MSG and Autism

Statement of Margaret Dunkle
Senior Fellow, Center for Health Services Research and Policy, George Washington University Director, Early Identification and Intervention Collaborative for Los Angeles CountyRecipient, American Academy of Pediatrics' Dale Richmond Award for Outstanding Achievement in the field of Child Development

May 12, 2008

Federal Interagency Autism Coordinating Committee

My name is Margaret Dunkle. Some of you know me through my current position as Senior Fellow with the Center for Health Services Research and Policy at George Washington University, and some from my prior work running policy seminars on Capitol Hill.

Some of you know me as recipient of the American Academy of Pediatrics' Dale Richmond Award for outstanding achievement in the field of child development, or for the collaborative efforts I direct in Los Angeles County to ensure all children receive good developmental screenings and effective follow-up.

More recently, some of you have come to know me because my nephew's daughter, Hannah Poling, is the little 9 -year-old girl from Athens, Georgia who was the subject of a case the government conceded in vaccine court. The nine vaccines Hannah received on one day in July of 2000 significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism and manifested as a regressive encephalopathy with features of autism spectrum disorder. Indeed, Hannah has autism, with a clear DSM-IV diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders.

I believe in a strong and safe immunization program. Yet, every day more parents and some pediatricians reject the current vaccine schedule. I am concerned that many people are missing Hannah's clearly scribbled handwriting on the wall. She has provided a critical clue (mitochondrial dysfunction) and a historic opportunity for our public health leaders and policymakers to act responsibly and decisively - undertaking serious science to address the very real concerns so many parents and families are raising.

Hannah's condition is not rare. The best evidence available strongly suggests that at least 7%, and perhaps as many as 20% or 30%, of children with autism have mitochondrial dysfunction similar to Hannah's. With one in every 150 children on the autism spectrum, these issues are both urgent and important.

Now that we know this, it is time to follow the prestigious Institute of Medicine's 2004 report that said:

"Determining a specific cause [for autism] in the individual is impossible unless the etiology is known and there is a biological marker. Determining causality with population-based methods requires either a well-defined at-risk population or a large effect in the general population."

Mitochondrial dysfunction defining an autistic subpopulation and the role of neuro-inflammation in autism are not esoteric theories. They are real leads that need to be quickly followed.

I urge you to support the following recommendations that reflect your Committee's mission to coordinate, monitor, and recommend changes concerning federal autism efforts.

#1 First and most importantly... With Marshall Plan speed and focus, I recommend a new, intense basic science research program to get to the bottom of what is going on with the many Hannahs out there - specifically focusing on the role of mitochondrial dysfunction and neuro-inflammation in autism.

How many Hannahs with mitochondrial dysfunction are there? 4%?, 7%?, 10%?, 20%? Where do these dysfunctions come from? How do they work? Can the negative effects be undone or limited?

This research must be bold, going wherever the science takes it, with nothing off the table.

I estimate $200 million will be needed to jump-start this research. This money must be a new or redirected appropriation, not borrowed or taken from the Vaccine Injury Compensation Program (VICP).

#2 Quickly find ways to screen for and identify the subset of children like Hannah for whom vaccines can cause or exacerbate mitochondrial damage and lead to symptoms of autism.

For example, start screening the siblings of children with autism to identify biomedical markers that could lead to screening tests and treatment.

#3 Piggyback new research onto existing studies to answer important questions about autism, vaccines, mitochondrial dysfunction and neuro-inflammation. For example:

Test alternative vaccine schedules and frequencies through the National Children's Study and use this data set of 100,000 children to get longitudinal data on these issues; and

Build new analyses into existing studies and cohorts of patients with known mitochondrial dysfunction - such as research already underway at Hopkins, the Cleveland Clinic Foundation and Columbia.

#4 Institute an immediate nationwide initiative to spot children, like Hannah, who have adverse vaccine reactions and speed them into intense early intervention (specifically, the federal IDEA Early Intervention program for children ages 0-36 months and the Preschool Education program for children ages 3-5).

An important corollary is to strengthen the Vaccine Adverse Event Reporting System (VAERS) so that it actually does the job it was set up to do - collecting information about adverse events, including "side effects," that occur after the administration of vaccines.

#5 Reform and improve the current vaccine schedule and practices to ensure they are as safe as they possibly can be. For example, examine the number and frequency of vaccines, use of combo vaccines, preservatives used, and ages administered to identify changes that would minimize damage to children, especially susceptible children such as Hannah Poling.

It is significant that the federal Advisory Committee on Immunization Practices' recently downgraded its preference for a MMRV vaccine (four-vaccines in one shot: measles, mumps, rubella and varicella) to "no preference" because of increased seizures among children receiving the MMRV.

#6 Update the Vaccine Injury Compensation Program. For example:

Allow parents longer than three years to file, especially given the newly identified "mitochondrial dysfunction" implications of the Hannah Poling decision and because we want parents and families to devote 100% of their energy to early intervention as soon as they learn their child has a problem; and

Update the list of "table injuries" to reflect the emerging discoveries about autism, mitochondrial dysfunction and immunological disorders.

#7 Improve the way the federal government approves and monitors vaccines and vaccine safety - perhaps establishing an independent agency (separate from the Centers for Disease Control, which also runs the National Immunization Program) to research, approve, and monitor vaccine safety and effectiveness.

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I am proud that my family is providing hope and voice to many families across our country who have their own Hannahs. I am also proud of their leadership to nudge those of us who care about good public health and good public policy to do the right thing and to do it right.

A little 9-year-old girl has raised incredibly tough and important questions. Your challenge, as leaders concerned about autism, is to tackle these issues in a way that is effective and unflinching - and that responds to her clear scribbling on the wall with equally clear advances in science and improvements in immunization practices.

July 10, 2008, studies indicated that at least 6 genes may be related to autism. The genes are:

1) C3orf58 - located at 3q24 (chromosome 3 - position q24)

This gene codes for a protein found in the human testes. It was deleted in cases of autism. The protein this codes for is not well known currently, but it is interesting that the protein is found in the male reproductive system considering that the risk of autism is greater in males than females. It is connected to tyrosine phosphorylation and epidermal growth factor. Is this a genetic clue as to why autism is more prevalent in males?

Neurexin 1 - In addition, in February of 2007, it was reported that the area of the human genome found to be associated with autism, contains the genes involved in buildingglutamate synapses - the very locations where glutamate is used as a neurotransmitter by the nerve cells.

The Amygdala and Fear Response in Autistic Children

Research about autism links overstimulation of the amygdala in the brain to perceiving faces as threatening. This explains why autistic children avoid the gaze of others.

It should be noted that the NMDA receptors that respond to both glutamate and aspartate (the amino acid found in aspartame) are found in the amygdala. The amygdala is part of the limbic system and is involved in the perception of taste and smell as well as fear. See glutamate receptors in the amygdala.

Could ingestion of MSG and aspartame, by targeting the amygdala, result in the perceptions and behaviors typically associated with autism?

Mercury

Children with autism have lower levels of glutathione, and may have difficulty chelating mercury (a suspected cause of autism) and removing it from the body. Excess glutamic acid has been proven to reduce glutathione levels that are protective against mercury poisoning. It is our belief that the large amount of free glutamic acid still present in all vaccines today as well as increasing amounts of free glutamic acid in processed food, is responsible for the autism epidemic.

We also believe that the mercury toxicity present in children with autism is a SIDE EFFECT of the disease, not the primary cause. Therefore, removal of thimerosol, will not reduce the incidence of autism, because mercury is still present in our food and water, and our dental fillings, and glutamic acid is STILL in the vaccines and present in ever larger quantities in processed wheat and dairy foods. The problem in autism is that no matter where the mercury comes from, it is not being removed as it normally should be. The excess of mercury caused by excess glutamate, then results in heavy metal toxicity. Considering that the newly discovered autism gene RNF8 is essential in FORMING glutathione, any additive in a vaccine that hinders glutathione formation is a not a good idea. Therefore free glutamic acid should absolutely be removed from vaccines given to children with autism genes.

Vaccine makers claim one "study" done in one Japanese city shows no link between autism and vaccines simply because after MMR vaccines were stopped in 1993, autism rates still rose. However, the study included only one city in a country that consumes more MSG, and fish (a dietary source of mercury) than most in the world. Also, only one vaccine was stopped - the MMR.

Compared to the amount of mercury consumed in fish, the amount of MSG in the diet, and the amount of glutamic acid in other vaccines, the MMR contribution of mercury and glutamate was small. Autism rates in Japan still increased.

Glutamate in any vaccine WILL put children at greater risk of mercury poisoning by hindering the ability of a child to rid themselves of mercury from ANY source. Unfortunately, free glutamic acid is found in nearly every vaccine in use today.

NOTE: We would be remiss if we did not mention TEACCH, an organization which helps address the behaviors of autism in an effort to enable autistic children and adults to lead productive lives in society. For while the causes of autism are still being investigated, these children are growing up and need to enter our society in meaningful ways. We should be ready to welcome them.

Gluten-Free, Casein-Free (GFCF) Diet

Current treatments for autism include gluten-free and casein-free diets. A current theory is that incomplete breakdown of gluten and casein result in the formation of casomorphins and gliadorphins, morphine-like compounds which act on the brain. Another theory (ours) is based on the fact that 15.5% of all the amino acids in wheat are glutamic acid in its free or active form and 22.9% of the amino acids present are aspartic acid in its free and active form (which can be converted to glutamate in only one step). In fact, wheat gluten is a considerable source of "natural" MSG in the diet. Items containing casein, like cheese, also are high in free glutamic acid. For example - 18.5 % of the amino acids found in cheddar cheese are free (active) glutamic acid. Parents helping their child adhere to a strict gluten-free, casein (dairy) -free diet may wish to consider also eliminating soy products from their child's diet as well, if glutamate is suspect.

McDonalds French Fries
Be aware that foods stating "natural flavor" on the label can be made from wheat and dairy products. As of February 22, 2006, McDonalds is in legal trouble after admitting their French fries which had been labeled gluten-free actually contain beef, wheat and dairy products due to the use of a "seasoning" placed into the oil where the fries are precooked before being shipped to restaurants. McDonalds spokespeople don't think the fries contain enough allergens or protein to cause a problem - or to label - but consumers are angry at not being told that dairy and wheat products were involved at all. Let the consumer be informed then they can decide to take the risk. Parents with autistic and celiac children are furious at being deliberately misled. Currently, there are three lawsuits pending.

The fact that McDonalds spokespeople are stating that there is no more protein left in the "seasoning" - tells this food scientist that the entire reason for using this "seasoning" is because it probably contains free glutamic acid broken down from the high glutamate containing protein foods mentioned (beef, wheat, and milk) - another way of flavoring their fries as if they were using MSG, without having to label it as such. Very clever, but completely unethical.