All eyes are on Vaccine Court this week, as people await rulings in the autism "test cases" on MMR and thimerosal. But another omnibus proceeding involving Hepatitis B vaccine and autoimmune disorders in adults, including MS, has already been quietly ruling in favor of several petitioners. (HERE)

The most recent case was announced about a week ago. In it, the Court ruled that the victim, an adult female, had contracted a form of demyelinating disease and MS, and eventually died, after receiving the Hepatitis B vaccine series. It was just the most recent case in a rash of rulings in the omnibus proceeding dealing with hepatitis B vaccine and "demyelinating diseases such as transverse myelitis (TM), Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating disease (CIDP), and multiple sclerosis (MS)," according to court papers.

"Petitioner has prevailed on the issue of entitlement. The medical records during decedent's final hospitalization reflect that she died from demyelinating disease. Not only did decedent have a vaccine injury, but also her death was vaccine-related," wrote the Special Master in the case.

Interestingly, the US government chose not to present any expert witnesses, nor to contest the case any further.

But the family of the deceased woman had presented testimony from an expert witness who stated that, "It is biologically plausible for hepatitis B to cause demyelination because vaccines are composed of organic compounds of viral or bacterial origin, whether recombinant or otherwise, whose purpose is to initiate an immune response in the recipient,: the Court noted in the ruling. "But if any of the vaccine antigens shares a homology with the recipient's antigens, the host's immune response will attack both the vaccine antigens and the host's antigens, resulting in an autoimmune response. This concept is also known as molecular mimicry and is well-established in immunology."

In the last few years, it turns out, the Federal Vaccine Court has issued a number of rulings in favor of petitioners seeking compensation for Hepatitis B vaccine-related demyelinating diseases, especially MS.

What is also notable about all the Hep B rulings is that they fly in the face of the reasoned opinion of an IOM panel that looked into the matter in 2002. That committee determined that "the epidemiological evidence favors rejection of a causal relationship between the hepatitis B vaccine in adults and multiple sclerosis." Likewise, the panel said that it "does not recommend that national and federal vaccine advisory bodies review the hepatitis B vaccine on the basis of concerns about demyelinating disorders."

Apparently, Vaccine Court Special Masters are willing to make their rulings independent of what the IOM has decreed (and given the IOM's spotty track record on the etiology of illnesses such as Agent Orange and Gulf War Syndrome, perhaps there is a solid legal underpinning for that).

So, what does any of this have to do with the autism cases? Perhaps nothing. But, if the autism Special Masters suggest that more research is needed, one area that scientists may want to explore is demyelination in autism and its many potential causes.

Myelin is the fatty acid sheath that protects and insulates nerve cells and the brain. Some people with autoimmune disorders, including MS, present with damage to myelin in the brain.

Myelin damage has long been suspected in autism, though the jury is still out on this question. One thing that does seem to be certain is that children with ASD appear to have unusually high levels of antibodies to myelin basic protein, or MBP. That would suggest they might have myelin damage as well. Some studies have also shown highly elevated levels (up to 90%) of MBP antibodies in ASD children who received the MMR vaccine. The development of MBP antibodies could possibly be caused by a reaction to the live measles virus in the vaccine, because the virus may mimic the molecular structure of MBP. (The finding of antibodies to MBP is also associated with MS, which is a demyelinating disorder).

This vaccine-myelin association was also supported by a study in the October, 2008 issue of the journal Neurology. It reported that exposure to Hep B vaccine in children was associated with a 50% increased risk for CNS inflammatory demyelination of 50 percent (OR: 1.50; 0.93 - 2.43). This was especially true for children who got GlaxoSmithKline's Engerix B vaccine, in which case the risk was elevated by 74% (1.74; 1.03 - 2.95). Among ASD children with confirmed multiple sclerosis, the risk increased by 177% (2.77; 1.23 - 6.24).

"Hepatitis B vaccination does not generally increase the risk of CNS inflammatory demyelination in childhood," the authors concluded. "However, the Engerix B vaccine appears to increase this risk, particularly for confirmed multiple sclerosis, in the longer term. Our results require confirmation in future studies."

Of course more studies are needed, but it is becoming more difficult these days to argue that there is no active immune/inflammatory response going on in the brains of autistic individuals, and even harder to contest that MBP is associated with at least one aspect of that response, although there are likely others. The MBP findings are not 100% concordant, but there is a fair amount of supportive evidence.

Equally intriguing, along these lines, is a new study published in the Journal of Child Neurology. That paper reported that "anti-myelin-associated glycoprotein positivity" was found in a stunning 62.5% of the autistic children studied. And, a family history of autoimmunity was five times more common in ASD children (50%) than controls (9.4%).

"Anti-myelin-associated glycoprotein serum levels were significantly higher in autistic children than those without such history," the authors wrote. "Autism could be, in part, one of the pediatric autoimmune neuropsychiatric disorders. Further studies are warranted to shed light on the etiopathogenic role of anti-myelin-associated glycoprotein antibodies and the role of immunotherapy in autism."

This information is tantalizing, to say the least. And it could provide new avenues of research into the role of vaccines, demyelinating diseases, "autoimmune neuropsychiatric disorders," and autism.

If the HepB series can destroy myelin in some kids and adults, and cause full-blown MS in adults, then is it really that "fringe" to investigate the plausibility of a biological mechanism whereby some vaccines (including MMR) in a subset of susceptible infants might produce symptoms that are characteristic of autism and/or other neuro-developmental disorders?

For years, the US Government and the IOM have insisted that Hepatitis B vaccine does not and can not cause MS. But the Federal Vaccine Court has now, essentially, overturned that opinion. Will the Court now do the same for vaccines and autism? I don't think so - not this week. But it just might keep that door slightly ajar for the future.

David Kirby is author of Evidence of Harm and a contributor to Age of Autism.