"Study links vaccines containing mercury with autism"

...In the late 1980s into the 1990s the CDC expanded the number of TCVs to be given to children. Because of this increase a child could have received as much as 200 micrograms (µg) of mercury during the first six months of life. During the same time epidemic levels of neurodevelopmental disorders (NDs) including autism were observed that, “cannot be explained by immigration, changed diagnostic criteria, or improved identification.”

The authors hypothesized that since thimerosal has been removed from many vaccines that this decrease in thimerosal exposure should be accompanied with a decrease in autism and other neurodevelopmental disorders. “Assuming a 3- to 4- year lag time between birth and diagnosis of an ND, the peak followed by a decline in NDs would be expected to occur around 2002 if thimerosal had a significant impact on NDs.”

Using the VAERS (Vaccine Adverse Event Reporting System) and CDDS (California Department of Developmental Services) databases, the independent researchers analyzed reports of childhood NDs, including autism, before and after removal of mercury-based preservatives.

From the data the authors determine that, “overall, it appears that the increasing and subsequent decreasing trends in the rates of NDs, observed in both the VAERS and CDDS databases, correlate with temporal periods when the cumulative amount of mercury in the childhood immunization schedule expanded and later contracted.” Continuing the authors note that, “the consistency of the effects observed for the spectrum of NDs, including autism and speech disorders, and the agreement between the observations from two separate databases, support the conclusion that the effect is real and not a chance observation....”

Strictly Embargoed until 00:01hours (BST), 19th October 2005

The Cochrane Library publishes the most thorough survey of MMR vaccination data which strongly
supports its use

There was no credible evidence behind claims of harm from the MMR vaccination.
This is the conclusion drawn by the Cochrane Review Authors, an international team
of researchers, after carefully drawing together all of the evidence found in 31 high
quality studies from around the world. They also highlight that the policy of
encouraging mass use of MMR has eliminated the scourge of measles, mumps and
rubella from many countries.

“In particular we conclude that all the major unintended events, such as triggering
Crohn’s disease or autism, were suspected on the basis of unreliable evidence,” says
lead author Dr Vittorio Demicheli who works at Servizo Sovrazonale di
Epidemiologia, Alessandria, Italy.

These findings will be published on 19 October, 2005 in The Cochrane Library¹.

“Public health decisions need to be based on sound evidence. If this principle had
been applied in the case of the MMR dispute, then we would have avoided all the
fuss,” says Demicheli.

http://www3.interscience.wiley.com/homepages/106568753/PR_mmr.pdf

Monday, February 06, 2006

How vaccine litigation distorts the contents of the VAERS database

Advocates who are convinced of a link between the mercury in thimerosal used in vaccines as a preservative and autism often point to data derived from the U. S. Vaccine Adverse Event Reporting System (VAERS) as "evidence" that vaccines cause autism. For example, Mark and David Geier, the father-son team of Don Quixotes of the thimerosal/autism movement, have made a veritable career of dumpster-diving the VAERS database and then using the results as their preferred lance to tilt at their windmills--not to mention to use as "evidence" in representing parents suing the Vaccine Injury Compensation Program (VCIP). Publications by the Geiers utilizing the VAERS database are often used by litigants as "evidence" for a link between mercury in vaccines and autism.

Unfortunately, the VAERS database is highly unreliable. The reason is that anyone can submit a report to it, and no one actually verifies the accuracy of the report. Indeed, James Laidler once tested the system by submitting a report that the influenza virus had turned him into The Incredible Hulk. The report was accepted and duly entered into the database. This report was so out of the ordinary that a representative actually contacted him and, amazingly, asked his permission to remove the report from the database (proving that it's not easy being green). If Laidler had not given it, the report of an adverse reaction in which the flu vaccine turned a man into a huge, immensely powerful green monster would still be in VAERS. Now, via Kathleen Seidel, who alerted me to this, comes more evidence of the corruption of the VAERS database. This evidence comes in the form of a study published in the most recent issue of the journal Pediatrics, in which the authors examine the question of how much of the seeming increase in autism related to vaccines reported to the VAERS database over the last several years might be related to litigation. Naturally, I couldn't resist downloading the complete article and reading it.

In the study, the authors, Michael J. Goodman and James Nordin, did something incredibly simple that no one had done before. They took data from the VAERS database from 1990 through 2003 and imported it into SAS data files for analysis. Then they searched the database using key words to look for reports associated with litigation, particularly with regards to autism. They searched for records containing "thimerosal," "mercury," or "autism" in their fields, especially when coupled with terms like "lawyer," "legal," "attorney," or "litigate," while excluding records containing "legal" coupled with the term "guardian" that did not relate to litigation. They also excluded cases related to well characterized allergic reactions to thimerosal. Finally, they compared records from nonlitigation cases to those from litigation cases regarding symptomatology reported.

http://oracknows.blogspot.com/2006/02/how-vaccine-litigation-distorts.html

Parker SK, Schwartz B, Todd J, Pickering LK.

Department of Pediatrics, Children's Hospital and University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.

OBJECTIVE: The issue of thimerosal-containing vaccines as a possible cause of autistic spectrum disorders (ASD) and neurodevelopmental disorders (NDDs) has been a controversial topic since 1999. Although most practitioners are familiar with the controversy, many are not familiar with the type or quality of evidence in published articles that have addressed this issue. To assess the quality of evidence assessing a potential association between thimerosal-containing vaccines and autism and evaluate whether that evidence suggests accepting or rejecting the hypothesis, we systematically reviewed published articles that report original data pertinent to the potential association between thimerosal-containing vaccines and ASD/NDDs. METHODS: Articles for analysis were identified in the National Library of Medicine's Medline database using a PubMed search of the English-language literature for articles published between 1966 and 2004, using keywords thimerosal, thiomersal, mercury, methylmercury, or ethylmercury alone and combined with keywords autistic disorder, autistic spectrum disorder, and neurodevelopment. In addition, we used the "related links" option in PubMed and reviewed the reference sections in the identified articles. All original articles that evaluated an association between thimerosal-containing vaccines and ASD/NDDs or pharmacokinetics of ethylmercury in vaccines were included. RESULTS: Twelve publications that met the selection criteria were identified by the literature search: 10 epidemiologic studies and 2 pharmacokinetic studies of ethylmercury. The design and quality of the studies showed significant variation. The preponderance of epidemiologic evidence does not support an association between thimerosal-containing vaccines and ASD. Epidemiologic studies that support an association are of poor quality and cannot be interpreted. Pharmacokinetic studies suggest that the half-life of ethylmercury is significantly shorter when compared with methylmercury. CONCLUSIONS: Studies do not demonstrate a link between thimerosal-containing vaccines and ASD, and the pharmacokinetics of ethylmercury make such an association less likely. Epidemiologic studies that support a link demonstrated significant design flaws that invalidate their conclusions. Evidence does not support a change in the standard of practice with regard to administration of thimerosal-containing vaccines in areas of the world where they are used.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15342856&query_hl=1&itool=pubmed_docsum

In November 1999, Bolen began distributing false and defamatory statements to the effect that I am arrogant, bizarre, closed-minded, emotionally disturbed, professionally incompetent, intellectually dishonest, a dishonest journalist, sleazy, unethical, a quack, a thug, a bully, a Nazi, a hired gun for vested interests, the leader of a subversive organization, and engaged in criminal activity (conspiracy, extortion, filing a false police report, and other unspecified acts). Bolen also began claiming that Terry Polevoy, MD (a Canadian pediatrician who operates anti-quackery Web sites) is dishonest, closed-minded, emotionally disturbed, professionally incompetent, unethical, a quack, a fanatic, a Nazi, a hired gun for vested interests, and engaged in criminal activity (conspiracy, stalking of females, and other unspecified acts) and has made anti-Semitic remarks. In 2000, after Attorney Christopher Grell, of San Francisco filed a suit on behalf of a former Clark patient who accused her of fraud, Bolen issued defamatory message charging that Grell is professionally incompetent and had filed a false report with the FBI.

In 2001, after learning that the Florida Board of Dentistry had asked Robert S. Baratz, MD, DDS, PhD, to provide expert testimony against Dr. Phillips, Bolen issued a series of libelous reports claiming that Baratz was emotionally unstable, had committed perjury, and had misrepresented many of his credentials in order to market himself as an expert witness. Most of these messages were republished by Clark supporters on Web sites, in news group postings, and in other e-mail messages. In 2003, Bolen began "helping" Dr. Kadile's defense by issuing further lies about Dr. Baratz.

None of us are thin-skinned or care when people attack our ideas. But unjustified attacks on our character or professional competence are another matter. As Bolen's campaign unfolded, my colleagues and I have notified him and many of the people spreading his messages that libel is a serious matter and that they had better stop. Some did, but it soon became clear that others would not. To defend ourselves, several of us have filed suit for libel...

In 1999, the mercury-based preservative thimerosal was removed from most childhood vaccines as a “precautionary” measure, but vaccines were not recalled and could be used up until their expiration date, as late as 2003. The total mercury dose that children under 5 years of age could have received from childhood vaccines declined from around 240 micrograms in 1999 to nearly zero in 2003, but could now increase to nearly 60 mcg if new recommendations to require annual influenza vaccine between the ages of 2 and 5 years are followed.

Proof of a causal relationship between thimerosal and neurodevelopment disorders could have serious repercussions for government agencies and drug companies. California and five other states have passed laws banning the use of thimerosal in vaccines for pregnant women and children, except in a public health emergency. Eleven other states are considering similar legislation, which is meeting stiff opposition.

Because of an immunity provision tucked into a must-pass defense appropriations bill last Christmas, trial lawyers say it will be nearly impossible for persons injured by a vaccine to force manufacturers to compensate them.

Association of American Physicians and Surgeons, Inc. http://www.aapsonline.org/nod/newsofday265.php

Analysis of two independent government databases shows that the alarming increase in reported cases of autism not only slowed but actually reversed since thimerosal was removed from childhood vaccines, according to the lead article in the spring 2006 issue of the Journal of American Physicians and Surgeons.

“This study is exactly the kind of thing people have been waiting for for three years now,” stated Richard Deth, a neuropharmacologist at Northwestern University (MetroWest Daily News 3/2/06).

Dr. Robert Davis, director at the immunization safety group at the Centers for Disease Control and Prevention (CDC) disagreed: “I don’t think this study can really be taken to provide any evidence one way or the other” (ibid.).

According to a study by HealthPartners Research published in Pediatrics, February 2006, 25 percent of reports in the Vaccine Adverse Event Reporting System (VAERS) that correlate thimerosal and autism were filed by lawyers, rather than “healthcare providers.” Thus, authors claim that VAERS data are biased because of litigation (MarketWire.com.)

The other government database relied upon in the J P&S article, from the California Department of Developmental Services (CDDS), has been called “skewed” because of a change in diagnostic criteria. CDC director Julie Geberding said that the autism rate reported by CDDS “sort of like the stock market bounces around a little bit.”

Columnist Dan Olmsted writes that the theme song of the CDC as it struggles with concerns over thimerosal and autism should be “Pretzel Logic,” as from the Steely Dan album.

According to two databases, rates went up steadily as thimerosal dose increased, then turned around and started to decline as thimerosal was removed, “but so what, say the CDC and others who are on record (and, let’s face it, on the line) backing thimerosal to the hilt” (Dan Olmsted, “The Age of Autism: Pay No Attention,” RedOrbit 3/2/06).

Association of American Physicians and Surgeons, Inc. http://www.aapsonline.org/nod/newsofday265.php

An article in the March 10, 2006 issue of the Journal of American Physicians and Surgeons shows that since mercury was removed from childhood vaccines, the alarming increase in reported rates of autism and other neurological disorders (NDs) in children not only stopped, but actually dropped sharply – by as much as 35%.

The numbers from California show that reported autism rates hit a high of 800 in May 2003. If that trend had continued, the reports would have skyrocketed to more than 1000 by the beginning of 2006. But in fact, the Geiers report that the number actually went down to only 620, a real decrease of 22%, and a decrease from the projections of 35%.

Association of American Physicians and Surgeons, Inc. http://www.aapsonline.org/press/nr-03-02-2006.php

In this study, we evaluated doses of mercury from thimerosal-containing childhood immunizations in comparison to US Federal Safety Guidelines and the effects of increasing doses of mercury on the incidence of neurodevelopment disorders and heart disease. This study showed that children received mercury from this source in excess of the Federal Safety Guidelines for the oral ingestion of methylmercury. Our analyses showed increasing relative risks for neurodevelopment disorders and heart disease with increasing doses of mercury. This study provides strong epidemiological evidence for a link between mercury exposure from thimerosal-containing childhood vaccines and neurodevelopment disorders.

Journal of American Physicians and Surgeons http://www.aapsonline.org/jpands/vol8no1/geier.pdf

This study provides strong epidemiological evidence for a link between increasing mercury from thimerosal-containing childhood vaccines and neurodevelopment disorders and heart disease. In light of voluminous literature supporting the biologic mechanisms for mercury-induced adverse reactions, the presence of amounts of mercury in thimerosal-containing childhood vaccines exceeding Federal Safety Guidelines for the oral ingestion of mercury, and previous epidemiological studies showing adverse reactions from such vaccines, a causal relationship between thimerosal-containing childhood vaccines and neurodevelopment disorders and heart disease appears to be confirmed. It is to be hoped that complete removal of thimerosal from all childhood vaccines will help to stem the tragic, apparently iatrogenic epidemic of autism and speech disorders that the United States is now facing.

Journal of American Physicians and Surgeons http://www.aapsonline.org/jpands/vol8no1/geier.pdf

Monday, February 06, 2006
How vaccine litigation distorts the contents of the VAERS database

Unfortunately, the VAERS database is highly unreliable. The reason is that anyone can submit a report to it, and no one actually verifies the accuracy of the report. Indeed, James Laidler once tested the system by submitting a report that the influenza virus had turned him into The Incredible Hulk. The report was accepted and duly entered into the database. This report was so out of the ordinary that a representative actually contacted him and, amazingly, asked his permission to remove the report from the database (proving that it's not easy being green). If Laidler had not given it, the report of an adverse reaction in which the flu vaccine turned a man into a huge, immensely powerful green monster would still be in VAERS. Now, via Kathleen Seidel, who alerted me to this, comes more evidence of the corruption of the VAERS database. This evidence comes in the form of a study published in the most recent issue of the journal Pediatrics, in which the authors examine the question of how much of the seeming increase in autism related to vaccines reported to the VAERS database over the last several years might be related to litigation. Naturally, I couldn't resist downloading the complete article and reading it.

In the study, the authors, Michael J. Goodman and James Nordin, did something incredibly simple that no one had done before. They took data from the VAERS database from 1990 through 2003 and imported it into SAS data files for analysis. Then they searched the database using key words to look for reports associated with litigation, particularly with regards to autism. They searched for records containing "thimerosal," "mercury," or "autism" in their fields, especially when coupled with terms like "lawyer," "legal," "attorney," or "litigate," while excluding records containing "legal" coupled with the term "guardian" that did not relate to litigation. They also excluded cases related to well characterized allergic reactions to thimerosal. Finally, they compared records from nonlitigation cases to those from litigation cases regarding symptomatology reported.

Not surprisingly, beginning in 2001, they noted a dramatic increase in the number of non-Lyme disease VAERS reports related to litigation, from only 7 in 2000 to 213 in 2002 and 108 in 2003. (They attributed the decline in 2003 reports to processing delays in creating public use files.) Next, they examined symptom sets related to symptom sets. For autism, they observed a dramatic increase in the percentage of litigation-related reports from 0% of the reports related to litigation in 1999 to over one-third (35%) in 2002. For records mentioning thimerosal that weren't related to allergic reactions, the rise was even more dramatic, from 0% of these reports related to litigation in 2000 to 87% in 2002.

This study once again hammers home the inherent unreliability of the VAERS database as a tool for longitudinal studies of the rate of vaccine-related complications. Not only can anyone access it and enter reports without verification, but there is no denominator, which means testing for causality is not even possible with VAERS. Worse, as the authors point out, the rate of reporting of autism as a complication of vaccines is easily influenced by numerous external factors. For example, the authors pointed out that 75% of the autism reports in VAERS between 1990 and 2001 were received not long after the the publication of the the now utterly and completely discredited Wakefield study that claimed to find a link between the MMR vaccine and autism and that 2/3 were received after the American Academy of Pediatrics recommendation that thimerosal be removed from vaccines. And it's not just autism. For example, in 2002, half the reports to the VAERS database about mental retardation were related to litigation. The authors conclude:



Indeed it is not. Computer programmers have a famous saying: "Garbage in, garbage out," meaning that the quality of the results of an analysis can be no better than the quality of the data upon which the analysis relies. Without correction for factors such as the ones for which the authors of this study tried to correct, the VAERS database definitely qualifies as "garbage in" when used to try to follow the incidence of vaccine-related complications over time. The VAERS database may serve a very important function as an early warning system for potential vaccine-related complications that were not picked up in initial clinical trials used to gain FDA approval, but it was never intended to be a means of following the rates of these complications in a longitudinal fashion. Even if it had been, the ease with which the rate of entry of various complications can be influenced by media hype and activists, as well as the indiscriminate use of the database by litigants, long ago destroyed any usefulness that VAERS might have had for such a purpose.

Indeed, it's even worse than described. The authors themselves recognize that they very well may have underestimated the effect of litigation-related VAERS reports:



In other words, the distorting effect of litigation-related cases on reports to the VAERS database is almost certainly worse than this first study suggests. I'm betting that it would be even worse still if the authors had been able to analyze the complete data sets from the years 2004 and 2005, given the firestorm that erupted last year due to the publication of David Kirby's much hyped conspiracy-mongering "expose" Evidence of Harm and the thoroughly dishonest scaremongering scandal piece by Robert F. Kennedy, Jr. published last summer. Perhaps the authors of this study will update their analysis when VAERS data for 2004 and 2005 become available. I might be going out on a limb here (not really), but I'd predict a huge jump in litigation-related VAERS entries for cases alleging that that vaccines caused autism in the year 2005. I'm also hoping that the authors manage to ovecome the difficulties they encountered and figure out a way to crossreference their data from the VAERS database with the list of litigants going before the VCIP. I predict that the results of such a study would be most illuminating. However, this is a study that, because of HIPAA regulations, will most likely never be done because it would probably require doing what Mark and David Geier once tried to do: Merging data sets in such a way that could risk patient confidentiality.

In the meantime, whenever someone tells you that the VAERS database shows that cases of autism related to vaccines have been rising, just remember two things: (1) garbage in=garbage out; and (2) the VAERS database, sadly, has evolved into a trial lawyer's best friend.

Just ask Mark and David Geier.

http://oracknows.blogspot.com/2006/02/how-vaccine-litigation-distorts.html

Indeed, James Laidler once tested the system by submitting a report that the influenza virus had turned him into The Incredible Hulk. The report was accepted and duly entered into the database. This report was so out of the ordinary that a representative actually contacted him and, amazingly, asked his permission to remove the report from the database (proving that it's not easy being green). If Laidler had not given it, the report of an adverse reaction in which the flu vaccine turned a man into a huge, immensely powerful green monster would still be in VAERS.

2005 Jan;94(1):90-4.
Lee-Wong M, Resnick D, Chong K.

Division of Clinical Immunology and Allergy, Department of Internal Medicine, Beth Israel Medical Center, New York, New York 10003, USA.

BACKGROUND: Thimerosal is a preservative commonly used in ophthalmic solutions, otic drops, and vaccines because of its bactericidal property. OBJECTIVE: To report a case of a generalized reaction to thimerosal in a patient who received an influenza vaccine. METHODS: We describe a patient who developed a generalized maculopapular eruption after receiving a thimerosal-containing influenza vaccine. Patch testing was performed to determine if there was an allergy to thimerosal. RESULTS: Patch testing confirmed a T-cell-mediated sensitivity to thimerosal. CONCLUSIONS: Physicians need to be aware that thimerosal is found in many products, including vaccinations. Clinicians should also be aware that allergic reactions occur with exposure to thimerosal even in vaccines. To our knowledge, this is the first case report in the literature of a generalized reaction to thimerosalfrom an influenza vaccine.

Publication Types:
Case Reports

PMID: 15702823

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15702823&query_hl=1&itool=pubmed_docsum

2005 Jan-Feb;22(1):1-5.
Seidenari S, Giusti F, Pepe P, Mantovani L.

Department of Dermatology, University of Modena and Reggio Emilia, Italy. seidenari.stefania@unimo.it

Contact sensitization in children is frequent. However, because exposure to sensitizing agents varies rapidly, it is of utmost importance to perform a periodic evaluation of patch test results. Our purpose was to compare our data on contact sensitization in children during the past 7 years to our previous 1988-1994 findings, in order to identify emerging allergens and update our pediatric series. From 1995 to 2001, 1094 consecutive children were examined. Of these, 997 patients were patch tested with our pediatric series, which includes 30 allergens, whereas 97 underwent patch testing with 46 allergens. A total of 570 children proved allergic (52.1%). The highest sensitization rate was observed in children under 3 years of age. No differences between atopic dermatitis patients and nonatopic ones were observed in the sensitization rate. Neomycin, nickel, wool alcohols, thimerosal, and ammoniated mercury gave most of the positive responses. With respect to 1988-1995 data, allergy to substances such as neomycin, nickel, wool alcohols, thimerosal, ammoniated mercury, propolis, potassium dichromate, and thiuram mix proved more frequent. In conclusion, as sensitization rates to different allergens show great variations over time, periodic evaluations of patch test results in children is necessary in order to update the test trays.

PMID: 15660887

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15660887&query_hl=1&itool=pubmed_docsum

2004 Sep;51(3):111-7.
Heine G, Schnuch A, Uter W, Worm M.

Klinik fur Dermatologie, Venerologie und Allergologie, Campus Charite-Mitte, Universitatsmedizin, Berlin, Germany.

Allergic contact dermatitis (ACD) affects approximately 7% of the general population. To evaluate the frequency of ACD in children, we analysed patch test results collected by the Information Network of Departments of Dermatology between 1995 and 2002. Data of 285 children (6-12 year) and 2175 adolescent patients (13-18 year) were analysed to determine the frequency of sensitization to the 30 most common contact allergens, adjusting for age and sex. As control group, we defined adult patients (60-66 year, n = 7904). The top allergens in children were thimerosal, gentamicin sulphate, nickel-II-sulphate, ammoniated mercury, cobalt-II-chloride, fragrance mix, bufexamac, Compositae mix, propylene glycol and turpentine. The overall proportion of sensitized patients according to the patch test results was 52.6% in the children group compared to 49.7% in the adolescent group. These findings were similar in the adult group at 52.2%. The detailed analysis regarding sex, occupation, atopy, site of eczema and age showed distinct patterns in each group indicating age-specific exposures. Atopy-related diseases were more common in children compared to adults. On the basis of the data of this study, the relationship between atopy and the risk of development of ACD, at least in children, needs further investigation.

PMID: 15479199

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15479199&query_hl=1&itool=pubmed_docsum

2004;17(4):321-7.
Garner LA.

Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA. lisa@lisagarnermd.com

Metals are in close contact with skin and mucous membranes on a repeated, if not constant, basis. Nickel and mercury, well-recognized causes of contact dermatitis; gold and palladium, recently gaining acceptance as patch test allergens on standard screening trays; and cobalt are reviewed in this article. Sensitization to nickel, the most frequently identified allergen on patch testing, is associated with ear piercing. Contact with this potential allergen is ubiquitous. Mercury may be encountered as organic mercury in thimerosal, used as an antiseptic and a preservative in topical medications and vaccines, and metallic mercury found in dental amalgam and thermometers. Both forms may cause contact dermatitis. Gold, recognized as a frequent sensitizer, has been implicated in some cases of eyelid, patchy diffuse and oral lichenoid dermatitis. Cobalt allergy, found frequently in patients who are nickel allergic, also has been associated with ear piercing. Palladium sensitivity is often associated with nickel allergy. However, the incidence of clinical relevance is yet to be established.

Publication Types:
Review

PMID: 15327477

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15327477&query_hl=1&itool=pubmed_docsum

2003 Feb;48(2):74-9.
Wong L, Freeman S.

Skin and Cancer Foundation, Darlinghurst NSW, Australia.

84 patients with oral lichenoid lesions (OLL) were seen in the contact dermatitis clinic. All these patients had reticulate, lacy, plaque-like or erosive lichenoid changes adjacent to amalgam fillings. Patch testing to metallic mercury, 0.1% thimerosal, 1% ammoniated mercury, 0.1% mercuric chloride, and in some cases 0.05% phenylmercuric nitrate and amalgam discs was undertaken. 33 (39%) patients had positive patch test findings. 30/33 patch test positive patients had replacement of their amalgam fillings, with 28 (87%) patients experiencing improvement of symptoms and signs within 3 months. This confirms that mercury allergy is a factor in the pathogenesis of OLL in some cases. In cases where patch test negative patients improve with amalgam replacement, mercury may be acting as an irritant in the pathogenesis of OLL.

PMID: 12694209

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12694209&query_hl=1&itool=pubmed_DocSum

Medical Studies/Trials
Published: Wednesday, 22-Mar-2006

"This is the first time that thimerosal has been shown to selectively alter the normal functions of dendritic cells," said Isaac Pessah, a toxicologist with the UC Davis School of Veterinary Medicine, director of the Children's Center for Environmental Health and Disease Prevention and senior author of the study. "Dendritic cells play pivotal roles in overcoming viral and bacterial invaders by coordinating the immune system's overall combat response." One dendritic cell can activate as many as 300 T-cells - white blood cells that help find and kill external agents that attack the immune system - making them the most effective immune system activators. The study shows how intricate connections between calcium channels in dendritic cells change when exposed to thimerosal.

"The slightest fluctuation in how calcium channels 'communicate' can alter the growth, maturation and activation of dendritic cells," explained Pessah. "Thimerosal dramatically alters how two key calcium channels, code-named RyR1 and IP3R1, found in dendritic cells function as a team by 'garbling' the normal signaling system between them."

When thimerosal, at a concentration as low as 20 parts per billion, alters the fidelity of normal calcium signals, dendritic cells show abnormal secretion of IL-6 cytokine - a potent chemical signal that initiates inflammatory responses. Higher concentrations - 200 parts per billion - causes programmed death of dendritic cells, preventing them from maturing and doing their primary job of activating T-cells. Without proper feedback to guide its response, a normal dendritic cell can quickly become "a rogue, producing misinformation that could activate aberrant and harmful immune responses," Pessah explained. "Even one rogue dendritic cell can activate many inappropriate immune responses."

The UC Davis study indicates that in addition to being a direct neurotoxicant, thimerosal may also be an immunotoxicant, leaving the immune system vulnerable to microbes and other external influences.

http://www.news-medical.net/?id=16816

2005;71:317-41.
Cohly HH, Panja A.

Department of Biology, Jackson State University, Mississippi 39217, USA.

The immunopathogenesis of autism is presented schematically in Fig. 1. Two main immune dysfunctions in autism are immune regulation involving pro-inflammatory cytokines and autoimmunity. Mercury and an infectious agent like the measles virus are currently two main candidate environmental triggers for immune dysfunction in autism. Genetically immune dysfunction in autism involves the MHC region, as this is an immunologic gene cluster whose gene products are Class I, II, and III molecules. Class I and II molecules are associated with antigen presentation. The antigen in virus infection initiated by the virus particle itself while the cytokine production and inflammatory mediators are due to the response to the putative antigen in question. The cell-mediated immunity is impaired as evidenced by low numbers of CD4 cells and a concomitant T-cell polarity with an imbalance of Th1/Th2 subsets toward Th2. Impaired humoral immunity on the other hand is evidenced by decreased IgA causing poor gut protection. Studies showing elevated brain specific antibodies in autism support an autoimmune mechanism. Viruses may initiate the process but the subsequent activation of cytokines is the damaging factor associated with autism. Virus specific antibodies associated with measles virus have been demonstrated in autistic subjects. Environmental exposure to mercury is believed to harm human health possibly through modulation of immune homeostasis. A mercury link with the immune system has been postulated due to the involvement of postnatal exposure to thimerosal, a preservative added in the MMR vaccines. The occupational hazard exposure to mercury causes edema in astrocytes and, at the molecular level, the CD95/Fas apoptotic signaling pathway is disrupted by Hg2+. Inflammatory mediators in autism usually involve activation of astrocytes and microglial cells. Proinflammatory chemokines (MCP-1 and TARC), and an anti-inflammatory and modulatory cytokine, TGF-beta1, are consistently elevated in autistic brains. In measles virus infection, it has been postulated that there is immune suppression by inhibiting T-cell proliferation and maturation and downregulation MHC class II expression. Cytokine alteration of TNF-alpha is increased in autistic populations. Toll-like-receptors are also involved in autistic development. High NO levels are associated with autism. Maternal antibodies may trigger autism as a mechanism of autoimmunity. MMR vaccination may increase risk for autism via an autoimmune mechanism in autism. MMR antibodies are significantly higher in autistic children as compared to normal children, supporting a role of MMR in autism. Autoantibodies (IgG isotype) to neuron-axon filament protein (NAFP) and glial fibrillary acidic protein (GFAP) are significantly increased in autistic patients (Singh et al., 1997). Increase in Th2 may explain the increased autoimmunity, such as the findings of antibodies to MBP and neuronal axonal filaments in the brain. There is further evidence that there are other participants in the autoimmune phenomenon. (Kozlovskaia et al., 2000). The possibility of its involvement in autism cannot be ruled out. Further investigations at immunological, cellular, molecular, and genetic levels will allow researchers to continue to unravel the immunopathogenic mechanisms' associated with autistic processes in the developing brain. This may open up new avenues for prevention and/or cure of this devastating neurodevelopmental disorder.

PMID: 16512356

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16512356&query_hl=3&itool=pubmed_docsum

2004 Nov 2;3(1):11.
Silva IA, Nyland JF, Gorman A, Perisse A, Ventura AM, Santos EC, Souza JM, Burek CL, Rose NR, Silbergeld EK.

The Johns Hopkins University Bloomberg School of Public Health, 615 N, Wolfe Street, Room E6642, Baltimore, Maryland 21201, USA. imtasilva@hotmail.com

BACKGROUND: Mercury is an immunotoxic metal that induces autoimmune disease in rodents. Highly susceptible mouse strains such as SJL/N, A.SW, B10.S (H-2s) develop multiple autoimmune manifestations after exposure to inorganic mercury, including lymphoproliferation, elevated levels of autoantibodies, overproduction of IgG and IgE, and circulating immune complexes in kidney and vasculature. A few studies have examined relationships between mercury exposures and adverse immunological reactions in humans, but there is little evidence of mercury-associated autoimmunity in humans. METHODS: To test the immunotoxic effects of mercury in humans, we studied communities in Amazonian Brazil with well-characterized exposures to mercury. Information was collected on diet, mercury exposures, demographic data, and medical history. Antinuclear and antinucleolar autoantibodies (ANA and ANoA) were measured by indirect immunofluorescence. Anti-fibrillarin autoantibodies (AFA) were measured by immunoblotting. RESULTS: In a gold mining site, there was a high prevalence of ANA and ANoA: 40.8% with detectable ANoA at > or =1:10 serum dilution, and 54.1% with detectable ANA (of which 15% had also detectable ANoA). In a riverine town, where the population is exposed to methylmercury by fish consumption, both prevalence and levels of autoantibodies were lower: 18% with detectable ANoA and 10.7% with detectable ANA. In a reference site with lower mercury exposures, both prevalence and levels of autoantibodies were much lower: only 2.0% detectable ANoA, and only 7.1% with detectable ANA. In the gold mining population, we also examined serum for AFA in those subjects with detectable ANoA (> or =1:10). There was no evidence for mercury induction of this autoantibody. CONCLUSIONS: This is the first study to report immunologic changes, indicative of autoimmune dysfunction in persons exposed to mercury, which may also reflect interactions with infectious disease and other factors.

PMID: 15522122

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15522122&query_hl=3&itool=pubmed_docsum