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Associate Professor, Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, 624 N. Broadway, Baltimore, MD 21205-1901, USA. email: kfrick jhsph ; . Correspondence should be addressed to this author. 2 Research Associate, Johns Hopkins University, School of Medicine, Baltimore, MD, USA. 3 Professor, Johns Hopkins University, School of Medicine, Baltimore, MD, USA. 4 Associate Professor, Johns Hopkins University, School of Medicine, Baltimore, MD, USA. 5 Project Director, Kongwa Trachoma Project, Kongwa, United Republic of Tanzania. Ref. No. 01-1640 Bulletin of the World Health Organization 2003, 81 2 ; 101.

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FIG. 7. Effect of corticosterone on the kinetics of TEA transport at pH 7 and 8 B ; in CHO-K1 cells stably transfected with hOCT2. Five-minute uptakes of 57 nM [3H]TEA 12 M corticosterone were measured at pH 7 and 8 E ; in the presence of increasing concentrations of unlabeled TEA 0 2.5 mM ; . For the representative experiment shown, at pH 7, the addition of 12 M corticosterone increased the Kt for TEA from 40.8 to 97.8 M and decreased the Jmax from 13.3 to 4.2 pmol cm 2 min 1. At pH 8, the addition of corticosterone increased the Kt for TEA transport from 56.4 to 77.5 M and decreased the Jmax from 15.2 to 4.8 pmol cm 2 min 1. Each point represented uptake from a single well. From the United States Naval Medical Research Unit No. 2 NAMRU-2 ; , and the National Taiwan University College of Medicine, Taipei, Taiwan. Method Qualitative study using focus groups with pharmacists n 18 ; and pharmacy technicians n 20 ; . Postal questionnaire to 731 community pharmacists. Madam, I do not know if you are involved directly in the problems of autism, but it appears that you are not aware of all the studies on the very controversial subject of the association between the MMR vaccine and autism. Allowing yourself to pass judgment on Dr Wakefield's work and to say that it is a botched job is absolutely unacceptable. I wish to remind you that his studies have been published in Lancet, The American Gastroenterology Report and, more recently, in the Journal of Clinical Pathology. It can therefore be assumed that at least his methodology is good enough for these medical journals! Should your spirit of criticism persist, you would be advised to doubt the studies of Taylor and Peltola as well. You should remember that Peltola's study, financed by the Merck pharmaceutical group, took 14 years and ended in 1996 at a time when no one had yet heard of a link between the MMR vaccine and autism. The word autism does not appear a single time in the study. Peltola himself admitted that the study did not have cases of autism as one of its objectives and that this criterion was not even mentioned. This just to mention one of the most flagrant irregularities concerning the pertinence of such a study in the matter of autism. As for the Taylor study, it is only a retrospective epidemiologic study that contents itself with analysing data and numbers and verifying the prevalence of gastro-intestinal disorders in autistic children. Dr Wakefield could retort that he checked the medical reports of many children concerned and that the quality of these reports is deplorable, the majority of gastro-enterological symptoms not being listed by the psychiatrists who drew up the reports. In addition, professor Vijendra K. Singh, biologist at the Department of Biology and Technology Centre, Utah State University, has confirmed Dr Wakefield's works while addressing the problem from another angle, i.e., by looking for the presence of anti-measles antibodies as well as antibodies against neuronal proteins such as myelin in autistic children. More than 60% of autistic children have these antibodies as compared to 0 in the control group. He produced a number of studies on the subject, the most recent of which I urge you to read. Journal of Allergy Clin. Immunol. 109 1 ; S232, 2002 It is certainly more comfortable to adopt the "medically correct" opinion than to assume the result of these researches, especially when they put into question an institution like vaccination. The only proper attitude in the face of these results is to demand further research. Marie-Christine Destison Mother of Adrien, autistic person aged 18!

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