Autism Study Sparks Concern

Now a new theory is triggering desperate parents' interest - and this time the stakes are higher because it could spur misuse of the nation's most precious antibiotic, vancomycin.

An Illinois mother persuaded scientists to try the bizarre-sounding experiment of testing whether vancomycin might help her son's severe autism. To their surprise, little Andrew Bolte got better.

Dr. Richard Sandler of Rush Children's Hospital in Chicago was skeptical of Ellen Bolte's theory that a neurotoxin-producing intestinal infection was behind some of her son's symptoms.

Sandler administered the antibiotic anyway, and afterward Andrew “was not cured, but all of a sudden he started saying words, became toilet-trained,” Sandler recalled. “I found that very intriguing. It's not supposed to happen.”

So Sandler treated 11 autistic children who, like about a third of children with this serious brain disorder, also suffer painful gastrointestinal problems. Neuropsychological testing concluded that 10 children improved, he reports in this month's Journal of Child Neurology, but only for a while.

And that's the problem: Andrew and the others worsened after just a few months. Yet already, parents are calling doctors about vancomycin, considered the best weapon against antibiotic-resistant infections. But the rush to vancomycin is worrisome, because overuse of the drug spurs germs to become impervious to it.

‘It is a danger,” said Sandler, who calls it inappropriate to try vancomycin until more research proves if it is a real clue or a false lead.

Another Chicagoan, Dr. Michael Chez, plans to compare vancomycin to a dummy drug this fall, important because simple attention during medical research markedly helps autistic children, the so-called “placebo effect.” (Send an e-mail to rushstudy@aol.com for study information.)

Like other autism experts, Johns Hopkins University neurologist Dr. Andrew Zimmerman is bracing for families' calls. “It's heartbreaking, because you know they really want answers,” yet the study is far to weak to promote antibiotics, he said.

Still, it's “provocative,” Zimmerman said, because scientists are scrutinizing whether bowel problems are caused by or worsen autistic symptoms or are a coincidental side effect of the terrible brain disorder.

More than 400,000 Americans have autism, characterized by profound social withdrawal, inability to communicate, repetitive behavior and sometimes aggression. No one knows what causes it, although much research suggests something goes wrong during critical fetal brain development.

Thousands of children have taken secretin, an intestinal hormone, after a mother said one dose brought her son out of autistic isolation. But in scientific studies, secretin so far has proved no better than a dummy injection.

Intense behavior therapy is autism's only proven treatment. But Andrew Bolte was so aggressive the therapy didn't stand a chance, his mother said. He screamed for hours. He even chewed drywall from the walls. Complicating matters were severe diarrhea and other gastrointestinal problems.

Bolte blames antibiotics prescribed for fluid in Andrew's ears shortly before he became autistic at 19 months. Based on her extensive studies in medical libraries, she theorized those drugs killed Andrew's normal gut-protective bacteria and allowed an intestinal infection that can produce nerve-killing toxins to enter his brain. Vancomycin, she thought, could kill that infection.

Thirty-six doctors scoffed. After all, autism typically appears between ages 14 and 22 months, and no sufferers have been found with neurotoxic infections.

Sandler called it “highly improbable,” too, but he tried because Andrew, by now 3, was miserable. Two months later, Andrew was “very calm,” allowed Bolte to hug him and finally followed verbal commands.

Aggression and other symptoms soon returned. But Bolte believes vancomycin eased his bowel problem enough to open a window for behavior therapy, saying Andrew retained his language improvements.

Even she cautions against demanding vancomycin, however. Instead, she is raising money for additional research.

EDITOR'S NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington

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