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Editorials

Wakefield’s article linking MMR vaccine and autism was fraudulent

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.c7452 (Published 06 January 2011) Cite this as: BMJ 2011;342:c7452

If Wakefield's Lancet study was a fraud, why were its findings duplicated in 5 other countries?

1) Gonzalez, L. et al., Endoscopic and Histological Characteristics
of the Digestive Mucosa in Autistic Children with gastro-Intestinal
Symptoms. Arch Venez Pueric Pediatr, 2005;69:19-25.

2) Balzola, F., et al., Panenteric IBD-like disease in a patient with
regressive autism shown for the first time by wireless capsule
enteroscopy: Another piece in the jig-saw of the gut-brain syndrome?
American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.

3) Balzola F et al . Autistic enterocolitis: confirmation of a new
inflammatory bowel disease in an Italian cohort of patients.
Gastroenterology 2005;128(Suppl. 2);A-303.

4) Krigsman A, Boris M, Goldblatt A, Stott C. Clinical Presentation
and Histologic Findings at Ileocolonoscopy in Children with Autistic
Spectrum Disorder and Chronic Gastrointestinal Symptoms. Autism Insights.
2009;1:1-11.

5) Horvath K., Papadimitriou J.C., Rabsztyn A., Drachenberg C.,
Tildon J.T. 1999. Gastrointestinal abnormalities in children with autism.
J. Pediatrics 135: 559-563.

6) Sabra S, Bellanti JA, Colon AR. Ileal lymphoid hyperplasia, non-
specific colitis and pervasive developmental disorder in children. The
Lancet 1998;352:234-5.

7) Sabra A, Hartman D, Zeligs BJ et al., Linkage of ileal-lymphoid-
nodular hyperplasia (ILNH), food allergy and CNS developmental
abnormalities: evidence for a non-IgE association, Ann Allergy Asthma
Immunol, 1999;82:8

8) Galiatsatos P, Gologan A, Lamoureux E, Autistic enterocolitis:
Fact or fiction? Can J Gastroenterol. 2009:23:95-98

9) Jarocka-Cyrta et al. Brief report: eosinophilic esophagitis as a
cause of feeding problems in an autistic boy. The first reported case.J.
Aut. Dev. Disord. Online July 10, 2010

The following articles support the importance of recognizing and
treating gastrointestinal symptoms in autistic children:

1) Buie T, et al. Pediatrics. 2010 Jan;125 Suppl 1:S19-29.
Recommendations for evaluation and treatment of common gastrointestinal
problems in children with ASDs.

2) Buie T, et al. Pediatrics. 2010 Jan;125 Suppl 1:S1-18.
Evaluation, diagnosis, and treatment of gastrointestinal disorders in
individuals with ASDs: a consensus report.

The following peer-reviewed papers provide further support for
gastrointestinal disturbances involving the immune system in autism.

1) Jyonouchi H., Sun S., Lee H. 2001. Proinflammatory and regulatory
cytokine production associated with innate and adaptive immune responses
in children with autism spectrum disorders and developmental regression.
J. Neuroimmunol. 120(1-2):170-9

2) Jyonouchi H, Geng L, Ruby A, Zimmerman-Bier B. Dysregulated Innate
Immune Responses in Young Children with Autism Spectrum Disorders: Their
Relationship to Gastrointestinal Symptoms and Dietary Intervention.
Neuropsychobiology. 2005;28:5177-85

3) Jyonouchi H, Geng L, Ruby A, Reddy C, Zimmerman-Bier B. Evaluation
of an association between gastrointestinal symptoms and cytokine
production against common dietary proteins in children with autism
spectrum disorders. J Pediatr.2005;146(5):605-10.

4) Jyonouchi H, Sun S, Itokazu N. Innate immunity associated with
inflammatory responses and cytokine production against common dietary
proteins in patients with autism spectrum disorder. Neuropsychobiology.
2002;46(2):76-84.

5) Vojdani A, O'Bryan T, Green JA, McCandless J, Woeller KN, Vojdani
E, Nourian AA, Cooper EL. Immune response to dietary proteins, gliadin and
cerebellar peptides in children with autism. Nutr. Neurosci. 2004;7:151-
61.

6) Whiteley P, Haracopos D, Knivsberg AM, Reichelt KL, Parlar S,
Jacobsen J, Seim A, Pedersen L, Schondel M, Shattock P. The ScanBrit
randomised, controlled, single-blind study of a gluten- and casein-free
dietary intervention for children with autism spectrum disorders. Nutr
Neurosci. 2010;13(2):87-100.

7) Knivsberg AM, Reichelt KL, H?ien T, N?dland M. A randomised,
controlled study of dietary intervention in autistic syndromes. Nutr
Neurosci. 2002;5(4):251-61.

8) Balzola F, et al. Beneficial behavioural effects of IBD therapy
and gluten/casein-free diet in an Italian cohort of patients with autistic
enterocolitis followed over one year. Gastroenterology 2008;4:S1364.

9) Valicenti-McDermott M., McVicar K., Rapin I., et al., Frequency of
Gastrointestinal Symptoms in Children with Autistic Spectrum Disorders and
Association with Family History of Autoimmune Disease. Developmental and
Behavioral Pediatrics. 2006;27:128-136

10) Chen B, Girgis S, El-Matary W. Childhood Autism and Eosinophilic
Colitis. Digestion 2010;18:127-129

11) Sandler R, Finegold SM., Bolte ER., et al. Short-term benefit
from oral vancomycin treatment of regressive-onset autism. J Child Neurol.
2000;15:429-435

Competing interests: No competing interests

14 January 2011
Lucija Tomljenovic
Postdoctoral Fellow
University of British Columbia