The Role of Allergy Desensitization in Autism

Darin Ingels, ND, MT(ASCP) New England Family Health Associates

2425 Post Road, Suite 100 130 5th Avenue, 9th Floor Southport, CT 06890 New York, NY 10011

203-254-9957

nefha.com

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Vaccines in 1974

•  2 mos: DTP, OPV •  4 mos: DTP, OPV •  6 mos: DTP, OPV •  1 yo: Measles, PPD (TB) •  1-12 yo: Rubella, Mumps •  1 1/2 yo: DTP, OPV •  4-6 yo: DTP, OPV

14 vaccines

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Vaccines in 2009

•  "Birth: Hep B •  2 mos: DTaP, Hib, Hep B, IPV, PCV, Rota •  4 mos: DTaP, Hib, Hep B, IPV, PCV, Rota •  6 mos: DTaP, Hib, Hep B, IPV, PCV, Flu, Rota •  12 mos: Hep B, Hib, IPV, MMR, Varicella, PCV, Hep A •  15-18 mos: DTaP, Hep A •  4-6 yrs: DTap, IPV, MMR, Varicella, MCV

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Vaccines: A Numbers Game Infectious Disease

1.  Measles 2.  Mumps 3.  Rubella 4.  Hepatitis B (HBV) 5.  H. influenzae (Hib) 6.  Diphtheria 7.  Tetanus 8.  Pertussis (Whooping

cough) 9.  Polio 10.  Menigococcus 11.  Pneumococcus

Cases per year < 35

250 (>6500 in 2006) <10 cases total since 2001

300,000-500,000 25 <1 <6

26,000 (In 2005, 38/39 deaths in infants , 6 mos)

0 (last case in 1979) 1400-2800

400 (96% of severe Dz from non-vaccine strains)

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Vaccines: Hidden Ingredients •  Mercury •  Aluminum •  Chicken serum •  Bovine serum •  Human serum albumin •  Formaldehyde/Formalin •  Antibiotics •  Soy •  Yeast •  MSG (MMRV-ProQuad, VZV) •  Insect cell protein (HPV)

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/ excipient-table-2.pdf

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Vaccines: Thimerosal-Free •  "Hep B: Recombivax HB, Engerix-B •  Rotavirus: Rotateq •  DTaP: Infanrix, Daptacel, Adacel, Boostrix •  Hib: ActHIB, OmniHIB, PedvaxHIB •  PCV: Prevnar •  Polio: IPOL •  MMR: MMR-II •  Hep A: Havrix, Vaqta •  Flu: Fluzone (Thimerosal-free), FluMist

(Intranasal) •  Varicella: Varivax

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Do Vaccines Predispose to Allergy? Dermal testing of vaccines for children at high risk of allergies. Sugai K, et al. Department of Pediatrics, Yokohama City University, Fukuura 3-9, Yokohama, Kanagawa 239-0004, Japan. kazgoto@be.mbn.or.jp

Vaccinations for children with allergic diseases often need to be postponed or terminated because of the presumed risk of an immediate-type allergic reaction such as anaphylaxis. A new skin test protocol for predicting allergic reactions using the vaccine itself and the following stepwise vaccination method were developed and tested. Intradermal tests using 1:10 and 1:100 diluted measles vaccine indicated that the former was superior to the latter because a positive reaction against 1:10 diluted vaccine was found in 28.6% of 49 patients with severe allergic diseases including bronchial asthma, atopic dermatitis, food allergies and allergies to two or more allergens with high levels of IgE, as compared with the reaction against 1:100 diluted vaccine in 10.2% of the patients. Patients negative for 1:10 skin tests were safe from the following full-dose vaccine shots. Three patients showed very strong local reactions against measles vaccine, and avoided receiving the following full-dose shot. Positive reactions to skin tests of 1:10 diluted vaccine were found in 11 patients, who were given stepwise vaccinations. Three patients had adverse reactions, and two of them had been negative for 1:100 skin tests. In the case of influenza vaccine, skin tests were again more sensitive to 1:10 than to 1:100 diluted vaccine, because 3 out of 14 patients with positive reactions showed immediate-type adverse reactions against the following stepwise vaccinations, and 1 of them was negative for the 1:100 skin test. Moreover, the results of the skin prick test (undiluted vaccine) and the intradermal skin test (1:10 diluted vaccine) indicated that the latter was more useful in both cases of measles (54 patients) and influenza vaccine (69 patients). Overall, the skin test using 1:10 diluted vaccine was the more suitable for predicting an immediate-type reaction to measles and influenza vaccinations. Patients having negative 1:10 skin tests can be expected to show no adverse reactions to the remaining injections and even the positive subjects will complete the course of vaccine doses by the stepwise method.

Vaccine. 2007 Apr 30;25(17):3454-63. Epub 2007 Jan 11.

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Do Vaccines Predispose to Allergy? Is infant immunization a risk factor for childhood asthma or allergy? Kemp T, et al. Department of Medicine, Wellington School of Medicine, New Zealand.

The Christchurch Health and Development Study comprises 1,265 children born in 1977. The 23 children who received no diphtheria/pertussis/tetanus (DPT) and polio immunizations had no recorded asthma episodes or consultations for asthma or other allergic illness before age 10 years; in the immunized children, 23.1% had asthma episodes, 22.5% asthma consultations, and 30.0% consultations for other allergic illness. Similar differences were observed at ages 5 and 16 years. These findings do not appear to be due to differential use of health services (although this possibility cannot be excluded) or con-founding by ethnicity, socioeconomic status, parental atopy, or parental smoking.

Epidemiology. 1997 Nov;8(6):678-80.

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Do Vaccines Predispose to Allergy?"Do early childhood immunizations influence the development of atopy and do they cause allergic reactions? Gruber C, Nilsson L, Bjorksten B Department of Pediatric Pneumology and Immunology, Charité - Humboldt University, Berlin, Germany.

Concerns about allergic side-effects of vaccines and about a possible promotion of allergic diseases contribute to incomplete vaccination rates in childhood. This article reviews the current understanding of these issues. There is evidence that pertussis and diphtheria/tetanus antigens elicit immunoglobulin E (IgE) antibody formation as part of the immune response. In murine models, pertussis toxin is an effective adjuvant for IgE formation against simultaneously administered antigens. In children, however, sensitization to unrelated antigens or development of allergic diseases do not seem to be augmented. In contrast, bacille Calmette-Guérin (BCG) and measles vaccination have been proposed as suppressors of allergy because of their T helper 1 (Th1)-fostering properties. In the murine system, BCG inhibits allergic sensitization and airway hyper-reactivity. Some epidemiological studies in humans suggest an inhibitory effect of tuberculosis on allergy. BCG vaccination in children, however, has no or merely a marginal suppressive effect on atopy. Other vaccine components such as egg proteins, gelatin, and antibiotics are a potential hazard to children with severe clinical reactions to these allergens. These rare children should be vaccinated under special precautions. In conclusion, vaccination programs do not explain the increasing prevalence of allergic diseases, but individual children may uncommonly develop an allergic reaction to a vaccine. The risks of not vaccinating children, however, far outweigh the risk for allergy. Therefore, childhood vaccination remains an essential part of child health programs and should not be withheld, even from children predisposed for allergy.

Pediatr Allergy Immunol. 2001 Dec;12(6):296-311.

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Do Vaccines Predispose to Allergy?"

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Who has allergies? •  According to the American Academy of Allergy,

Asthma and Immunology, more than 50 million people in the U.S. have some form of allergy.

•  Allergic diseases affect more than 20% of the population.

•  Allergies are the 6th leading cause of chronic disease in the U.S.

•  Since “allergy” has a strict definition, the number of people with hypersensitivity is likely much higher.

•  There is a higher likelihood of growing into an allergy than growing out of one. Allergy symptoms can occur at any age.

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What is Allergy? •  Allergy is defined as a “harmful, increased susceptibility to a

specific substance”, also known as hypersensitivity. •  Typically used to describe type I or immediate hypersensitivity

reactions, mediated by IgE, but may include types II, III and IV hypersensitivity.

•  However, this definition does not encompass the breadth of

immune reactions to substances.

•  Anyone presenting with recurrent infections or multiple endocrine dysfunction should be evaluated for allergies.

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Common Allergens

•  House dust mites •  Pollen (trees, grasses and weeds) •  Mold •  Animal danders (cat, dog, rabbit, etc.) •  Insects •  Foods: milk, egg, peanuts, wheat, soy, tree nuts •  Food components: histamine, tyramine, MSG,

phenolics

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Weapons of Mass Destruction

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Less Common Allergens

•  Food dyes, especially tartrazine (yellow #5) •  Chemicals: perfume, formaldehyde, phenol,

petroleum, preservatives, tobacco smoke (think about your local mall with all new products)

•  Medications •  Hormones, neurotransmitters? Do some of the

body’s proteins stimulate immune reactions? •  Vaccines and their components?

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Classification of Hypersensitivity Adapted from Johansson SGO et al. Allergy 2001;56:813-24

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Hypersensitivity

Allergic hypersensitivity (Immunologic mechanism defined)

Nonallergic hypersensitivity (Immunologic mechanism excluded)

IgE mediated Non-IgE mediated

Atopic Classic allergy Non-atopic

Insect sting

Parasites/Infection

Drugs

Others

T-cell (contact dermatitis, Celiac disease)

Eosinophillic reactions

IgG-mediated (allergic alveolitis, food allergies?)

Idiosyncratic

Classification of Hypersensitivity Adapted from Johansson SGO et al. Allergy 2001;56:813-24

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Hypersensitivity

Allergic hypersensitivity (Immunologic mechanism defined)

Nonallergic hypersensitivity (Immunologic mechanism excluded)

Enzymatic Food Intolerance (i.e. Lactose intolerance)

Pharmacologic Reactions (i.e. caffeine)

Psychological Reactions

(i.e. aversions to foods)

Classical Allergy Symptoms

•  Allergic rhinitis (hayfever) •  Sinusitis •  Allergic conjunctivitis •  Otitis media/Otitis interna •  Asthma •  Eczema •  Contact dermatitis •  Hives (urticaria) •  Gastroenteritis

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Other conditions that may suggest allergy

•  Arthritis •  Autism (ASD) •  Bladder infections •  Candidiasis •  Canker sores •  Celiac disease •  Chronic infections •  Colic •  Constipation •  Depression •  Diarrhea •  Fatigue (Chronic) •  Gallbladder attacks

•  GERD •  Glaucoma •  Hypertension •  Hypoglycemia •  Hypothyroidism •  IBS •  Inflammatory Bowel Dz •  Irregular menses •  Migraine headaches •  Obesity •  PMS •  Psoriasis •  Ulcers

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Allergic Shiners

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Allergic “Salute”

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Dennie’s Lines

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Diagnosis of Allergies

Skin Tests: •  Prick Test •  Scratch Test •  Patch Test •  Intradermal injections

Blood Tests: •  Total IgE •  RAST: Specific IgE •  IgG4 tests (foods) •  IgA (selective IgA

deficiency) Blood tests limited to IgE/IgG4

reactions, so will miss all non-allergic and non-IgE hypersensitivities

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Diagnosis of Allergies

•  Provocation/Neutralization: Intradermal method of using serial 1:5 dilutions to provoke symptoms with one dilution and turning the symptoms off with the neutralizing dose. Used for foods.

•  Serial endpoint titration (SET): Used for inhalants. •  *Esoteric Testing: Electrodermal screening (EDS),

kinesiology, NAET. * These methods are not FDA approved as diagnostic methods, but may provide insight into one’s allergies.

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Food Sensitivities •  The term “food allergy” is grossly misused in medicine.

This term is reserved for anaphylactic or immediate hypersensitivity reactions, which are rare.

•  Food sensitivity refers to a delayed reaction to food which does not involve the same immune mechanisms as food allergies. Studies suggest food sensitivity reactions may occur up to 72 hours after ingesting a food.

•  Conventional allergists test for food allergies (IgE) by RAST or skin prick testing. If your child does not have a food allergy and has a food sensitivity, the test will likely be negative.

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Food Sensitivities •  Many parents will observe when their child is having

a food sensitivity reaction: red ears, dilated pupils, random tantrums or more irritability, mental fogginess, bowel changes, skin rashes, distended abdomen to name a few.

•  Food sensitivities are different than food intolerances, such as gluten/casein intolerance or lactose intolerance. These must be tested by different methods. Enterolab (www.enterolab.com) offers reliable testing for gluten, casein, soy and egg intolerance.

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Food Sensitivities •  Food sensitivities appear to be triggered by immune

reactions to specific phenolic compounds naturally found in the food(s). Common phenolic compound sensitivities include malvin, piperine, phenylisothiocyanate (PITC), coumarin, tyramine.

•  Food sensitivity treatment is two-fold: eliminate the food temporarily (about 6 months) and desensitize the immune system against the underlying phenolic sensitivity. Once the immune system is desensitized, foods may be added back and eaten on a rotation basis.

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Disruption of the Immune System 1.  Chronic Occult Infection

Strep (PANDAS) Candida or other yeast infection Parasites (hookworm, pinworm, etc.) Lyme disease Small intestine bacterial overgrowth (SIBO)

2.  Endocrine Dysfunction

Hypothyroidism Hypoadrenalism (or cortisol dysregulation) Hypoglycemia Puberty (especially in boys) 17"#$$%"&'()*"+*,-./0"#&"

Electrodermal Screening (EDS) •  Developed by Reinhold Voll, MD in the

early 1950’s •  The electric current passing through

acupuncture points differs from random places on the skin

•  In 1994, Dr. Alfred Gillman discovered cells communicate electrically before they communicate biochemically

•  This means we can use the body’s electrical patterns to detect changes in tissue

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Advantages of Electrodermal Screening (EDS)

1.  Non-invasive! No needles, scratching, injections. 2.  Ability to assess sensitivities in a short time period.

Conventional: 4-6 foods in an hour EDS: 100 foods in 15 minutes

3.  Ability to assess for allergens/sensitivities that may not be possible through conventional means (chemicals, hormones, neurotransmitters, etc.).

4.  More sensitive than conventional methods. May detect subtle sensitivities or allergies.

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Sublingual Immunotherapy (SLIT) •  Treatment concept same as injection; different route

of administration. Allergy drops taken under tongue and then swallowed. Can also be applied on the skin.

•  Used in Europe more widely than in U.S. More than 30 years of clinical use.

•  Proven safety record. No risk of anaphylaxis. Safe to use with children.

•  Can use same diagnostic techniques to determine neutralizing dose (endpoint).

•  More than 600 published clinical trials showing SLIT effective in treating inhalant and food allergies. Potential to treat other allergies/sensitivities (chemicals, autoimmune conditions)?

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Sublingual Immunotherapy (SLIT)"

What can be treated with SLIT? 1. Food allergies/sensitivities 2. Molds/Yeasts 3. Pollens (trees, grasses, weeds) 4. Dust and dust mites 5. Animal danders: cat, dog, horse, etc.

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Sublingual Immunotherapy (SLIT)"

What can be treated with SLIT? 6. Chemicals: Formaldehyde, phenol, benzene,

toluene, perfume, newsprint, etc. 7. Hormones: Cortisol, T3, T4; this can be

significant in adrenal stress 8. Neurotransmitters: Serotonin, dopamine, GABA,

norpepinephrine, epinephrine; think about medicines/supplements that increase these substances. Would you eat a peanut if you were allergic to it?

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Sublingual Immunotherapy (SLIT): Is It Effective?"

Studies show SLIT is effective 75-90% of the time. The effectiveness of the treatment is based on quality of antigen, dose of antigen and duration of treatment. This is equal or superior to conventional injection immunotherapy.

The duration of treatment can be short (6 months for food) up to many years (mold, pollens).

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Advantages of Sublingual Immunotherapy (SLIT)

1.  Non-invasive. Drops are administered under the tongue or on the wrist. No needles or injections.

2.  Excellent safety record. 3.  No weekly doctor’s visits to get treatment.

Able to administer at home. 4.  More control over dose. Treatment can be

easily tailored to response. 5.  More effective than conventional

immunotherapy? 24"#$$%"&'()*"+*,-./0"#&"

Classical Homeopathy •  Founded by Samuel Hahnemann, MD in 1796 •  Treatment principle based on Law of Similars or

“like cures like” •  Substances derived from plants, minerals, animals

and other sources are potentized (dilution and secussion) to make specific remedies and their potencies

•  ‘X’ dilutions are serially 1:10 dilutions; ‘C’ dilutions are serially 1:100 dilutions

•  Anything beyond 12C or 24X is not likely to contain any of its original substance

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Classical Homeopathy

You must look past the autism to see the individual…

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Theory of Miasms"

•  Psora: “The mother of all diseases”. Weakness, low energy, anxiety, fears, skin problems (itchy), coldness, clear discharges

•  Sycosis: High energy (night owl), impatient, impulsive, jealous, extremes, high fevers, spasms, green/yellow discharges

•  Syphilis: High energy, destructive, aggressive, isolated, secrecy, suspicious, deformity, bloody discharges

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Miasmatic Prescribing

•  The remedy prescribed should match the miasmatic quality of the person.

•  Miasms are inherited or acquired. They form the foundations of health and illness.

•  If you understand the miasmatic qualities of a person, you can predict what types of illnesses they may be susceptible to.

•  Even if the wrong remedy is selected, but if it is the right miasm, you are likely to see positive results.

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How Does It All Fit? Drug therapy Nutrients SLIT Homeopathy

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