Press Release: Thoughtful House scientists make important breakthrough in autism
Embargoed until 24.00hrs 31st October 2004
512 569 3777
Dr Andy Wakefield MB.BS., FRCS., FRCPath
512 695 0020
Thoughtful House scientists make important breakthrough in autism
Scientists from the Austin-based foundation Thoughtful House Center for Children have made an important breakthrough in identifying the source of damage to the immune system and intestine in children with regressive autism.
Autism is a developmental disorder that has reached epidemic proportions in the US and Europe. Autism severely impairs a child’s speech and language development and social interaction. In regressive autism, which is becoming increasingly common, skills are lost in a previously developmentally normal child. Children with autism and regressive autism in particular, frequently have gastrointestinal symptoms such as abdominal pain and diarrhoea that have been largely ignored by doctors for many years.
Thoughtful House scientists have previously discovered and reported a novel inflammatory bowel disease in children with regressive autism. The study published in this month’s Journal of Clinical Immunology confirms that this new disease is unlike other childhood intestinal disorders such as Crohn’s disease, celiac disease or ulcerative colitis.
The importance of the intestinal inflammation in these children is that it is thought to be a source of toxic intestinal products that may cause injury to the developing brain.
The key findings of this study include:
§ The demonstration that molecules (cytokines) produced by immune cells in the intestine that cause or control inflammation show an abnormal pattern in autistic children compared with children without autism, and that this pattern is different from other forms of intestinal inflammation.
§ That the disease resembles a longstanding viral disease of the intestine, not unlike the intestinal inflammation seen in patients with other viral infections such as HIV-associated enteropathy (meaning intestinal disease) that often accompanies infection with HIV, the virus that causes AIDS.
§ That the level of one potent pro-inflammatory molecule called Tumor Necrosis Factor Alpha (TNFα) was particularly high in the cells from the intestinal lining, providing a potential target for treatment. Drugs that block this molecule have been shown to be beneficial in patients with Crohn’s disease and rheumatoid arthritis.
§ In children on a diet that excludes gluten (from wheat and other cereals) and casein (from cow’s milk products), that is often used by parents to benefit their affected children, levels of the pro-inflammatory molecule TNFα were significantly lower than those not on this diet. This provides important biological data in support of the use of this diet in autism.
Dr Arthur Krigsman, a specialist in childhood intestinal disease from New York University, who has independently confirmed Dr Wakefield’s original findings of bowel disease in these children and who is joining Thoughtful House’s specialist team, commented:
“Not only does this important finding provide convincing evidence of a specific inflammatory disease in these children, but also it gives us targets for treatment.”
Thoughtful House Board member and Austin physician Deborah Peel M.D said:
“This study resolves any controversy about whether or not these children have intestinal disease; the crucial research questions need to focus on what is causing the current epidemic rise in this disorder.”
Thoughtful House physician and scientist Dr Andrew Wakefield who led the research team, commented:
“Changing people’s perception of a disease is a long, painstaking process. The science must lead and the rest will follow. Parents and their affected children have been short-changed for too long. Thoughtful House is set to help change all that. Austin is the place to make it happen.”
Grant support was given by the US 501(c)(3) foundations: The Ted Lindsay Foundation, The Johnson Family Foundation, Liz Birt and Medical Interventions for Autism, and the Autism Research Institute
The UK charities: The Scott of Yews Trust, VISCERAL, and the Normamby Trust.
What is Thoughtful House?
Thoughtful House is a new initiative in Austin, Texas, that will provide specialist clinical and education services for children affected by childhood developmental disorders, in combination with a dedicated research program.
The goal of Thoughtful House is to utilize the benefits of past and current research and combine the talents of leading clinicians, researchers and educators in one dedicated facility.
Thoughtful House is a data-driven, results-focused environment for generating “best practice” educational models and setting new standards of medical care for children affected by childhood developmental disorders.
In addition, Thoughtful House will address the physical, recreational and creative needs of children in areas of occupational therapy, speech therapy and hippotherapy.
Clinical services are set to begin in December of 2004 with pediatric and pediatric gastroenterology clinic for children with autism and related disorders.
Why Thoughtful House?
Thoughtful House was named by Marshall Ball, son of the founders Troy and Charlie Ball. Despite severe handicaps Marshall is a highly gifted child who has appeared on Oprah and published several best-selling collections of his poetry.
Relevant Scientific Publications and Presentations
1. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA.
Ileal lymphoid nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children.
1) 2. Krigsman AC., Boris M., Goldblatt A.
2) Frequency of histologic enterocolitis and lymphonodualr hyperplasia in autistic children presenting for ileo-colonoscopy.
3) International Meeting for Autism. University of California, Davis. June 2004
3. Wakefield AJ., Anthony A., Murch SH., Thomson M., Montgomery SM., Davis S.,.et al. Enterocolitis in children with developmental disorders. Am J Gastroenterol. 2000;95:2285-2295
4. Furlano R,. Anthony A., Day R., Brown A., McGavery L., Thomson M., et al. Quantitative immunohistochemistry shows colonic epithelial pathology and gd-T cell infiltration in autistic enterocolitis. J Pediatrics 2001;138:366-372
5. Torrente F, Machado N, Ashwood P, et al. Enteropathy with T cell infiltration and epithelial IgG deposition in autism. Molecular Psychiatry. 2002;7:375-382
6. Ashwood P, Murch SH, Anthony A, Pellicer AA, Torrente F, Thomson M, Walker-Smith JA, Wakefield AJ. Intestinal lymphocyte populations in children with regressive autism: Evidence for extensive mucosal immunopathology. Journal of Clinical Immunology, 2003;23:504-517
7. Ashwood P, Murch SH, Anthony A, Hayes C, Machado MP, Torrente F, Thomson MA, Heuschkel R, Wakefield AJ., Mucosal and peripheral blood lymphocyte cytokine profiles in children with regressive autism and gastrointestinal symptoms: Mucosal immune activation and reduced counter regulatory interleukin-10. Gastroenterol. 2002;122 (Suppl):A617
8. Wakefield AJ. The Gut-Brain Axis in Childhood developmental Disorders. Journal of Pediatric Gastroenterology and Nutrition. 2002;34:S14-S17
9. Wakefield AJ., Puleston J. Montgomery SM., Anthony A., O’Leary J.J., Murch SH Entero-colonic encephalopathy, autism and opioid receptor ligands. Alimentary Pharmacology & Therapeutics.2002;16:663-674
Uhlmann V, Martin CM, Sheils O, Pilkington L, Silva I, Killalea A, Murch SH, Wakefield AJ, O’Leary JJ., Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Molecular Pathology 2002;55:84-90
Horvath K, Medeiros L, Rabsztyn A, et al.: High prevalence of gastrointestinal symptoms in children with autistic spectrum disorder (ASD). J Pediatr Gastroenterol Nutr. 2000, 31:S174.
Horvath K and Perman JA, Autistic disorder and gastrointestinal disease, Current Opinion in Pediatrics. 2002, 14:583–587
Horvath K, Papadimitriou JC, Rabsztyn A, et al.: Gastrointestinal abnormalities in children with autistic disorder. J Pediatr 1999, 135:559–563.
Melmed RD, Schneider C, Fabes RA, et al.: Metabolic markers and gastrointestinal symptoms in children with autism and related disorders. J Pediatr Gastroenterol Nutr. 2000, 31:S31–S32.