Tuesday, December 29, 2009

Bad Science plus Autistic Children equals Big Money

In waging war against disease, modern medicine augments the evolutionarily derived defenses of the human immune system and saves millions of lives. Despite this fact, medical science continues to be plagued by denalism, particularly in regards to the condition known as autism.

Through hundreds of millions of years the process of biological evolution has, through trial and error, refined the vertebrate immune system to an astonishing degree. However, despite these great successes, humans continue to be susceptible to the attacks of bacteria and viruses, as well as to assaults from blunders in our own internal physiological processes. Luckily, through the process of science, which includes clinical evaluation and peer-review, modern medicine augments the natural fortifications of the human immune system as it opposes illness. In the evolutionary arms race against disease, medicine is an essential armament and doctors are very much needed arms dealers. Unfortunately for those on the front lines, not all arms dealers are equally sound.

As a case in point, back in 2005 Diana L. Vargas and other scientists published a paper in which they described the occurrence of neuroinflammation (’neuro’ = brain; ‘inflammation’ = irritated) in the brains of recently deceased patients who had lived with confirmed autism. The brain tissues autopsied in conjunction with the study had been provided by the Autism Tissue Program, and all samples were taken from people who had died of accidental deaths; deaths such as drowning, hyperthermia, trauma, and other non-pathogenic causes. Clinically, neuroinflammation is a symptom that is often associated with immune system disorders and its connection to autism is, for the most part, not yet understood. The potential for misinterpretation and misuse of the paper’s inflammation-to-autism link inspired the researchers to emphasize in the conclusion of the study and elsewhere that although “the role of neuroinflammation in the context of the genetic and other factors that determine the autism phenotype remains an important issue to be investigated.” The paper made clear that treating persons afflicted with autism with protocols for immune dysfunction was not recommended.

And yet since publication of this neuroinflammation paper, it has been used by ‘doctors’ as a rationale for treating children with alternative and non-standard procedures aimed at immune system disorders… Despite the lack of evidence, quacks, particularly those associated with the Defeat Autism Now network, have been promising progress to the parents of autistic children through the use of strong immunosuppressant drugs, hormone treatments, intravenous immunoglobulin, and therapies using hyperbaric oxygen chambers.

Scary stuff… It seems as though ’snake oil’ is abundant resource when there’s money to be made. It’s a real shame that these treatments bring only slight and transient emotional relief to agonized parents. Especially when considering that such harsh treatments bring only pain and suffering to the kids on the receiving end. The victims in this case happen to be diagnosed with autism - a condition that is already widely misrepresented as being brought about by life-saving vaccinations.

Vaccinations are disease preventing medical treatments that stimulate a natural immune response through the bodily introduction of biological molecules. As a product of evolution, the immune system attacks foreign, potentially pathogenic proteins; because the agents introduced during vaccination contain a molecule that is structurally similar to the protein of a disease causing microorganism, the body’s chemistry reacts defensively. The immune system first seeks-out the foreign protein; it then records its identifying characteristics as ‘military intelligence’ for later operations before finely destroying the medically infiltrated invader. Through this process, vaccinations effectively increase the immune system’s repertoire of available defensive tactics, thus reducing the likelihood of serious besiegement when the real pathogen is encountered.

Most medical procedures - including vaccines - have a potential for adverse side effects which can range from minor aches and pains to death; BUT, when compared to the risks inherit to the disease itself there is absolutely no comparison - vaccines are the hands-down best option. Key to the effectiveness of vaccination programs is public participation; this starts with gaining confidence through the elimination of misinformation, which in the case of autism is a substantial quantity…

Although there is no valid, or for that matter even plausible, connection between autism and vaccination, or any reason to treat autism with therapies designed for immune deficiency, the spread of misinformation on these topics is rampant. The resulting distrust of medical science has contributed to numerous illness and deaths that would have otherwise been preventable. Those in the anti-vaccine movement are similar to creationists; they allow personal bias, subjective opinion and their penchant for conspiracy theories to override rationality, facts and morals. In the case of medical science this denialism comes at a tremendous price.

There is a reason why it's called ‘alternative’ medicine – it’s alternative because it doesn’t work.

UPDATE: This post was also posted at the Faster Times - several additional comments can be found there.

A good write-up on the topic can be found at the Timesleader.

Vargas, D., Nascimbene, C., Krishnan, C., Zimmerman, A., & Pardo, C. (2005). Neuroglial activation and neuroinflammation in the brain of patients with autism Annals of Neurology, 57 (1), 67-81 DOI: 10.1002/ana.20315

Image of human blood from Wikipedia


  1. In the context of diseases with few or costly treatments, "alternatives" may make some sense. What depresses me about this article is that it just dismisses any alternative treatment as "quackery." That is not scientific, merely bigotry.

    That said, the list of therapies this group is suggesting sounds a bit ghastly. And indeed, for inflammatory conditions in the CNS, none of those seem sensible (e.g., hyperbaric oxygen, which is costly and doesn't seem to do much). Ah--just FYI, IVIG isn't really an HIV therapy.

    By contrast, there ARE data for a variety of non-pharmaceutical interventions (what IS "alternative" anyway??) that may have an impact on things like elevated inflammatory cytokines like IL-1 and IL-6. This occurs as part of the spectrum of neurocognitive/neurological problems that can arise with HIV disease (and not necessarily ameliorated by antiretroviral drug therapy). Therapeutic implications include agents like N-acetylcysteine (NAC) and alpha lipoic acid or even milk thistle. Acetylcarnitine may also help to normalize TNF levels.

    There are some data to support these kind of interventions. Clearly, more data and clinical research rooted in SCIENCE (not Marketing, whether drugs or "supplements") can help clarify. Fish oil and vitamin D3 are seeing much wider acceptance of late since such data have confirmed findings an observations that erstwhile would have placed them merely in the "CAM" category, if not simply dismissed as quackery.

    All I'm asking for is to take a careful look. And by all means, if you think what this group is suggesting is indeed crap, say why! (I suspect, sadly, that you are correct in this case.)

  2. Hey GM – nice to hear from you again!

    I may have gotten a wee bit worked-up while writing this post…

    Frauds are bad people, but frauds that prey on the unfortunate circumstances of others (particularly kids) are far worse parasites altogether, and that is exactly how I would sum the above situation – frauds preying on children.

    The focus of my angst isn’t those professionals that seek management/mitigation of symptoms or discomfort through nutritional, herbal or even pharmaceutical therapies, rather I’m perturbed by those that push untested and unproven ‘cures’ or ‘treatments’ with false promises.

    In the above case it seems to me that the autism-immune dysfunction link is being ‘played-up’ by incredulous people as a means of securing income. In addition to having a wide range of potential side effects (none of which by the way is combating autism), the treatments are undoubtedly draining the wallets and morale of well intended families, friends and charities.

    Additionally, in contrast to the available “data” that you mention in your comment, the folks involved in the autism treatment scheme are actively misrepresenting the work of Vargas, Pardo and others as a means of justifying their therapies – they’re either lying or they’re being reckless.

    I certainly didn’t mean to imply that any medication without a Pzier or Johnson and Johnson label was quackery, in my mind ‘alternative’ is anything lacking the data that you described.

    In regards to IVIG specifically, it’s my understanding that it is currently used to combat a wide range of immunodeficiencies – including pediatric HIV. Is that not the case?

    Thanks for taking the time to comment!

  3. Lacking data is a problem; empirical data are also potentially relevant, even if not derived from controlled studies...as we too well know that "missing" data (i.e., unpublished studies) and distorted data can be great marketing tools. Sigh. Whither science?

    Re IVIG--well, it's not really used, probably because it's been horrifically costly. It has some uses, like during NHL chemo to prevent dyscrasias. Most of the data are old--however! Maybe it should get a second look as it may help to flush out HIV reservoirs and reducing immune activation markers. (That latter is a rather interesting idea as it is hyperactivation and accelerated senescence that may explain the massive apoptosis of uninfected CD4 cells and development of AIDS--this activation is generally not seen, for example, in sooty mangabeys who are naturally infected with an SIV in the wild that results in a productive infection but no clinical disease/AIDS...) (Google aidsmeds, IVIG, for example, for a story on this potentially novel therapeutic use of IVIG...)

    Well, there's today's digression!! Thanks for the IVIG comment as it's made me look at it again.

  4. Thanks again GM, always a pleasure.