SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet"

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September 27, 2002 CALENDAR LISTING: EVENTS@doitnow.com

[Editor's note: Much dreary, some tabloid-esque news items today, not including the research, however. These stories seem to come in clusters. –LS.]

RESEARCH

* 'Glutaid' on the horizon? Cereal Protein May Cause

Autoimmune Disorder

* Stanford Researchers Find Cause, Possible Cure For

Gluten Intolerance

* On The Twin Risk In Autism

* Neocortical System Abnormalities In Autism:

An fMRI Study Of Spatial Working Memory

FORENSIC

* Aspergers Boy Accused Of Mutilating Poodle To Remain In Custody

* Aspergers Boy Accused of Mutilating Dog Remains in Detention

* Evicted Mum Says Autistic Son Is Victim

* Autistic Man Pleads Guilty To Murder

CARE

* Mother Fed Up Over Fence: Autistic Boy Hit By a Car

* Youngsters Link Up In Art Contest For Volunteer Respite Care

PUBLIC HEALTH

* Company to Launch Preservative-Free Influenza Vaccine For Infants

* Reader's Posts

RESEARCH

'Glutaid' on the horizon? Cereal Protein May Cause Autoimmune Disorder

Scientists have identified a protein fragment in many cereal grains that may cause the autoimmune disorder, Celiac Sprue, and an enzyme that may help treat the disorder. Celiac Sprue requires strict adherence to a gluten-free diet, and affects approximately one in 200 individuals, according to U.S. and Norwegian researchers. The team reports its findings in the journal Science, published by the American Association for the Advancement of Science.

Although Celiac Sprue is relatively common, scientists generally know little about its specific cause or how to treat it, according to study author Chaitan Khosla of Stanford University.

"When I do presentations about the disease, typically the response I get is, 'Who is Celiac Sprue?'" Khosla said. "This disease has been overlooked in a very serious way by the basic science, clinical, and pharmaceutical communities." The disorder is a major burden for people who have it, according to Khosla. Gluten proteins, which occur naturally in wheat, rye, and barley, are used in many other foods, as certain forms of food starch, flavorings, or processing agents. For "celiacs," even small amounts of gluten can cause a variety of symptoms, many digestion-related. Over the long term, eating gluten can cause serious damage to their small intestines.

"If you are diagnosed with Celiac Sprue, typically the physician gives you a referral to a dietician, who gives you a book about the size of a New York City phone book, that lists all the things you can't eat. The bottom line is, if you go into a typical grocery store with that phone book, it will tell you that you can't buy 90 percent of the things in the store," Khosla said.

The main toxic components of gluten are a family of proteins called gliadins, which, like all dietary proteins, can be broken down into subunits called peptides. Khosla and his colleagues have identified a large gliadin peptide that does not break down during digestion, and likely triggers celiacs' immune systems upon reaching the small intestine, the authors suggest.

"The peptide is essentially like sand. If most people ate it, not much would happen to it. It would just go through the gut. But in the small intestines of celiacs, this peptide is highly inflammatory," Khosla said.

The researchers also identified a bacterial enzyme that breaks down this and related peptides, suggesting that adding it or a similar enzyme to celiacs' diets might allow them to eat some gluten. Products like Lactaid, for lactose intolerant individuals, contain an analogous enzyme that breaks down lactose, Khosla explained.

Exactly how the peptide causes intestinal damage isn't completely clear yet. Thus far, scientists have figured that the autoimmune reaction to gluten is related to a gene shared by 90 percent of celiacs, called HLA-DQ2. The gene plays a role in one of the immune system's strategies for recognizing and destroying foreign peptides, or "antigens." Specifically, the gene encodes a key receptor on the surface of certain immune cells. The receptor binds to antigens, "displaying" them to activate certain T cells to launch a specialized attack.

It's generally agreed that the HLA-DQ2 receptor seems to be prone to binding with gluten peptides, which are first modified by an enzyme in the small intestine called "tissue transglutaminase" to make them a particularly "sticky" match. The T cells then mistake the modified peptides for a foreign antigen and attack the body's own tissue.

Khosla and colleagues identified their candidate peptide by exposing gliadin proteins to various enzymes that simulated the digestion process. A relatively large fragment, made up of 33 amino acids, stayed intact throughout these experiments, and also proved resistant to digestion in live rats.

The peptide was also readily modified by tissue transglutaminase, the authors found, and the resulting product was a potent stimulant of inflammatory T cells isolated from small intestines of celiacs.

Although other peptides capable of triggering celiac-specific T cells have been identified from gluten, they are structurally related to the peptide identified in this study. Thus, Khosla and his colleagues believe that the same bacterial enzyme could also destroy those peptides, although this yet to be shown. Another outstanding question is why some people with the HLA-DQ2 gene do not have the disorder at all.

"That's a major unanswered mystery about the disease that hopefully will be answered in the next few years," Khosla said.

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Stanford Researchers Find Cause, Possible Cure For Gluten Intolerance

[Here is another report from the same news service as the previous article. It does contain some additional informaton. –LS.]

Stanford, Calif. - A team of investigators led by Stanford University researchers have discovered the cause and a potential treatment for celiac sprue, an autoimmune disease that leads to an inability to digest gluten, a major protein in wheat, rye and barley products. The disease is estimated to afflict as many as 1 in 200 Americans.

In the Sept. 27 issue of Science, researchers identify a fragment of gluten called gliadin as the celiac culprit. They showed that this fragment is resistant to digestion and is responsible for the intestine-damaging inflammatory response experienced by celiac patients. They also report the use of a dietary enzyme made by a bacterium that can break down the fragment into harmless bits, suggesting future treatment through dietary supplements.

"These findings are the first step to giving people with celiac disease real hope for a normal life," said Chaitan Khosla, PhD, professor of chemistry, chemical engineering and, by courtesy, of biochemistry. Lu Shan, a graduate student in Khosla's lab, was lead author on the paper. The team included other Stanford researchers as well as a group from the University of Oslo in Norway.

The lining of the small intestine is normally carpetlike, covered with small protrusions called villi. Celiac disease, however, results in a smooth, pipelike intestine. The reduced surface area keeps the body from absorbing nutrients. Often diagnosed in childhood, the disease can lead to the distended stomach and stunted growth typical of starvation.

"The only effective therapy for most people is a lifelong gluten-free diet, and that's fairly restrictive," explained co-author Gary M. Gray, professor of medicine, emeritus. The diet is essential over the long term both to restore normal intestinal function and to reduce the risk of developing osteoporosis, lymphoma or cancer of the small intestine, he added.

In the laboratory, Shan simulated the digestive process, exposing gliadin to digestive enzymes in test tubes. She identified a protein fragment made up of 33 amino acids that was resistant to further digestion and whose structure was known to be toxic. Most proteins are broken down into small peptides of between two and six amino acids or into single amino acids. She then repeated her study in rats and again in test tubes using tissue taken by biopsy from patients undergoing unrelated medical procedures. "Even with prolonged treatment (exposure to intestinal enzymes), the peptide doesn't lose the ability to induce the inflammatory response," Shan said.

When they looked more closely at the fragment, Shan and her colleagues found that it was made up of even smaller fragments already known to induce human T-cells to attack the intestine. The team in Norway then measured the ability of the gliadin fragment to induce autoimmune activity. "The response by T-cells was about 10 to 20 times higher than the smaller peptides themselves," Shan said.

Because the fragment is rich in the amino acid proline, investigators reasoned that a peptidase (an enzyme that breaks down proteins) with the ability to digest proline-rich chains might be able to break down the gliadin fragment, rendering it harmless to celiac patients. They have now shown that this is the case in test tubes and in rats. Because there are no animal models of celiac disease, testing this approach in humans is a long way off and will require further preclinical work, Khosla said. "We think that this mode of therapy - peptidase supplementation - may offer hope in treating celiac sprue eventually, and we're going to test this hypothesis."

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On The Twin Risk In Autism

ds=12297988&dopt=Abstract

Hallmayer J, Glasson EJ, Bower C, Petterson B, Croen L, Grether J, Risch N. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. joachimh@stanford.edu

Autism is considered by many to be the most strongly genetically influenced multifactorial childhood psychiatric disorder.

In the absence of any known gene or genes, the main support for this is derived from family and twin studies.

Two recent studies (Greenberg et al 2001; Betancur et al 2002) suggested that the twinning process itself is an important risk factor in the development of autism.

If true, this would have major consequences for the interpretation of twin studies.

Both studies compared the number of affected twin pairs among affected sib pairs to expected values in two separate samples of multiplex families and reported a substantial and significant excess of twin pairs.

Using data from our epidemiological study in Western Australia, we investigated the possibility of an increased rate of autism in twins.

All children born between 1980 and 1995 with autism, Asperger syndrome, or pervasive developmental disorder not otherwise specified

(PDD-NOS) were ascertained.

Of the 465 children with a diagnosis, 14 were twin births (rate

30.0/1,000) compared to 9,640 children of multiple births out of a total of 386,637 births in Western Australia between 1980 and 1995 (twin rate weighted to number of children with autism or PDD per year 26.3/1,000).

These data clearly do not support twinning as a substantial risk factor in the etiology of autism.

We demonstrate that the high proportion of twins found in affected-sib-pair studies can be adequately explained by the high ratio of concordance rates in monozygotic (MZ) twins versus siblings and the distribution of family size in the population studied.

Our results are in agreement with those of two similar studies by Croen et al (2002) in California and Hultman et al (2002) in Sweden.

PMID: 12297988 [PubMed - in process]

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Neocortical System Abnormalities In Autism: An fMRI Study Of Spatial Working Memory

ds=12297562&dopt=Abstract . Luna B, Minshew NJ, Garver KE, Lazar NA, Thulborn KR, Eddy WF, Sweeney JA. Departments of Psychiatry (Drs. Luna and Minshew and K. Garver) and Neurology (Dr. Minshew), University of Pittsburgh, and Department of Statistics (Drs. Lazar and Eddy), Carnegie Mellon University, Pittsburgh, PA.

OBJECTIVE: To test the hypothesis that deficits in spatial working memory in autism are due to abnormalities in prefrontal circuitry.

METHODS: Functional MRI (fMRI) at 3 T was performed in 11 rigorously diagnosed non-mentally retarded autistic and six healthy volunteers while they performed an oculomotor spatial working memory task and a visually guided saccade task. RESULTS: Autistic subjects demonstrated significantly less task-related activation in dorsolateral prefrontal cortex (Brodmann area [BA] 9/46) and posterior cingulate cortex (BA 23) in comparison with healthy subjects during a spatial working memory task.

In contrast, activation of autistic individuals was not reduced in other regions comprising the neural circuitry for spatial working memory including the cortical eye fields, anterior cingulate cortex, insula, basal ganglia, thalamus, and lateral cerebellum. Autistic subjects also did not demonstrate reduced activation in any brain regions while performing visually guided saccades.

CONCLUSION: Impairments in executive cognitive processes in autism may be subserved by abnormalities in neocortical circuitry as evidenced by decreased activation in prefrontal and posterior cingulate circuitry during a spatial working memory task.

PMID: 12297562 [PubMed - in process]

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FORENSIC

Aspergers Boy Accused Of Mutilating Poodle To Remain In Custody

[By David J. Cieslak in the Tucson Citizen.]

A high school student accused of mutilating a blind poodle must stay in the Pima County Juvenile Court Center until his trial, a judge ruled this afternoon.

Judge Kenneth C. Stanford also ordered a psychological evaluation of Chris Faw, 14, before his trial, scheduled for Oct. 10.

Faw, a Rincon High School student, was charged with felony animal cruelty for allegedly sodomizing Prince, a 7-year-old blind toy poodle, with a tree branch.

The dog was euthanized because the sodomy caused severe damage to his internal organs and anus.

Faw, of the 6800 block of East Lightning Drive, did not speak at today's hearing, but his mother pleaded with the judge to have her son released. Susan Faw said her son has a neurobiological disorder similar to autism.

Detectives said the dog was found Friday bleeding on the floor of its owner's home at Davis-Monthan Air Force Base.

Susan Faw said the family has several pets. "I've not had any reason to believe he would hurt them prior, nor do I believe he would hurt them in the future," she said.

Faw's arrest came as a result of phone tips to police and eyewitness accounts, investigators said.

Two other youths also are being sought in connection with the mutilation.

Read more on this story in tomorrow's Tucson Citizen and online.

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Aspergers Boy Accused of Mutilating Dog Remains in Detention

A14 year old boy charged in the mutilation of a poodle, will stay in detention for at least two weeks. The teenager is charged with one felony count of animal cruelty in Pima County Juvenile Court. He was arrested Wednesday afternoon. Detectives believe the boy along with two younger boys, took part in the brutal attack last Friday at a home on Davis-Monthan Air Force Base.

Thursday afternoon in a courtroom at the Pima County Juvenile Justice Center, the boy's parents and asked the judge to release the teen into their custody. The parents agreed to change their work schedules to provide around the clock supervision for the boy. The boy's mother also told the judge her son suffers from a neurobiological disorder, called Asperger's Syndrome, a form of autism. She says the boy is already seeing a psychologist for counseling and a psychiatrist for treatment of the disorder. Some of the traits of the disorder include poor social skills and poor communication. One expert says the sufferer's bad behavior may stem from his inability to express frustration or anxiety.

The judge decided to keep the boy in detention, until he's sure the boy is not a danger to his neighbors. The dog's owners think he is. They asked a member of the victim witness program to ask the judge to keep the boy in custody. They said they are devastated by the loss of their pet, and they worry the boy could potentially harm their children or neighborhood children and pets.

Prosecutors also asked the judge to keep the boy in custody until they could determine if he is a danger to the neighborhood. The judge will revisit the issue of release in an October 10th hearing, after the results of a court-ordered psychological exam are complete.

Prosecutors also say they have not decided whether to keep this case in juvenile court, or try the boy as an adult.

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* * *

Evicted Mum Says Autistic Son Is Victim

ontent&sourceNode=99871&contentPK=2670845 <- - address ends here.

A mother says her autistic son remains extremely distressed following the family's eviction from their rented home.

Sally Lamb-Cooper, 24, had to quit Lilac Road, Wonford, earlier this month after the bailiffs were sent in.

Her seven-year-old son, Ryan, who suffers from autism, obsessive compulsive disorder and Tourette syndrome - which can make him swear involuntarily - was also made homeless, along with his younger brother Joshua, four.

Their two dogs and two cats were also taken away by Exeter City Council and put into kennels and catteries.

She said Ryan is desperate for the return of the family pets.

Now, the mother and children are staying with mum Sheri and sleeping in one room.

The city council claims Miss Lamb-Cooper, who has lived at the house for six years, owes £2,000 in rent.

But she claims the council made a mistake over her rent calculations and did not take into account she was getting housing benefit.

The family is now working with social workers, who are trying to sort out the problem.

She said: "I didn't think that the council could do this. I still can't believe that it has.

"It has completely messed up Ryan's routine. He is finding it difficult because of the different atmosphere.

"He is getting very angry and is very upset about it all. Normally it is not too bad, but his involuntary swearing has been brought out because he is anxious.

"We are hoping we can get somewhere as soon as possible. If we can prove that they messed up then we can get re-housed."

Ryan had only just begun work with a special needs unit at Bradley Rowe First School - but the eviction is causing him to behave badly, according to his mother.

She said: "He has been a little bit disruptive at school because they can't cope with him. He is disruptive all the time with anger and aggression and he hits you and shouts at you.

"For his sake, something has got to be done pretty soon as we can't go on like this.

"He is missing the dogs badly, it has so much effect. The first few days were bad.

"He is asking where the dogs are and when they are coming home, he does not want to understand that they are gone.

"He thinks they have gone on holiday."

She said: "The council does not realise the effect it has on people when it does this."

A spokesman for Exeter City Council said it takes a firm but fair line on rent arrears to help all tenants by spending money on other housing.

* * *

Autistic Man Pleads Guilty To Murder

August Stuckey, 19, of Fort Bragg, pleaded guilty to second-degree murder Sept. 19, cutting short what was to have been a preliminary hearing in Ukiah court to determine whether he should stand trial for the killing of Santa Ana resident Don Perez in September 2001.

In exchange for his plea, the prosecution agreed to drop the remaining charges against him, including special allegations that the murder was committed during the course of a robbery, kidnapping and carjacking.

Though Stuckey had been accused of instigating the robbery and killing of Perez, two other men were also charged in the crime.

Stuckey's friends and codefendants, Tai Abreu, 20, and Aaron Channel, 21, both of Fort Bragg, have already undergone trials or plea agreements: Abreu was sentenced to life in prison without parole; Channel was sentenced to 19 years, eight months, of which he must serve at least 85 percent before being paroled.

Stuckey is the only one of the three who knew the victim. Both he and Perez were reportedly homosexuals.

[. . . gruesome details deleted. . .]

During an earlier competency trial for Stuckey, Hamilton argued he had had developmental, social and other mental health problems since childhood.

Two mental health witnesses testified Stuckey suffers from personality disorders and depression and was unable to communicate adequately with his attorney as a result.

Stuckey's symptoms included paranoia, autism, short attention span and difficulty differentiating between fantasy and reality, according to psychologist Kevin Kelly and county Mental Health Psychiatrist Doug Rosoff.

They said Stuckey, as a result, had to repeat kindergarten and be home-schooled, despite a normal IQ. He's also qualified for Social Security payments for his mental disabilities.

Davenport did not contest Stuckey's mental illness, but insisted he was able to understand the charges against him, the role of the various judicial officials, and to help his attorney with his defense, all of which are required in order to find someone legally competent to stand trial.

The jury later agreed.

* * *

Mother Fed Up Over Fence: Autistic Boy Hit By a Car

2002.htm

On Aug. 27, Lisa Attanazio experienced a mother's nightmare: Her 4-year-old son, Ajay, was struck by a car.

Ajay sustained no serious injuries, but the accident hit at the heart of a months-long conflict between Attanazio and the Medford Housing Authority, from whom she rents her home on Light Guard Drive.

Attanazio contended that the Housing Authority needed to build a fence around her front yard to protect Ajay, who suffers from autism and attention deficit-hyperactivity disorder. A fence recently built in her backyard, she said, is insufficient.

"They worried that if I got a fence, other people would want one," she said. "But other people don't have a kid like mine."

John Greco, director of the Housing Authority, said that his office has been putting considerable effort into meeting her requests.

"We have been accommodating Lisa Attanazio on her requests in accordance with the law," Greco said. "You have to make a reasonable accommodation for a person with a qualifying disability, and we've done that. We base it on the need, on the nature of the request, and on the financial burden involved."

The Housing Authority has posted a sign in front of Attanazio's home and built the 14-by-14-foot enclosure around her back steps. Attanazio said that steps taken by the Housing Authority have been insufficient and delayed.

"I asked for the sign in September," she said, "and it finally went up in June. It took me 9 months, and the traffic there is out of control. One symptom of his autism is that he bolts - he just runs."

As for the backyard fence, Attanazio said that the process was frustrating and protracted and ultimately had unsatisfying results.

"We had a doctor fill out an extensive questionnaire," she said. "The doctor took the time to answer all these questions about Ajay. I asked for the fence at the beginning of March. Originally they were telling me it was going to go in the front yard."

Attanazio said that she would have preferred a fence in the front, but that Greco was concerned about neighbors, mail delivery, and other issues. Attanazio obtained a letter from neighbor Yolene St. Surin approving of a fence in front.

"I feel this fence would be in the best interests of everyone involved in this matter, especially the child," St. Surin said in her letter.

At the end of August, the Housing Authority built the fence in Attanazio's back yard, but she felt that the size of the fenced-in area - 14 feet by 14 feet, with a significant portion taken up by her back steps - was too small. Attanazio said that she agreed to the fence in back out of frustration, not satisfaction.

"I only agreed to it because it never would have gotten done," she suggested. "It's no place for a child. It's demeaning."

Last week, Attanazio met with Greco and Mayor Michael McGlynn to attempt to find a compromise solution. Attanazio described the meeting as productive.

"All parties came to an agreement," McGlynn said. "The Housing Authority will draw the dimensions, and we'll get to work on it. It was a reasonable request that we're able to accommodate."

The fence will be extended several feet into a side portion of the yard, giving Ajay more room to run.

Attanazio said that her hope is fairly simple: She wants her son, who turned 5 this month, to be able to play safely in his own yard. After attempting to work through the Massachusetts Commission Against Discrimination and the U.S. Department of Housing and Urban Development, she expressed hope that the situation could be mediated closer to home.

"It's been a long six months," she said. "But I'm a fighter. I'm not going to give up on this."

* * *

Youngsters Link Up In Art Contest For Volunteer Respite Care Cambridge, England

Young winners picked up their awards for scooping top prizes in an art competition. The competition was organised as part of Cambridgeshire Social Services Link Care Scheme's Share the Care Week.

The scheme brings together the parents of a youngster with a disability with a family willing and able to offer short break respite care.

The three winners received prizes including a jigsaw made from their winning picture.

Some 400 youngsters were invited to create pictures at two art sessions organised by Link Scheme staff.

The work is on show at Shire Hall.

The theme of Share the Care Week is autism and in Cambridgeshire, 38 children, 18 of whom have autism, are waiting to be matched with suitable Link carers.

For more information on Link Care or becoming a foster carer or adoptive parent, call the freephone information line on (0800) 052 0078.

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PUBLIC HEALTH

Company to Launch Preservative-Free Influenza Vaccine For Infants

Reuters Health - Aventis Pasteur Inc., a US subsidiary of French drugmaker Aventis SA, said on Thursday that it has received approval from the US Food and Drug Administration (FDA) to market a preservative-free formulation of its influenza vaccine Fluzone for infants ages 6 to 35 months.

According to the Swiftwater, Pennsylvania-based concern, this would be the first preservative-free influenza vaccine approved for infant administration. But due to the current manufacturing schedule, Aventis Pasteur said only a limited quantity of pediatric vaccine will be available for the 2002-2003 season.

Aventis, which supplies about 50% of the nation's flu vaccine, said it developed the pediatric formulation to boost public confidence in the immunization of young children. Fears regarding the use of vaccines containing preservatives in infants have grown in the US since the FDA revealed in 1999 that the amount of mercury intake for some babies in their first six months might exceed limits set by the US Environmental Protection Agency (EPA). Mercury is the main ingredient in the vaccine preservative thimerosal.

The firm has the capacity to produce greater quantities of the vaccine for the 2003-2004 season and will proceed to make more if the US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) strengthens its current recommendations for the annual immunization of healthy children, Aventis said.

The ACIP currently is considering a plan to strengthen its present recommendations to include annual immunizations of healthy children aged 6 to 23 months.

For the 2002-2003 influenza season, Aventis said the infant vaccine will be packaged in pre-filled syringes and launched in early to mid-November.

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Readers' Posts

I was wroking for a school district and went to due process. After that they have required that my autistic child not come to the bus garage to board from there for school. I am a disabled parent of a disabled child and cannot find adequate child care for my child in the local school dist. I find this in violation and i cant relocate the law. It is obvious retalliation. They are now telling me that my decision to not return to work was based on my no show because i wasnt allowe to bring the child to board as i always had. Can someone please help me. I live in Mahomet, Illinois just west of Champaign Anna jbenton@pdnt.com

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Attention East San Diego County! I have started a new internet support group for people in the East County. The purpose is to provide a forum for people to ask questions, share successes, find resources, etc. We are new, but hope to build a healthy membership. Go to ecasn@yahoogroups.com.

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My name is Becca Knaack, and I am the Parent Liaison for Child and Family Connections #13, in Illionis. I am looking for information on where I can find some financial assistance for a family that has attended conferences about Autism and needs help paying for them. Do you know of anyone that would be able to help. Thank you for your time. Becca Knaack Parent Liaison Child and Family Connections #13 knaack@galesburg.net

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Autistic disorders - Attention parents of individuals diagnosed with high-functioning autism. The Greater New Haven PDD/Asperger's Support Network offers education, support and more. This network is trying to reach more families whose loved ones are diagnosed with autistic spectrum disorders. For info. call Lois Rosenwald at 272-7529.

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