The Truth About Andrew Wakefield

14 Oct

Regular readers will know that an eminent UK scientist writes the occasional guest blog piece for LB/RB. Here is his piece in the wake of the the Lipkin/Hornig study and the amusing claim that it vindicates Wakefield. Enjoy – Kev.

A scientist who has followed the Wakefield saga from the start sets the record straight.

According to recent newspaper reports Andrew Wakefield is planning to publish his account of the MMR/autism controversy next year, under the title The Lesser Truth. He is currently facing charges of gross professional misconduct at the General Medical Council (the case is expected to conclude in April 2009). Meanwhile, Wakefield and his supporters continue to claim that his research is valid and continue to smear the investigative journalist Brian Deer who exposed the conflicts of interest and dubious ethics – as well as the junk science – behind the claims of a link between MMR and autism. But it was Wakefield who was obliged to back down in court from his libel allegations against Deer. Wakefield was unable to contradict Deer’s claim that he has been “unremittingly evasive and dishonest in an effort to cover up his wrong-doing”.

Here are some truths about Wakefield and his research that may not find their way into The Lesser Truth:

Wakefield was never a respected researcher. His first foray into the Lancet was a controversial paper in 1989 saying that Crohn’s disease was due to problems in the blood supply to the gut (vasculitis). But this was wrong. In the early 1990s he was funded by pharmaceutical companies for research along the same lines, mostly in animal models, and produced a series of low-impact, forgettable, papers.

Wakefield first courted notoriety in 1993 when he claimed to have identified measles virus in Crohn’s disease gut tissue. Coincidently, measles virus can cause vasculitis so it is easy to understand how, from 1989 onwards, Wakefield had to find measles in Crohn’s. We now know this result was not possible: there is no measles virus in Crohn’s disease and the antibodies Wakefield used were not specific for measles either. In Wakefield’s own lab, a good molecular biologist, Nicholas Chadwick, could not find measles in Crohn’s by sensitive molecular techniques. However, Wakefield said he could find measles, using crude techniques using flawed reagents. Suppressing data which ruins your hypothesis is scientific fraud.

In February 1996 Wakefield cooked up the idea that MMR was involved in autism with the solicitor Richard Barr and parent activist Rosemary Kessick. He wrote a research protocol to get into the children’s colons to look for measles virus and gut damage, and applied to the Legal Aid Board for £55K.

By October 1996, the Royal Free team had scoped enough children to provide Wakefield with tissue samples so that his technician could look for measles virus in the guts of autistic children by immunohistochemistry. This was clearly research, without clinical or ethical justification.

By spring/summer 1997 Wakefield had enough cases and enough creative data for his story. He believed that autistic children had gut inflammation and most importantly, he believed that he had discovered the cause – measles virus persisting in the gut from MMR. Wakefield first tried to get this study published in Nature but it was rejected.

Towards the end of 1997 he sent an abstract of this work to be presented at Digestive Diseases Week in the USA in May 1998. He also submitted two papers to the Lancet. The first was accepted and published as the now notorious February 1998 Lancet paper. The second, the study claiming to have identified measles virus in the gut by immunohistochemistry, was rejected. To see Wakefield’s pictures of measles virus in the guts of autistic children go here (slides 37 and 38). The second paper was never published and has now mysteriously disappeared, although Wakefield showed it all over North America for years.

In 2000, Wakefield published a larger series on “autistic enterocolitis”, the new disease he claimed to have identified (Wakefield et al 2000 Enterocolitis in children with developmental disorders. American Journal of Gastroenterology 95: 2285-95). Analysis of the data in this paper has revealed that it was a scam: autistic children do not have a chronic inflammatory bowel disease. Normal findings in children were called pathology, pathological results were re-examined and sexed up, and new abnormalities were manufactured, all to make it appear that these children had gut inflammation (MacDonald TT, Domizio P. Autistic enterocolitis; is it a histopathological entity? Histopathology. 2007 Feb;50(3):371-9).

As the litigation in the UK began to heat up around 2000, the defendants (the MMR manufacturers) started to ask simple questions, such as, where is the paper which shows measles in the gut of autistic children? This was part of the MMR/autism story that was rejected by Nature and the Lancet. Who knows why Wakefield never published it? Maybe he realised it was junk since at the same time his identification of measles virus in Crohn’s disease had unravelled. Maybe he knew that the experts for the defence had looked at the data and the methodology and shown it was junk.

Wakefield now hooked up with Dublin pathologist John O’Leary. O’Leary was supposedly an expert in an unsound and discarded methodology called in cell PCR, which he claimed allowed him to amplify measles genetic material in tissue samples, in this case, from the guts of children with autism, and identify its cellular location. He also set up PCR techniques to amplify measles from samples of gut. The O’Leary lab’s studies of Wakefield’s gut biopsy specimens were published in another notorious paper (Uhlmann et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. J Clinical Path: Mol Pathol 2002;55: 84-90).

In his testimony to the Omnibus Autism proceedings in Washington in summer 2007, London-based molecular biologist Professor Stephen Bustin showed the utter incompetence of O’Leary and his lab. He revealed the fact that a result was called positive if the sample contained measles virus but no DNA (a biological impossibility). He also revealed that if they analysed the same autistic sample 6 times and got a positive once, the patient was deemed to be positive, even though they were also getting positive measles results out of samples of pure water.

It seems that O’Leary has belatedly seen the error of his ways: in the recently published Hornig study, his lab – in common with other labs in the USA – failed to find measles in samples from autistic children (Hornig et al 2008 Lack of association between measles virus vaccine and autism with enteropathy: a case-control study. PLOS One 3(9):e3140). The attempts by Wakefield and his acolytes to claim that the Hornig study vindicates the Uhlmann paper are preposterous. Distancing himself from Wakefield as fast as is possible for any man of 20 stone, O’Leary cleaned up his lab and did things properly.

A review of the career of Andrew Wakefield is a trawl through the underbelly of science. Wakefield did not do experiments to seek the truth – he did experiments to confirm his own beliefs. He produced junk science for over a decade and did immense damage to patients with Crohn’s disease, and autistic children and their parents. Hopefully the GMC will nail the charlatan, and show some sympathy for the Royal Free clinicians who thought Wakefield was honest. The Andy Wakefield show has now moved to the USA where he can get the attention he craves and he can play the role of the selfless seeker of truth whom the establishment had to silence. Being a victim is a good career move for him. It will help Thoughtful House sell junk therapies for autism to desperate parents and allow Andy to live in a really big house, where he can entertain his showbiz friends. He really wanted to be a famous scientist, but he was rubbish at that, so he had to become (in)famous by other means.

15 Responses to “The Truth About Andrew Wakefield”

  1. mike stanton October 14, 2008 at 21:09 #

    Thank you for a trenchant summary of the story so far. I hope you forward this post to the Express reporter who wrote the uncritical nonsense about Wakefield on Sunday.

  2. Ms. Clark October 15, 2008 at 06:17 #

    Speaking of Mady Hornig (lead author of the paper that Wakers and fans are saying rescues the O’Leary lab’s reputation from the gutter) she too had a string of utterly forgettable papers on work in mice. She would never had gotten the attention she got had she continued in the same line she had been on, but the mercury parents made her a heroine and got her all kinds of speaking gigs. Her work with “Rain Mouse,” including the additional attempts at misrepresenting what her research found using video footage of mice attacking and killing other mice, apparently staged to some degree, should follow her always the way Wakers 1998 paper should follow him always. She should not get away with what she did even though the authorities have not seen fit to give her more than a slap on the wrist. Hornig should take her place in the history of the antivax/autism debacle right alongside of Wakefield and O’Leary… and I could name about a dozen others whose names should become household terms representing untrustworthy scientists.

    Like we have the “Piltdown man”, we should have the “Hornig Mice”.

  3. David N. Andrews M. Ed. (Distinction) October 15, 2008 at 09:24 #

    “Wakefield did not do experiments to seek the truth – he did experiments to confirm his own beliefs.”

    Then they weren’t true experiments, in any scientific sense. Confirmation bias seems to run his work for him. I guess he was absent from the research methods class when they covered the topic of null hypotheses and why we have them.

  4. Jen October 15, 2008 at 11:42 #

    Great summary- thank you.

    A question that I’ve always had- why does it take so long to go through the General Medical Council on charges of gross misconduct? Is that typical for most governing bodies of professional organizations?

  5. Ringside Seat October 15, 2008 at 17:38 #

    The claims going round that the Hornig study support Wakefield are beyond stupid. O’Leary has plainly cleaned up his lab and/or got new staff, and/or made pretty fuckin sure he didn’t screw up again. Some fruitcake is also claiming that it justifies the Royal Free’s experiments on kids: of course not realizing that the whole point of Wakefield’s GMC hearing (or at least a chunk) is that he didn’t research biopsies carried out on kids for clinical reasons, but he duped the parents of autistic kids to let his people get into their guts in his hunt for measles virus: a research project. The reason why the Hornig study has taken so long is they had to wait for autistic kids to be referred to hospital for ileocolonoscopies on clinical grounds: which is quite unusual (unless you’re anybody to do with Wakefield). My prediction is that Thoughtful House will get sued back to the scrap value of Wakefield’s favorite chair once they seriously injure a child, and the insurance company refuses to pay.

    The GMC delays are a result of five factors: (a) the defendants refused to reply to the charges or give any account of their case for years after they were approached; (b) the evidence is very lengthy and must be delivered to standards much higher than in civil trials; (c) it’s difficult to assemble the panel for long periods, particularly for the lay members, who have jobs to go to; (d) there are four legal teams, who are not always available; (e) there are three defendants, which means that three defence cases have to be heard.

  6. Tinkerbell October 15, 2008 at 20:33 #

    unHoly shit, the lot of it.

  7. Dedj October 15, 2008 at 20:33 #

    Unfortunetly Jen, it is quite typical, although that still doesn’t mean that Wakefield isn’t in some way being protected by his previous status and reputation.

    To put it simply, members of the ‘lesser’ professions have been struck off for significantly less, with less evidence and with shorter hearings.

  8. Tsu Dho Nimh October 16, 2008 at 22:46 #

    Related story: Here’s one of Wakefield’s victims.

    http://www.dailymail.co.uk/health/article-500611/500-000-boy-left-fighting-life-used-MMR-guinea-pig.html
    “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.
    At the time, it was at the centre of controversy after employee Dr Andrew Wakefield claimed that the triple measles, mumps and rubella jab was linked to autism and bowel problems.

  9. Patricia Fischer October 26, 2009 at 14:37 #

    Is there a website of former Wakefield supporters? What I see in interviews and coverage are people who are passionate about Wakefield because “he listens to us” or “he’s such a voice for us” or “he’s great.” But I’m not hearing anything medical.
    I’d like to know if there is a group, no matter how small, that followed him and then decided he was full of it.
    It sickens me to know he’s charging parents thousands of dollars for quack medicine not an hour from where I live. (He’s in Austin, Texas.) According to a recent article in the Austin-American Statesmen, his Thoughtful House gets parents “enough grant money to get their children initially tested” then tells them what they need to do to get their children “well.” He’s conducting procedures to cure ADD, Autism, etc and charging parents thousands of dollars a month.
    Amazing to me that people actually believe him.

  10. Ringside Seat October 26, 2009 at 19:41 #

    Patricia,

    I think you need to ask Brian Deer. He is the main reference point on Wakefield, and I’m sure he can put you in touch with others, if you haven’t already.

    http://briandeer.com/contact.htm

  11. David N. Brown October 26, 2009 at 21:26 #

    Texas is also home of ApotheCure, which sold the chemicals and apparently taught the inappropriate procedures that caused the death of Tariq Nadama. I suspect that Texas is a chosen location, due to lax regulation.

  12. John Sullivan January 29, 2010 at 23:22 #

    <>

    This “eminent scientist” doesn’t know what he is talking about. I remember this report and Wakefield was one of a three man team from the Royal Free showing narrowing of the blood vessels in the gut lining in patients with Crohns. The anonymous scientist has absolutely no basis to assert “this was wrong”. This report was the first to draw a potential link between smoking and relapse in Crohns which is now established.

  13. Sullivan January 29, 2010 at 23:44 #

    Tsu Dho Nimh,

    there are some important details to keep in mind–

    1) Dr. Wakefield (to my knowledge) did not do colonoscopies himself.

    2) That child was injured after the Lancet article was published, as I recall. The news story states that the procedure was on the recommendation of one of the team from The Lancet article, but I don’t know if it is public who actually performed the (botched) procedure.

  14. Chris January 30, 2010 at 04:49 #

    Sully, Tsu Dho Nimh posted that over a year ago. I have no idea what John Sullivan is talking about, and why he chose to post on an old post.

Trackbacks/Pingbacks

  1. Brian Deer Discusses Andrew Wakefield in the Sunday Times « Holford Watch: Patrick Holford, nutritionism and bad science - February 8, 2009

    […] year, Left Brain/Right Brain carried a thorough analysis of Andrew Wakefield’s standing as a scientist and the many problems with his data and subsequent attempts to replicate […]

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