Showing posts with label Irva Hertz-Picciotto. Show all posts
Showing posts with label Irva Hertz-Picciotto. Show all posts

Sunday, September 20, 2009

Environmental Autism Research Study Follow-Ups? Let's Even Out Genetic and Environmental Autism Research Funding

Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones.

We need to even out the funding.

Irva Hertz-Picciotto, UC Davis M.I.N.D. Institute Researcher

Recent years have seen the "it's gotta be genetic" stranglehold on autism research funding identified by Teresa Binstock in 1999 break slightly, albeit ever so slightly, with genetic research still overwhelmingly favored for funding purposes at the expense of environmental autism research as reflected in the above quote from Irva Hertz-Picciotto. The obvious danger is that if you look for genetic causes you will find genetic causes and nothing more. If you do not look for environmental causes of autism then those environmental causes will not be found. Possible preventive measures may never be discovered and undertaken and even cures may be missed.

Two studies of particular interest to me were published in the last two years with the authors of both studies qualifying their conclusions with the caution that more research was required, more follow up needed to be done before any firm conclusions could be reached.

The authors of Proximity to point sources of environmental mercury release as a predictor of autism prevalence, Raymond Palmer, Stephen Blanchard and Robert Wood, found that "environmentally released mercury from power plants in 1998 is significantly associated with autism rates in 2002. For every 1000 pounds of release there is a corresponding 3.7% increase in autism rates." The authors also found that "for every 10 miles away from the source, there is a significant 1% decrease in the autism Incident Risk. A 20-mile distance would yield a 2.2% decreased risk."

Palmer, Blanchard and Wood were careful to point out that their study should be viewed as "hypothesis generating" with further research required to examine the role of environmental mercury and childhood developmental disorders. The authors pointed out other existing research related to environmental mercury and autism disorders:

"a host of other plant, animal and human studies have demonstrated that distance to sources of environmental mercury exposure are related to increased body burdens of mercury(Ordonez et al., 2003; Fernandez et al., 2000; Hardaway etal., 2002; Navarro et al., 1993; Kalac et al., 1991; Moore and Sutherland, 1981). However, the effects of duration and dose amounts of environmental exposures are not currently known—and we do not know that body burden of mercury is in fact related to the potential exposure measures used in these analyses.

Mercury is a known immune modulator (Moszczynski,1997). These effects include the production of auto antibodies to myelin basic protein (El-Fawal et al., 1999) and effects on the ratio of Th1/Th2 immunity factors (Kroemer et al., 1996). This is consistent with the literature demonstrating similar types of altered immune function in autistic children (Singh et al., 1997; Singh and Rivas, 2004; Krause et al., 2002; Cohly and Panja, 2005; Vojdani et al., 2003).

I previously blogged about a study noted in the Toronto Star concerning the effects of pollution from two Hamilton, Ontario steel mills on mice living down wind from the mills. The study Germ-line mutations, DNA damage, and global hypermethylation in mice exposed to particulate air pollution in an urban/industrial location was published in PNAS :

"Mice breathing the air downwind from Hamilton's two big steel mills were found to have significantly higher mutation rates in their sperm, a new Health Canada-led study says.

While there's no evidence that residents of the area are experiencing the same genetic changes, the project's lead author says the findings do raise that question.

"We need to do that experiment and find out," said Carole Yauk, a research scientist with Health Canada.

A future study will look at "DNA damage in the sperm of people living in those areas."

...

Dr. Rod McInnes, director of genetics at Canadian Institutes of Health Research, said the mice could be "the canary in the coal mine" signalling the genetic risks to humans of breathing toxic air. ... While genetic changes in sperm would not affect a male directly, they'd get passed on to the offspring that receive his DNA.


Why did this particular story grab MY attention? We lived on Leominster Drive, in the westerly area of Burlington adjacent to Hamilton for 12 months prior to Conor's conception and a further 9 months until he was born at the Joseph Brant Memorial Hospital in Burlington. Two years later he was diagnosed with PDD-NOS, shortly thereafter changed to Autistic Disorder with profound developmental delays.

No, I have not jumped to any rash conclusions concerning the Hamilton steel mills study but I would certainly be interested in any follow up studies done or planned as suggested by lead author and Health Canada research scientist Carole Yauk Ph. D., who stated that an experiment needed to be done to find out whether residents living in the area would suffer the same consequences. I actually emailed Dr. Yauk and asked about the prospects for the follow up study she had indicated needed to be done. She said she was optimistic that funding would be obtained but that such experiments were very expensive and obtaining grants was very competitive. I don't know if Dr. Yauk was ultimately successful in obtaining funding for her experiments. Hopefully the funding was found.

How about it Autism Speaks? Can you chip in to provide funding for some badly needed environmental autism research?

In the opinion of this humble autism dad it is long past time to shift some of the research funding from the overwhelmingly genetic oriented autism research to environmental based research.

20 to 1 doesn't sound right. Equal parts, 1 to 1, genetic to environmental autism research sounds a whole lot better.




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Tuesday, August 11, 2009

Autism Rising: 1 in 100 US Children Have an Autism Disorder


The images above are taken from the autism section of the 2007 US National Survey of Children's Health and indicate that 1 in 100 American children in the 2 to 17 age range have an autism spectrum disorder. That figure is yet another startling indication of the existence of a real autism crisis. Those who deny that environmental factors cause, in whole or in part, autism disorders, will have less and less credibility as 1% of American children are reported autistic. The expanded definition of autism disorders to include Aspergers Disorder in 1993-1994 is irrelevant to an increase from 1 in 150 reported by the CDC in the past few years to 1 in 100 now as reported by the NSCH. The 1 in 100 figure is in line with the UK figures as well although there a recent study suggests the actual rate may be closer to 1 in 58.

This new report is startling but where is the mainstream media on this? Why is the same media that have been busy ridiculing parents who question possible vaccine autism connections silent when public authorities provide information showing dramatic increases in autism? Since my son was diagnosed with autism in 1998 the reported figures for autism have changed from 1 in 500 to 1 in 250 to 1 in 166 to 1 in 100. Does the 1993-4 diagnositc definition change really explain fully the relentless increase in reported cases of autism over the past decade from 1999 to 2009?

And why are people like Dr. Tom Insel of the Inter Agency Autism Coordinating Committee silent? Autism researcher Teresa Binstock pointed out in 1999 that autism research funding allocations had been weighted heavily in favor of the "it's gotta be genetic" model of autism research funding allocations. The authors of the recent University of California Davis study which suggested environmental factors were involved in the increasing autism numbers in California have highlighted the neglected funding for environmental autism research:

“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said."

Over the past decade the numbers of autism cases have skyrocketed and yet the autism research funding still reflects the "it's gotta be genetic" model that Binstock outed in 1999. What is wrong with this picture? What is wrong with the decision makers who refuse to authorize funding to research environmental causes of autism? Do they have conflicts of interest that tie their hands or are they just too stubborn and tied to outdated paradigms to change?

In his recent appearance before Senator Harkin's subcommittee Dr. Insel desperately insisted that a comparative study of vaccinated and unvaccinated populations could not be done for ethical reasons even though unvaccinated populations already exist in the US and even though contrary statements have been made by people like Dr. Bernadine Healy, Dr. Julie Gerberding, and Dr. Duane Alexander. I DO NOT allege ANY conflicts of interest on the part of Dr. Insel. He seemed more like a true believer who does not have an open mind to arguments that challenge his views about vaccine safety.

Autism research funding has been heavily weighted toward genetic causes of autism. It is time to provide some balance as researcher Irva Hertz-Picciotto said and conduct environmentally based autism research. It is time to research all possible environmental causes of autism, including possible vaccine factors, as Dr. Jon Poling has stated.




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Sunday, January 11, 2009

Autism Research Folly

"the NIH and NIMH are impeding progress in research about causes, diagnostics, and treatment in autism and similar syndromes.

By clinging to an oversimplified and outmoded model of autism (ie, it's gotta be genetic), the stubborn persistence of several research administrators in the NIH and NIMH means that funding for autism and autism-spectrum syndromes remains funneled into the hands of a small group of researchers who pledge (via NIH-grant contracts) to conduct their research in accord with the model wherein "it's gotta be genetic" (1).

This funding pattern imposes a serious limitation on research that ought be occurring, given the growing amount of new data which indicate that *more than* genetic-aspects need be considered.

The relationship between (a) the offically approved though outmoded paradigm and (b) subsequent funding patterns is worth re-stating:

The persistence of the NIH and the NIMH in focusing almost entirely upon a genetic-theory of autism means that a goodly amount of data continues to be ignored, shunted from view, and unfunded -- even as the primary genetics-model researchers are blessed with abundant funding despite decades of non-success (1). For instance, the data from Wakefield, Warren, Singh, Shattock, Oleske et cetera are important, as are patterns amidst parental anecdotes -- eg, gastrointestinal atypicalities, vaccination effects, extraodrinarily recurrent otitis et cetera.

However, as recent years have shown, despite the many new data and anecotes, the NIH and NIMH are resistant to change. The new data remain virtually ignored, the parents' anecdotes treated as if mere hearsay. Not surprisingly, in the face of this bureaucratic intransigence, the goal of changing and improving the NIH and NIMH in regard to autism funding will require increased effort."

Teresa Binstock, Researcher in Developmental and Behavioral Neuroanatomy, in IGNAZ SEMMELWEISS and AUTISM: when prevailing paradigms resist change, 1999

The Binstock article, referenced above, was a review of Jeanne Achterberg's book Woman as Healer and the sad story of Ignaz Semmelweiss who challenged medical orthodoxy of his time (1818-1865) by gathering data and arguing that peuperal (childbed) fever was caused by the unclean hands of those who delivered, or assisted, delivery of children. Hospital wards staffed by midwives had a 3% mortality rate due to fever while those staffed by medical students who often came straight from autopsy rooms to the maternity rooms, and either did not wash their hands, or wiped them on already bloody, dirty clothes, had a 10% rate.

The medical establishment of the time did not believe Semmelweiss and he was professionally punished by lowering his academic standing and restricting his hospital privileges. Ultimately he became depressed and committed to an asylum where he died of blood poisoning. Binstock noted similarities between the treatment afforded Semmelweis, his conclusions, and his data and what has happened today to the anecdotal evidence of parents and researchers who followed up on that anecdotal evidence.

Teresa Binstock's contention that research of a possible vaccine-autism conection has been discouraged by public authorities is in fact confirmed in the Institute of Medicine (IOM) Immunization Safety Review: Vaccines and Autism (2004) . In that document the public health authorities expressly discouraged research of vaccine-autism connections as shown at p. 152:

Biological Mechanisms Conclusions

In the absence of experimental or human evidence that vaccination (either the MMR vaccine or the preservative thimerosal) affects metabolic, developmental, immune, or other physiological or molecular mechanisms that are causally related to the development of autism, the committee concludes that the hypotheses generated to date are theoretical only.

SIGNIFICANCE ASSESSMENT

The committee concludes that because autism can be such a devastating disease, any speculation that links vaccines and autism means that this is a significant issue.

PUBLIC HEALTH RESPONSE RECOMMENDATIONS

The committee recommends a public health response that fully supports an array of vaccine safety activities. In addition the committee recommends that available funding for autism research be channeled to the most promising areas.

Policy Review

At this time, the committee does not recommend a policy review of the licensure of MMR vaccine or of the current schedule and recommendations for the administration of the MMR vaccine.

At this time, the committee does not recommend a policy review of the current schedule and recommendations for the administration of routine childhood vaccines based on hypotheses regarding thimerosal and autism.

Given the lack of direct evidence for a biological mechanism and the fact that all well-designed epidemiological studies provide evidence of no association between thimerosal and autism, the committee recommends that cost-benefit assessments regarding the use of thimerosal-containing versus thimerosal-free vaccines and other biological or pharmaceutical products, whether in the United States or other countries, should not include autism as a potential risk.


Apart from the express discouragement of funding of research of a possible vaccine autism connection it is interesting to note the first paragraph of the above quote. The highlighted portion states "In the absence of experimental or human evidence " that vaccines are causally related to autism any such hypothesis can be theoretical only. Having noted an absence of evidence the IOM then discouraged any research that might have produced such evidence. It is also becoming less certain that the epidemiological studies were as well designed as the IOM contended given the continued presence of thimerosal in vaccines, including some vaccines given to pregnant women.

In the last year the Poling case upset the IOM 2004 strategy. Government had to acknowledge that, at least in some subsets of children vaccines could trigger "autism like symptoms" :

if you're predisposed with the mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism.

Dr. Julie Gerberding, Director, CDC, CNN Interview with Dr. Sanjay Gupta, March 29, 2008

As many have noted there is no intelligent distinction between autism and autism like symptoms. Autism is currently diagnosed by symptomatic behavior. In addition to Dr. Gerberding's reluctant acknowledgement of a vaccine-autism connection, Dr. Bernardine Healy, former director of the American Red Cross and the NIH, exposed limits of the epidemiological studes and expressed the need for further research of possible vaccine-autism connections in April 2008.

It is sheer folly to discourage research into possible environmental triggers or causes of autism. Not doing the research means that we might have missed out on possible treatments or preventative measures for autism. Teresa Binstock pointed out the folly of such a course of action in her 1999 comment. Now Irva Hertz-Picciotto, an author of the recent California study, has called for increased funding of research of possible environmental causes of autism.

It is time to move away from the "it's gotta be genetics" paradigm of autism research that Binstock described in 1999. It is time to move ahead with the autism research paradigm shift that the University of Minnesota called for in 2007, a paradigm based on the premise that autism is caused by a combination of environmental influence and genetic vulnerabilities.

It is time to end the "its gotta be genetics" autism research folly.




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Friday, January 09, 2009

Environmental Causes of Autism - It Is Time To Get The Research Done

The new UC Davis Mind Institute study indicating the likelihood of environmental factors in the dramatic increases in autism cases in California is a step forward in the still developing autism research paradigm shift that investigates autism disorders and their causes from the perspective that autism is caused by a combination of environmental influence and genetic vulnerabilities:

Autism research is poised for another paradigm shift, from an irreversible condition to a treatable disease. In the revolutionary paradigm, autism is not a rare disorder with a constant rate but frequent condition with a rising incidence. It is a combination of environmental influence and genetic vulnerabilities. It is both preventable and treatable, not by any one method but by a combination of behavioral and biomedical approaches. Autistic kids are not defective, they are sick but otherwise normal kids, and thus, recoverable

University of Minnesota, Press Release, July 2007

The move to a combined environmental-genetic research model seems to be long overdue. The vaccine-autism controversy may well have pushed public authorities away from possible environmental causes of autism generally but it is difficult to understand why anyone ever assumed that autism is entirely genetically determined. In a December 2007 interview piece published on TimesOnLine, Freedom of Expression, Professor Simon Baron-Cohen made the following salient observiation:

Studies of twins have established that it is not 100 per cent genetic, since even among identical twins, when one has autism, the likelihood of both twins having autism is only about 60 per cent. This means there must also be an environmental component, but what it is remains unknown. 

The vaccine-autism controversies have generated entrenched positions and ideologies on all sides of those controversies.  One of the unfortunate tendencies has been a tendency to berate and ridicule any mention of possible environmental causes of autism disorders. Another has been a focus on genetic research to the near exclusion of environmental factors.  That has begun to change, as called for in the University of Minnesota 2007 press release but the change is not as fast as it could be.  

The vaccines we give children still contain the mercury based preservative thimerosal, according to the FDA web site and children are exposed to a variety of toxic materials in toys and jewelry including mercury, lead, and arsenic.  If specific environmental factors are causing or contributing to autism, whether in isolation, or in concert, then preventative measures can be taken and research into curing autism can, and should,  incorporate those factors.

It is time to drop the rigid, ideological belief that autism is 100% genetic and get the environmental research done to help our children.




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Thursday, January 08, 2009

Autism Rising - UC Davis Mind Institute Study Points To Environmental Factors

Although Classics Professor Kristina Chew, ASAN co-founder Dora Raymaker, and the once progressive Change.org have decreed that autism is most likely entirely genetic, with no environmental contributing factors, recent research says otherwise. The UC Davis MIND Institute has published a news release of a study indicating that the dramatic rise in California autism cases probably arises from environmental factors. The news release also calls for an autism research paradigm shift from simplistic focus on genetic causes of autism to an examination of both genetic and environmental factors. ... with the funding necessary to fully implement the shift. In fact UC Davis Mind Institute has already been a leader in this autism research paradigm shift with its CHARGE program, a major epidemiological study investigating environmental factors and gene-environment interactions in autism disorders.

January 7, 2009 (SACRAMENTO, Calif.)A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted — and the trend shows no sign of abating.

Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California’s children.

“It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher. .... Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state’s increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.

...

“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said.








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Wednesday, November 19, 2008

"MARBLES" - Rare Study Examines Environmental Factors In Autism Disorders

MARBLES, Markers of Autism Risk in Babies - Learning Early Signs, is a rarity. The study being conducted by UC Davis researcher Irva Hertz-Picciotto is looking at possible environmental triggers for autism.

The Autism Knowledge Revolution advances almost daily with announcements of genetic studies and breakthroughs in understanding genetic causes or bases for autism spectrum disorders.
But there seem to be fewer studies focusing on possible environmental factors.

The News10/KXTV report quotes Ms. Hertz-Picciotto:

"Autism is very clearly not a single cause type of condition. It's got to be multiple factors," said Hertz-Picciotto, who hopes her study will reveal environmental factors that combined with genetics can trigger autism.

"We expect to find a number of different exposures that affect neurodevelopment and may be related to autism mildly, small increments of risk, for each exposure, but there may be multiple exposures," said Hertz-Picciotto.

To date the study involves 100 women and 59 babies who are being followed for a three year period. Blood samples will be withdrawn at regular periods.




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