape vine” which says that Dr. Hornig is working on her own replication. (as a side note: given that Dr. Hornig apparantly failed to separate animals that were damaging others, why should she be given money to do this again? That sounds to me like an ethics breach).

    Not to give away Kev’s future blog posts, but Dr. Mumper also relied on Hornig. In an even more strange twist, she asked for a copy so she could read it overnight. I mean, it is one thing to consider the original paper better than the replication (it isn’t) but it is another to be ignorant of the attempted replication.

  11. Kev May 16, 2008 at 23:30 #

    I have to come clean and say I quite liked Aposhian. His voice is very friendly with what I think is a Maine accent? I also think he had some difficulty hearing some of the questions. Not sure why they didn’t provide him with a set of headphones or a hearing aid.

    But yeah, he seemed very hesitant and unsure. He also seemed genuinely taken aback when it became obvious how threadbare his ‘six pillars’ actually were.

  12. Sullivan May 17, 2008 at 00:25 #

    Well,

    I think he must have been a good lecturer. When on the subjects he knows, he did well. You could feel his momentum increase when he would take a question and go into his comfortable areas.

    It is a big stress having 5,000 kid’s lives (plus more) on the line. I’m sure he was being really careful with the cross.

    All other things aside, I wish him well with his family. While I disagree with his science, I appreciate that he took the time out to support autistic kids even when he has what sounds like major concerns of his own. He stressed that he has much respect for Dr. Clarkson and others he disagrees with. In that, especially, he set a very good example.

  13. Matt May 17, 2008 at 01:24 #

    Kev,

    Ms. Davies reminded me of something interesting in the Omnibus–

    Dr. Mumper looked at the videos of one of her patients. She ‘blinded’ herself to the timeing of the vaccinations that are suggested to have caused the regression.

    It’s as good as she could do, admittedly, but it was a strange thing to hear someone say about a patient one has obviously spent a lot of time studying.

  14. kristina May 17, 2008 at 06:51 #

    As I recall, another poster presentation about the MMR vaccine or mercury at IMFAR got covered as a “study” when it came out——seems to that too many don’t have a solid understanding of what is research, and what not.

  15. Kev May 17, 2008 at 21:26 #

    I just got to that bit in the Mumper testimony Matt – a truly weird way of ‘blinding’ onesself!

    Kristina, you’re thinking of Steve Walker. I think I mention that poster in the ‘monkeying around’ post.

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