biomedical By Suzette Lawrence, MSN, CNM

 biomedical Lower Autism Treatment Evaluation Scores (ATEC) correlate with dietary transfer factor use in autism spectrum disorders (ASDs), pediatri...
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 biomedical

Lower Autism Treatment Evaluation Scores (ATEC) correlate with dietary transfer factor use in autism spectrum disorders (ASDs), pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS), and primary immunodeficiency (PI) disease/CD19 defect: Two case studies. By Suzette Lawrence, MSN, CNM

Suzette Lawrence, MSN, CNM, earned her bachelor’s degree in nursing from the University of Maryland at Baltimore and practiced high-risk labor and delivery there. She graduated Sigma Theta Tau from the University Of Texas School Of Nursing with a master’s degree (MSN). Concurrently, she earned the National Certification for Nurse Midwives (CNM) from Texas Tech University Health Sciences Center. Suzette went on to practice full-scope nurse midwifery in Denver, Colorado. In 1998, she joined 4Life Research (Sandy, Utah) as an independent representative for the transfer factor family of products. She is a founding member of the 4Life Research Health Sciences Advisory Board. She contributes to transfer factor research and product design. Suzette helps her clients to develop health, wellness and immune strengthening strategies. Her special area of interest is autism spectrum disorders (ASDs). www.suzettelawrence.com.

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n 1949, Dr. Sherwood Lawrence conducted a landmark study that demonstrated that immunity is transferable in a small compound found in white blood cells. Dr. Lawrence was able to transfer the immune memory (not the disease but protection from it) of tuberculosis (TB) in a substance in lymphocytes (white blood cells) to a person who had no such immune recognition abilities. The recipients became skin test positive for TB in a matter of days indicating that the recipients had adopted the immune recognition capabilities for TB from the donors. This was achieved without suffering the illness or the primary immune response. Lawrence was able to transfer immune memory, hence the name “transfer factor.” What are transfer factors (TFs) and how do they influence immune system function? Structurally TFs are polypeptides or chains of specific amino acids that encode the identity of specific microbes and, therefore, educate the immune system to recognize the correlating disease causing organism (Kirkpatrick, 2000). TFs are the reason that most infections confer some measure of future immunity. The influence of transfer factors on immune system function extends to a general ability to improve immune system readiness by improving the activity and proliferation of natural killer (NK) cells (Lang, 1982) (Kisielevsky, Khalturina, 2005). NK cells are a subset of immune cells that differentiate self from non-self. NK cells identify and destroy cells that are infected with viruses and bacteria as well as cancer cells (see Khemka, Sahl, Bui, Tilles, 1997; Imai, Matsuyama, Miyake, Suga, Nakachi, 2000). When NK cell function is strong, we expect less illness, and when we do get sick, we expect to REPRINTED WITH PERMISSION © THE AUTISM FILE

be able to recover naturally. Dr. David Markowitz’s clinical experience supports this expectation. He reported an 82-85% reduction in antibiotic use and a 75% reduction in illness in his pediatric patients who used TF over a 6-month period. He collected data during a 7-year period, from 1999 to 2006, in over 680 patients in an age matched retrospective clinical observation. (David Markowitz, MD, personal communication, April, 28, 2010). Dietary TF has also been shown to improve salivary immune globulin A (sIgA) in healthy adults (Bennett, Vaughn, Lefler, McCausland, Lisonbee, 2009). This research supports anecdotal reports of improvement in sIgA in children with ASD and supports the wider influence of TF in immune system function. SIgA is the first line antibody defense of the upper respiratory system, the gastrointestinal tract, and all mucus membranes of the body (Corthesy, 2006). Autism spectrum disorders, autoimmunity and dietary TF Autoimmunity is when the immune system loses its regulatory capacity. It begins to attack self instead of just non-self. ASD is described in the immunology literature as an autoimmune condition (Singh, 2009; Gupta, Aggarwal, Rashanavan, Lee, 2005). Autoimmunity in ASD may be expressed in high autoantibodies to the brain (Singh, Warren, Averett, Ghaziuddin, 1997; Singh, Jensen, 2003), and inflammation of the brain (Singh, 2005). Inflammation and immunopathology of the gastrointestinal tract have been established in children with ASD (Ashwood, Anthony, Pellicer, Torrrente, WalkerSmith, Wakefield, 2003; Ashwood, Anthony, Torrente, Wakefield , 2004). Autoimmunity has a chaotic effect on the immune response. www.autismfile.com

biomedical  Allergy, eczema, and asthma are all states of autoimmunity (Kidd, 2003). TF has a modulating effect on immune function (Dwyer, 1996; Vorobiev, 2004). The emerging science points to immune modulation, that is, the ability to upregulate or downregulate as a critical component to immune competence (R.H. Bennett, PhD personal communication, May, 20, 2004). For people contending with autoimmune conditions like ASD, PANDAS, or PI disease, this may be the most important contributing factor to success with this dietary supplement. Where do TF molecules come from? TFs are naturally occurring molecules that are the same in all mammals. During pregnancy they are collected in the breast tissues of the parturient and secreted into colostrum at birth (Parley, Beer, 1976; France, Marmer, Steele, 1980). When the newborn nurses, his immature and naive immune system is educated by the maternal immune history via the TF molecule. This education trains the immune system to recognize, respond, remember, and regulate the newborn’s immune function. The immuneenhancing benefits of dietary TF are available to us at any age (Vorobiev). Many children with ASD benefit from a gluten- and casein-free diet (GF/CF). TF is GF/ CF. The large milk proteins naturally found in colostrum are removed through an ultra filtration process (Wilson and Paddock,1983). TF is typically suggested for people with ASD because it is a natural, gentle, effective, and well-tolerated immune modulator (Pizza, DiVinci, Fornarola, Parlareti, Baricirdi, Viza, 1996; Vorobiev; Bock, 2004). I suggest dose and product adjustments for the individual as parent interviews and reports indicate. We use a series of ATEC reports to mark progress (www.autism.com/ind_atec_survey. asp). In these cases, the ATEC illustrates the range of influence that a functional immune system has on the central nervous system, far beyond resistance to colds and flu. Dietary TF as a first biomedical intervention for a 46-month male with ASD/regression after vaccination PA weighed 5 pounds 1 ounce and was

delivered at 37 weeks gestation via spontaneous vaginal birth. He was nursed for 5 months. PA’s paternal history is significant for allergy, rheumatoid arthritis, and lupus. Mom’s prenatal course was remarkable for extensive dental treatments for an abscessed tooth that included 30 days of antibiotic therapy. At 3 weeks of age, PA began suffering from colic and gastric cramping. PA was diagnosed and treated for croup at 10 months, double ear infection at 12 months requiring a 30-day course of antibiotics, upper respiratory infection at 14 months, herpangina at 16 months, constipation at 16 months and 1 week, streptococcus at 20 months, croup at 21 months and 1 week, and at 22 months asthma was ruled out. Figure 1: Vaccine Chronology: Birth 2 month 4 month 6 month 12 month 12/27/02 3/03/03 4/28/03 6/27/03 12/30/03 HepB HepB HepB Hib Hib Hib Hib DTaP DTaP DTaP DTaP IPV IPV IPV MMR Prevnar Prevnar Prevnar

Vaccination schedule stopped after 20 month shots PA’s pediatrician was concerned about ASD by his 20-month well-baby visit on 8/11/04 and referred him to a Defeat Autism Now! (DAN!) doctor, where he received an autism diagnosis at 24 months of age. By 28 months he was receiving 20 hours a week of 1:1 applied behavioral analysis (ABA). PA was 46 months of age when immune modulation with dietary TF was instituted. At that time, PA’s ABA therapist completed a series of three autism Treatment Evaluation Checklists over a 20-week period to evaluate his progress. She was unfamiliar with TF and was uncertain of what to expect. PA was not on any medications and had not received any dietary supplements prior to supplementation with TF . He was on a regular diet. At the time PA began his 20-week trial with stress doses of the TF, these were his parents’ observations of greatest concern:

20 month 8/11/04

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 Delayed speech  Constipation: 3-4 difficult stools per week  Eczema all over  Unable to follow two-part commands  Didn’t jump with both feet  Unable to have a conversation  Inconsistent eye contact  Unable to potty train  Covers ears with hands on occasion  Zones out and stares into space  Does not interact with others often  Sense of fear is absent

Left: At the time of the ASD diagnosis Middle and right: PA Christmas 2004 at age 2 PA and his little brother Christmas 2009, www.autismfile.com

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PA’s ATEC scores dropped from a baseline of 35 to 4 during this first intervention with the TF product. His nearly neurotypical ATEC score was reflected in his daily life. He became a happier and healthier child. His eczema resolved and his recurring infectious illnesses abated. He potty trained during the second half of the trial. He was able to carry on a conversation and his sensitivities to noise resolved. He became more “connected” with our world and joined his neurotypical peers in 2008 in kindergarten. PA attends public school and is in the 90% percentile of his first grade class academically. In a follow-up interview for this publication, Mom reported PA is enjoying great health and a happy childhood with no special considerations regarding his former ASD status. PA’s maintenance regimen includes TF , probiotics, and digestive enzymes to support his excellent health. Antibiotics and antipyretics have not been prescribed since age 20 months.

*fever ** febrile seizure ***see text. 1m = 1 month 108 • THE AUTISM FILE 36 2010

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NJ: A 16-year-old male with ASD, regression after vaccination, PANDAS, and PI disease/ CD19 defect. The pregnancy was significant for the treatment of two bladder infections. One in the first trimester was treated with Macrodantin, and one at 5 months was treated with amoxicillin. NJ was delivered spontaneously at 42 weeks gestation (2 weeks post due date). NJ weighted 9 lbs, his Apgar scores were 9/9. He was formula fed. NJ’s paternal history included anxiety, depression, ulcers, asthma, diabetes, and ulcerative colitis. NJ’s maternal history included ovarian cancer, recurrent sinusitis, arthritis, depression, ulcers, Crohn’s disease, ulcerative colitis and mood disorder. Following delivery, NJ was a calm and beautiful baby who made eye contact with his mom. At 48 hours he received the hepatitis B vaccine and began crying. He cried for the next 3 weeks for about 18 hours a day. He was switched to a soy formula. He continued to cry. His demeanor improved by 8 weeks but eye contact was difficult to elicit. By 4 months his eye contact improved and Mother was less concerned until NJ suffered a pulmonary infection at 6 months of age. It was treated with erythromycin. At 9 months, he suffered the first of a series of nine ear infections. They occurred monthly and were treated with antibiotics. By the fall of 1995, he had his first set of ear tubes placed; these helped reduce ear infections to just three by the time they fell out for good at age 6. He suffered countless sinus infections during this time. At 13 months he ran a fever after receiving the MMR. He looked dazed in his birthday pictures. At 15 months, NJ was diagnosed with rotavirus and was ill for 2 weeks; 1 month later the rotavirus was back. At 18 months, NJ received the chicken pox vaccine and developed a 105-106 degree fever within 4 hours. This continued for 48 hours despite alternating doses of ibuprofen and acetaminophen. His fever dropped to 103-104 degrees and his capillary refill time was 3-4 seconds. On day 3 he improved and broke out in a rash. Within 1 month, he was fully disengaged − no eye contact and no curiosity. Mom approached the pediatrician asking whether NJ was autistic. At 19 months NJ characterized autism. He received an ASD diagnosis at 30 months. At 30 months, Mom completed the Diagnostic Checklist for Behavior-Disturbed Children, Form E2 (1996), an early version of the ATEC currently in use at the Autism Research Institute, and he received a score of 8+ indicating that NJ was indeed autistic. Mom hired a well-known and respected therapist, and www.autismfile.com

biomedical  a 30-hour per week in-home therapy plan was developed for NJ. It consisted of ABA, sensory integration, speech, Mayer Johnson cards (NJ was hyperlexic), music therapy, and TEACCH in his school. NJ made great progress and spoke his first words at 41/2 years of age following intensive speech therapy. At age 5 he had a streptococcal infection and regressed. It took a year to recover his lost progress. He frequently had sinus infections and ran fevers of 104-105 degrees. By age 7 he was unable to develop a fever. Fever stimulates the immune system to respond to invaders and creates an inhospitable environment for microbes. He continued to progress until age 9 when NJ got a Strep infection that went undiagnosed for 6 weeks. During this time he developed a severe tic involving his head and neck. He started to tantrum. His Anti-Streptolysin O (ASO) antibody level was 400: normal range is