The Institute of Chronic Illnesses Inc, 14 Redgate Ct, Silver Spring, MD, USA.
Transl Neurodegener. 2013 Dec 19;2(1):25. doi: 10.1186/2047-9158-2-25.
Autism spectrum disorder (ASD) is defined by standardized criteria of qualitative impairments in social interaction, qualitative impairments in communication, and restricted and stereotyped patterns of behavior, interests, and activities. A significant number of children diagnosed with ASD suffer a loss of previously-acquired skills, which is suggestive of neurodegeneration or a type of progressive encephalopathy with an etiological pathogenic basis occurring after birth. To date, the etiology of ASD remains under debate, however, many studies suggest toxicity, especially from mercury (Hg), in individuals diagnosed with an ASD. The present study evaluated concerns about the toxic effects of organic-Hg exposure from Thimerosal (49.55% Hg by weight) in childhood vaccines by conducting a two-phased (hypothesis generating/hypothesis testing) study with documented exposure to varying levels of Thimerosal from vaccinations.
A hypothesis generating cohort study was undertaken to evaluate the relationship between exposure to organic-Hg from a Thimerosal-containing Diphtheria-Tetanus-acellular-Pertussis (DTaP) vaccine in comparison to a Thimerosal-free DTaP vaccine administered, from 1998 through 2000, for the risk of ASD as reported in the Vaccine Adverse Event Reporting System (VAERS) database (phase I). A hypothesis testing case-control study was undertaken to evaluate the relationship between organic-Hg exposure from Thimerosal-containing hepatitis B vaccines administered at specific intervals in the first six months of life among cases diagnosed with an ASD and controls born between 1991 through 1999 in the Vaccine Safety Datalink (VSD) database (phase II).
In phase I, it was observed that there was a significantly increased risk ratio for the incidence of ASD reported following the Thimerosal-containing DTaP vaccine in comparison to the Thimerosal-free DTaP vaccine. In phase II, it was observed that cases diagnosed with an ASD were significantly more likely than controls to receive increased organic-Hg from Thimerosal-containing hepatitis B vaccine administered within the first, second, and sixth month of life.
Routine childhood vaccination is an important public health tool to reduce the morbidity and mortality associated with infectious diseases, but the present study provides new epidemiological evidence supporting an association between increasing organic-Hg exposure from Thimerosal-containing childhood vaccines and the subsequent risk of an ASD diagnosis.
自闭症谱系障碍（ASD）的定义是社交互动、沟通方面存在定性障碍，以及行为、兴趣和活动存在受限和刻板模式。相当数量被诊断患有 ASD 的儿童会丧失以前获得的技能，这表明存在神经退行性变或一种出生后发生的进行性脑病，具有病因发病基础。迄今为止，ASD 的病因仍存在争议，但是许多研究表明，毒性，特别是来自汞（Hg）的毒性，在被诊断患有 ASD 的个体中存在。本研究通过进行一项两阶段（生成假设/检验假设）研究，评估了儿童疫苗中的有机汞（以重量计 49.55%的 Hg）对硫柳汞的毒性作用的担忧，该研究记录了从疫苗接种中接触不同水平的硫柳汞的情况。
进行了一项生成假设的队列研究，以评估在 1998 年至 2000 年期间，接受含硫柳汞的白喉-破伤风-无细胞百日咳（DTaP）疫苗与接受无硫柳汞的 DTaP 疫苗接种的儿童体内的有机汞（来自含硫柳汞的 DTaP 疫苗）暴露与疫苗不良事件报告系统（VAERS）数据库中报告的 ASD 风险之间的关系（第 I 阶段）。进行了一项检验假设的病例对照研究，以评估在出生后前 6 个月内以特定间隔接种含硫柳汞的乙型肝炎疫苗的有机汞暴露与在疫苗安全数据链接（VSD）数据库中诊断患有 ASD 的病例和在 1991 年至 1999 年之间出生的对照之间的关系（第 II 阶段）。
在第 I 阶段，观察到与接受无硫柳汞的 DTaP 疫苗相比，接受含硫柳汞的 DTaP 疫苗接种后 ASD 的发病率的风险比显著增加。在第 II 阶段，观察到与对照组相比，被诊断患有 ASD 的病例更有可能在出生后的第一个、第二个和第六个月内接受更多的含硫柳汞的乙型肝炎疫苗中的有机汞。
常规儿童疫苗接种是减少传染病相关发病率和死亡率的重要公共卫生工具，但本研究提供了新的流行病学证据，支持含硫柳汞的儿童疫苗中有机汞暴露的增加与随后 ASD 诊断风险之间存在关联。
