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Re: MMR vaccine and autism - Autism (The biggie)

Posted by Alamo Joe on September 12, 2001 at 14:04:55:

In Reply to: Re: MMR vaccine and autism - IBS posted by Alamo Joe on September 12, 2001 at 14:01:13:

MMR vaccine and autism: Wakefield is partially correct

Autism can follow MMR vaccination, but the vaccine does not directly cause autism. Wakefield et al. reported the temporal proximity of onset of autism and of gastrointestinal disorders (Primarily inflammatory bowel disease) with respect to immunization. (1) The confounding arises because 1) a single factor underlies both autism and inflammatory bowel disease and 2) the underlying factor was initiated by a reaction to the vaccination. This underlying factor once initiated, is self sustaining. The underlying factor is one or more of sleep related breathing disorders (Upper airway resistance syndrome and obstructive sleep apnea) of which obstructive sleep apnea is better known. Allergies make obstructive sleep apnea worse. (2) In individuals whose tissues define a narrow airway, when the vaccine causes an allergic reaction, swelling narrows the airway, leading to obstructive sleep apnea. When the ‘vaccine swelling’ is replaced by the airway swelling associated with obstructive sleep apnea, the case of obstructive sleep apnea becomes self sustaining. The primary gastrointestinal disorder, inflammatory bowel disease is caused by obstructive sleep apnea as has been explained in another paper. (3)

Postulated mechanism underlying autism.
Autism is caused by an insufficient oxygen supply. Deprived of oxygen the brain will die. However, obstructive sleep apnea can reduce blood oxygen during respiratory events, and these low oxygen levels occur every night. The loss is sufficient to effect the brain as indicated by the “memory deficits, inability to concentrate, and decreased alertness” symptoms of obstructive sleep apnea. (4) Additionally, 11 of 100 children diagnosed with obstructive sleep apnea experienced “delayed language acquisition and decreased school performance”. (2) The same paper reports “asocial” behavior of some of the children.

These same sleep related breathing disorders underlie the physical disorders which are comorbid with autism. Enuresis, sleep disturbance, (5) reflux (6), inflammatory bowel disease (1) and irritable bowel syndrome (7) have all been reported as comorbid with autism. Both enuresis and sleep disturbance are symptoms of obstructive sleep apnea. (2)

Horvath et al (6) linked gastrointestinal disorders to autistic children when esophageal reflux was detected in 69% of the 36 children. A letter to CHEST (8) describes the mechanism by which obstructive sleep apnea can cause reflux in individuals, even those with intact sphincters. Additionally that letter points out that another sleep related disorder, upper airway resistance syndrome also can cause reflux. Children are subject to both of these sleep related breathing disorders. (2, 9)

Both irritable bowel syndrome (10) and inflammatory bowel disease (3) have been described as secondary to sleep related breathing disorders.

Summary;
One consequence of identifying the cause of autism is that drugs will no longer be used to treat ADD/HD, a subset of autism. Parkinson’s disease may be linked to sleep related breathing disorders by virtue of the gastrointestinal disorders comorbid with Parkinson’s disease (11) and the high percentage of Parkinson’s disease patients diagnosed with sleep disturbance. (12) Further the nocturia which disturbs the Parkinson’s patient’s sleep (13) is a symptom of obstructive sleep apnea. Although the severity of Parkinson’s disease matches the severity of sleep disturbance, the precise relationship between Parkinson’s and sleep disturbances is unknown. (13)

References:
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 Lancet (England), Feb 28 1998, 351(9103) p637-41 (abstract)

2) Guilleminault C. Obstructive Sleep Apnea, The Clinical Syndrome and Historical Perspective. Medical Clinics of North America vol 69(6): 1187-1203 (full text)

3) Herr JR. The relationship between inflammatory bowel disease and sleep related breathing disorders.

4) Flemons WW; Tsai W. Quality of life consequences of sleep-disordered breathing. J Allergy Clin Immunol, 99(2):S750-6 1997 Feb (abstract)

5) Taira M; Takase M; Sasaki H. Sleep disorder in children with autism. Psychiatry Clin Neurosci, 1998 Apr, 52:2, 182-3 (abstract)

6) Horvath K; Papadimitriou JC; Rabsztyn A; Drachenberg C; Tildon JT. Gastrointestinal abnormalities in children with autistic disorder J Pediatr 1999 Nov;135(5):559-63, (full text)

7) Roberts TK. Chronic pain and chronic fatigue and related disorders. Talk-Hobart ME/CFS support group, Hobart, Tasmania. 13, May 2000. 14 August, 2001. 6, September 2001 (full text)

8) Herr JR. A Possible Pathologic Link Between Chronic Cough and Sleep Apnea Syndrome Through Gastroesophageal Reflux Disease in Older People. [letter] Chest 2001; 120(3): 1036-1037

9) Guilleminault C; Pelayo R; Leger D; Clerk A; Bocian RC. Recognition of sleep-disordered breathing in children. Pediatrics 1996 Nov;98(5):871-82 (full text)

10) Herr JR. Irritable Bowel Syndrome and Sleep disorders

11) Edwards LL, Pfeiffer RF, Quigley EM, Hofman R, Balluff M. Gastrointestinal symptoms in Parkinson's disease. Mov Disord 1991;6(2):151-156 (abstract)

12) Tandberg E; Larsen JP; Karlsen K. A community-based study of sleep disorders in patients with Parkinson's disease. Mov Disord 1998 Nov;13(6):895-9 (abstract)

13) Partinen M. Sleep disorder related to Parkinson's disease. J Neurol 1997 Apr;244(4Suppl 1):S3-S6 (abstract)

ca Alamo Joe

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