Autism Street

Arizona Chelation Study Update

Will this research “fly”?

Remember that great scene in the movie “Toy Story” where Buzz Lightyear demonstrates to all the toys in Andy’s room that he can fly? Imagine that Buzz Lightyear represents the Arizona chelation study itself. Woody will play the part of a skeptic, and the rest of the toys will be parents trying to make heads or tails of what the research proves (whether or not Buzz Lightyear actually flys).

Toy:         Oh, uh, Mr. Lightyear, uh, now, I’m curious.
                  What does a Space Ranger actually do?           
 
Woody:    He’s not a Space Ranger! He doesn’t fight evil or..
                  or shoot lasers or fly!  
 
Buzz:        Excuse me.
                  (As he reveals his wings at the click of a button)

Toy:         Wow!                   

Toy:         Oh, impressive wingspan.
 
Toy:         Very good!             
 
Woody:    Oh, what? What? These are plastic. He can’t fly.    

Buzz:        They are a terillium-carbonic alloy, and I can fly.       
 
Woody:    No, you can’t.

Buzz:        Yes, I can.  
 
Woody:    You can’t.         

Buzz:        Can.               

Woody:    Can’t. Can’t. Can’t!
 
Buzz:        I tell you, I could fly around this room with my eyes closed!
 
Woody:    Okay, then, Mr. Light Beer, prove it.                 
 
Buzz:        All right, then, I will. Stand back, everyone.
                  To infinity and beyond!

Buzz then climbs the bedpost and leaps. He immediately nosedives towards the ground head first into a ball (kind of like this study getting rejected by the IRB at ASU). But the ball deflects him onto a Hot Wheel car and track where he’s catapulted through the loop and back into the air (kind of like this research being taken up by the Southwest College of Naturopathic Medicine). At the height of his ‘flight’ he sticks to a toy airplane suspended from the ceiling and takes a few spins around, that to many, could appear like flying in and of itself (a little like some TV coverage from NBC which apparently looked at this study, as research that might scientifically prove something one way or the other). Finally, he flings off the plane and tumbles to a landing back on the bed with the other toys.

Buzz:        Can!

Toy:         Whoa!
 
Toy:         Oh, wow! You flew magnificently!  
 
Toy:         I found my movin’ buddy.   

Buzz:        Thank you. Th-Thank you all. Thank you.                 
 
Woody:    That wasn’t flying. That was falling with style.

When NBC’s Dateline recently aired a brief segment about this study at the Southwest College Of Naturopathic Medicine (Matt Baral, Naturopath as the study’s principal investigator) it briefly rekindled my interest in the subject. Did the media have anything new to add? Would they have investigated it to the extent that they would have learned any details that parents trying to understand the science of this should have?

Did Dateline ask whether or not this research will “fly”? Will this research land back with the parents in a publication that is not a peer-reviewed mainstream medical journal indexed on Pubmed? Or, will it really “fly” and land with acceptance in the scientific community? At this point, the latter would seem a real challenge.

• It was rejected by ASU’s IRB.
• A questionable mail-order laboratory is being used.
• The study appears to employ non-standard methodology.
• There doesn’t appear to be any normative studies published in scientific journals indexed on Pubmed that support the methodology.
• No trained medical professional with board certification in toxicology or developmental pediatrics appears to be involved.
• It’s likely (although by no means certain) to reference other widely refuted research, as well as research that has simply never been published in peer-reviewed scientific journals indexed on Pubmed.

So Dateline apparently didn’t delve all that deep into the science itself. If they decided to investigate in earnest, I wonder if they’d ask about whether or not the children in this study even had mercury toxicity in the first place? I wonder if they’d ask about reporting spot urine mercury excretion levels (as opposed to 24-hour collection) as a ratio to creatinine. I wonder if they’d ask about creatinine.

The ASU professor could point them to the 2005 DAN! Consensus Paper on his ASU website where they can find:

“Creatinine is often found to be marginal in the urine of autistics, and low creatinine can skew urine analyte results to high levels. So, also take note of creatinine levels if the laboratory results include ratioing to creatinine.”

He could also point them to this new information, while not conclusive, that suggests that creatinine in autistics probably ought to be researched thoroughly, prior to determination that autistic children have mercury toxicity based on a non-standard (provoked) measurement expressed as a ratio to creatinine.

Spot urinary creatinine excretion in pervasive developmental disorders
Authors: WHITELEY, PAUL; WARING, ROSEMARY1; WILLIAMS, LEE2; KLOVRZA, LIBUSE1; NOLAN, FRANCES3; SMITH, SUSAN3; FARROW, MALCOLM4; DODOU, KALLIOPI2; LOUGH, W. JOHN2; SHATTOCK, PAUL5

Source: Pediatrics International, Volume 48, Number 3, June 2006, pp. 292-297(6)

“a significant decrease in urinary creatinine concentration was found in the PDD group compared to controls using a Mann–Whitney two-tailed ranks test”

“Issues regarding the use of single urine creatinine measurements and associated confounding variables are discussed in light of the findings, together with recommendations to use other internal or external standards for the quantification of urinary compounds in PDD research” 

Did the children who went to Phase 2 in this study really have mercury toxicity to begin with? Given the methodology and potential confounding issues, it doesn’t seem likely at all, but I could be wrong. Will the final paper include 24-hour urine collection and report creatinine levels to the scientific community so it can be seen if urinary analytes were artificially high due to ratioing to creatinine (that could potentially be lower than non-autistic peers)?

From notes on the autismone website, their recent conference in Chicago included a brief presentation/update about this study. I could be wrong about this, but it looks as though this study might be down to 12 participants. If that’s true, it doesn’t seem like (as I’d seen it so often described) a “large scale” study at all.

Will this study “fly” in the scientific community? Or, is it simply “Falling with style”?