Holford, autism, Wakefield and a manufactured disease

In a 17/3/08 e-mail to his mailing list, Prof Patrick Holford of Teesside University discusses Wakefield’s work and the possible role of the gut in autism.

Wakefield’s hypothesis can be summarised as follows:
[A] subset of children…develop[e] a particular form of developmental regression following previously normal development, in combination with a novel form of inflammatory bowel disease…Exposure [to the MMR vaccine] leads to long-term infection with measles virus within key sites, including the intestine, where it is associated with lymphoid hyperplasia and acute and chronic mucosal inflammation.

It sounds like a plausible hypothesis, but it’s wrong. One would expect a professor carrying out research in this field to know this – but we will recap the evidence, in case Prof Holford might have missed some of it. This idea of a ‘novel form of inflammatory bowel disease’ is – as a scientist writing on Left Brain Right Brain argues – an example of how one can manufacture a disease (which then creates a market for treatments). The evidence for such a disease was never good:

In a forensic dissection of the key paper by Wakefield and colleagues in the Am J Gastroenterology in 2000 (Am J Gastroenterol. 2000 95:2285-95), MacDonald and Domizio clearly showed that the so-called enterocolitis was due to Wakefield incorrectly deeming enlarged lymphoid follicles in the gut as pathological abnormalities, and that he had also created new and unsubstantiated pathological abnormalities to give the impression of gut pathology.

A particular problem is that Wakefield claimed that

a tissue section from the gut of an autistic child was abnormal if it contained a lymphoid follicle. However when the gut biopsies were taken at colonoscopy from autistic children, lymphoid follicles were specifically targeted for sampling because they wanted to look for measles in these tissues. So it is obvious that all will have pathology if one uses this invented criteria.

Things look even more suspicious when one notes that

MacDonald was also an expert witness last year in the Hazelhurst versus HHS case in the USA. In his testimony MacDonald re-iterated in some depth the extent of Wakefield’s rogue and junk science, going back all the way to his identification of measles virus in Crohn’s disease using reagents which were not specific for measles virus. However he picked up yet another deception in the Am J Gastro paper. Much of the paper deals with the alleged lymphoid hyperplasia in the ileum of autistic children, graded by Wakefield on a score 0-3, with 0 being no follicles and 3 allegedly an undefined “severe” lymphoid hyperplasia. To illustrate the colonoscopic appearances of grades 0-3, a panel of photographs purportedly showing the different grades is included as Figure 1 of the paper. The date and time each photograph was taken is reproduced in figure. The image of alleged grade 0 ileal lymphoid hyperplasia (ILH) was taken on the same day and only 1 minute 54 seconds before the image of alleged grade 3 ILH. It is impossible to remove a colonoscope from 1 child and scope another child, reaching the ileum in 1 minute 54 seconds. Therefore the grade 0 and grade 3 images were taken from the same child; the grade 0 image most probably from the caecum ( the part of the colon just after the ileum) and the grade 3 image from the terminal ileum.

Of course, autistic children do have bowel problems – and no-one is saying that they should be denied treatment for such problems. However, constructing these problems as a novel disease is a different matter: as the scientist blogging on Left Brain Right Brain notes

Throughout this saga, Wakefield has traded on the fact that autistic children do have real gut problems. However instead of attributing these problems in the majority of children to a combination of chronic and severe constipation, fecal impaction, unusual diet, diarrhea, bloating, parasites, gas etc, he had to find a new disease!

This finding of new diseases is a favourite big pharma tactic – once you have manufactured a disease, you can then sell ‘treatments’ for it. Coincidentally, Wakefield now offers dubious autism treatments at the Thoughtful House clinic in America. Holford recommends that those with autism supplement omega 3 fats and “Nutrients for a healthy gut”, and happens to have a commercial interest in selling these products.

No wonder that Holford will be outside Andrew Wakefield’s GMC hearing – where Wakefield is accused, based on strong evidence, of unethical research on vulnerable children – at a protest in support of Wakefield. Manufactured new diseases are a great thing for a whole manner of people – especially for those in big pharma and big CAM, with shiny new treatments to sell – but not, by and large, for those ‘diagnosed’ with and ‘treated’ for these new maladies.



Filed under Andrew Wakefield, MMR, patrick holford, vaccination

8 responses to “Holford, autism, Wakefield and a manufactured disease

  1. Nice post. Didn’t know about the Am J Gastro paper, though I had seen in various places that the GI endoscopy findings were “normal mislabelled as pathological”.

    Amazing, isn’t it, how after all the demonstrations that every single aspect of Wakefield’s work was invented, misreported and misrepresented nonsense, PH and the rest of the Wakefield cheerleaders can’t accept it. The patient selection was fixed, the GI findings are misclassified to “invent” a non-existent syndrome, the measles virus detection was a farrago of nonsense, the concealed conflicts of interest were damning… and STILL they can’t accept the obvious interpretation: that Wakefield was hungry to be famous and an utterly lousy scientist. Instead they have to carry on seeing him as a “wronged crusader for Truth” (for a recent example see the depressing comments
    thread here).

    Why is it so hard to accept that the obvious is true, I wonder? It pretty much goes without saying, but I have never met a single scientist or medic, including a couple of GI clinician scientists I know, who views Wakefield other than as a “data fiddler”.

  2. Real Prof

    I would be very keen to see photographs of Professor Patrick Holford of Teesside University at the anti-MMR protest outside the GMC.

    Could anyone oblige?

    Anyone nearby in UCL, UCLH, ICH perhaps?

    The world should know about the Teesside Professors strong views on ethics in research.

  3. I’m not hugely surprised that PH and AW are associated. Birds of a feather and all that….

    I read the LBRB piece you linked to – thought it was excellent. I also looked at Dr Aust’s link to the Times comments, though. Not so good:

    “As far as I know back in history adults and children drank mead as part of their stable diet. This article is an insult to us mothers who have vaccine damaged children”; “Dr Wakefield’s research was not discredited and the results still stand”; and my favourite – “The truths stareing us in the face mercury and vaccines dont go”.

  4. I tried adding a comment over at the Sunset Times online pointing out that (i) the article wasn’t about Wakers; (ii) most of the Lancet authors had retracted the paper; and (iii) every aspect his work had been comprehensively discredited.

    Oddly enough it failed to reach the “Comments Thread”.

    I then emailed the ST to tell them I thought that leaving a whole thread of anti-vax loons up without a single countervailing comment was abysmal work on their part, but that didn’t elicit anything either.

    I actually suspect sometimes that the Meejah enjoy comments threads full of ultra-barking lunacy. It enables them to rub their hands – “Yaay! Controversial!” – and also to maintain the line (visible in many an editorial piece recently) that the blogosphere is “all static with nothing to tell responsible journalists”.

  5. Sometimes, it is a little like the meejah are offering up John Merrick for our entertainment and it makes me a little queasy…

  6. pv

    What are the likes of Holford and Wakefield to do if they don’t make a lot of distracting noise and fight to defend their respective nonsenses? There’s a lot of money at stake and maybe even their liberty.

  7. Pingback: Patrick Holford and His Recommendations for Vaccines: As Canard-Stuffed As We Feared « Holford Watch: Patrick Holford, nutritionism and bad science

  8. Pingback: Brian Deer Discusses Andrew Wakefield in the Sunday Times « Holford Watch: Patrick Holford, nutritionism and bad science

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