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Showing posts with label Camel. Show all posts
Showing posts with label Camel. Show all posts

Friday, 12 December 2025

Lactoferrin - the "Liquid Gold" protein for babies, older people and some Autism

 


This post is rather long. You could summarise by "Trial lactoferrin, or camel milk."


For many families managing autism, the most challenging co-occurring issues are often chronic gastrointestinal (GI) problems and related behavioral challenges. The link between the gut, the immune system, and the brain—the Gut-Brain Axis—is a growing area of research, and one key protein is generating significant interest in Lactoferrin.

Lactoferrin is a multifunctional protein found naturally in milk, recognized for its anti-inflammatory, antimicrobial, and immune-modulating properties. But how exactly does this protein connect to the world of autism?

 

The "Good" Lactoferrin: Immune Support and Neuroprotection

When consumed as food or a supplement, lactoferrin acts as a protective agent. Its potential benefits for individuals with ASD are rooted in its ability to target two core issues: inflammation and microbial imbalance.

The Natural Power of First Milk

  • Human Colostrum & Research Status: Lactoferrin is abundant in colostrum (the "liquid gold" first milk). It acts as the newborn's first immune shield, helping to "seal" the gut, prevent infections, and establish a healthy microbiome. In the context of ASD, bovine colostrum products (BCP), often combined with probiotics, have been the subject of small-scale pilot studies. These initial trials suggest BCP may be well-tolerated and can help reduce GI inflammation and improve gut function, leading to associated improvements in certain behavioral symptoms. However, large-scale clinical trials are still required to validate colostrum as an effective core therapy for ASD.

  • Camel Milk's Unique Role: In regions like Saudi Arabia, camel milk has been traditionally used and studied as a complementary intervention for autism symptoms. Camel milk is naturally rich in lactoferrin—often higher than cow's milk—and possesses a unique protein profile.

    • High Bioavailability: Crucially, the lactoferrin in camel milk is considered more resistant to stomach acid and digestive enzymes than bovine (cow) lactoferrin, suggesting higher bioavailability (more of the intact, active protein reaches the lower intestine) in humans.
    • Immune Modulation & Allergy: Research suggests camel milk can modify the overall immune response. This is important because the benefits may not be limited to those with GI symptoms; its immune-rebalancing effect (immunomodulation) suggests it could benefit people with ASD who suffer from frequent allergies, eczema, or systemic immune dysregulation, even if they lack chronic GI distress.

 

How it Relates to Autism

Lactoferrin works by several different mechanisms:

Addressing Iron Dysregulation (The "Starvation" Mechanism)

  • Harmful gut bacteria and pathogens (which contribute to gut dysbiosis in ASD) thrive on free iron. When there is excess, unregulated iron in the gut, these pathogens proliferate, worsening the microbial imbalance and gut-related inflammation.
  • Lactoferrin is a powerful iron-binding protein that tightly sequesters two molecules of ferric iron (Fe3+) per molecule, even at the low pH often found in inflamed or infected tissues.
  • This process effectively starves the harmful bacteria of the iron they need to grow, limiting their colonization and virulence. This helps rebalance the gut microbiome, which is the first step in calming the Gut-Brain Axis.

Limiting Oxidative Stress (The "Antioxidant" Mechanism)

  • Free, unbound iron is highly reactive. It participates in the Fenton Reaction, leading to the creation of toxic Reactive Oxygen Species (ROS), which cause widespread oxidative stress. Oxidative stress is a well-documented biological abnormality in the brains and bodies of individuals with ASD, contributing to cellular damage and inflammation.
  • By binding nearly all free iron in the gut and circulation, Lactoferrin acts as an iron scavenger, preventing this iron from participating in the damaging Fenton reaction.
  • This significantly reduces overall oxidative stress and lipid peroxidation (damage to cell membranes), thus protecting brain cells from injury and supporting anti-neuroinflammatory mechanisms.

Optimizing Iron Delivery to the Brain (The "Transport" Mechanism)

  • Iron is an essential nutrient, critical for key neurodevelopmental processes like myelination (insulation of nerve fibers) and the synthesis of neurotransmitters (like Dopamine and Serotonin). Both iron deficiency and improperly delivered iron are linked to cognitive and behavioral deficits in ASD.
  • Lactoferrin is structurally related to transferrin (the main iron transporter in the blood) and has its own receptors that facilitate iron transport. LF can act as a more efficient, regulated iron supplier, particularly to cells that need it. Furthermore, it is believed to cross the Blood-Brain Barrier (BBB) and deliver iron to the central nervous system.
  • Ensures that the brain receives a regulated supply of iron for proper neuronal function and neurotransmitter balance, which is vital for attention, mood, and socio-communicative skills.

In summary, Lactoferrin's primary role regarding iron is to sequester free iron to kill pathogens and stop oxidative stress, while simultaneously regulating the delivery of iron to the cells that need it for brain development.


Mechanisms Mediated by the Gut-Brain Axis

Reducing Gastrointestinal Inflammation (Anti-Inflammatory Action):

o reduces chronic, low-grade inflammation in the gut by downregulating pro-inflammatory signaling molecules (cytokines like IL-6 and TNF alpha and promoting anti-inflammatory ones like IL-10.

o    Alleviates gastrointestinal distress, which is a common comorbidity that can worsen behavioral symptoms in ASD.

Healing the Intestinal Barrier ("Leaky Gut")

o     supports the structure and function of the intestinal lining by promoting the repair and maturation of the epithelial layer and reinforcing the tight junctions between cells.

o    Prevents the abnormal passage of inflammatory molecules and neurotoxic compounds from the gut into the bloodstream, thereby reducing peripheral inflammation that can compromise the brain.

  Rebalancing the Gut Microbiome (Antimicrobial Action):

o    Reegulates the availability of iron, which is essential for certain pathogenic bacteria (like some Clostridium species) often found in higher levels in the gut of some people with ASD. By binding to iron, limits their proliferation.

o    Corrects microbial imbalance (dysbiosis), leading to a healthier gut environment and more beneficial microbial metabolites.


The "Bad" Lactoferrin - Fecal Lactoferrin (FLA)

It is crucial to understand that not all lactoferrin is beneficial in all contexts.

While the lactoferrin you consume is protective, the lactoferrin measured in stool tells a different story:

Fecal Lactoferrin (FLA) is a diagnostic marker, not a nutrient. A high FLA score is "bad" because it signals that large numbers of neutrophils (white blood cells) are migrating into the intestines to fight active, destructive inflammation (like IBD or severe infection). A high FLA indicates a serious problem, whereas a normal or low FLA suggests that symptoms are likely due to a non-inflammatory functional disorder (like IBS).

High Fecal Lactoferrin (FLA) is observed in a distinct subgroup of children with autism and indicates active inflammation within their gastrointestinal tract. While the average FLA level across the entire ASD population is usually normal, studies consistently identify a minority (often around 20-30%) whose FLA is significantly elevated. This finding is crucial because FLA acts as a biomarker, signaling a high level of neutrophil infiltration—white blood cells rushing to the site of damage—which means their chronic GI symptoms (like pain, constipation, or diarrhea) are likely caused by an inflammatory disease (like undiagnosed Colitis or IBD) rather than a non-inflammatory functional disorder (like IBS).

The presence of high FLA in this subgroup is vital to the Gut-Brain Axis hypothesis in autism research. It suggests that in these children, the underlying GI inflammation releases chemical signals (cytokines) that may travel to the brain, contributing to neuroinflammation and potentially exacerbating core autistic symptoms and co-occurring behavioral issues. Therefore, detecting high FLA helps clinicians distinguish this subgroup and target their treatment, focusing on anti-inflammatory interventions to address the root physical cause of their distress and associated behavioral challenges.

Fecal Lactoferrin (FLA) is a very common and increasingly standard laboratory test in gastroenterology, particularly for diagnosing and monitoring inflammatory bowel conditions.


For those with access to a very good lab and are going to test FLA, consider also TGF-β – one of the most reliable biomarkers of immune dysfunction in autism

One of the most consistently abnormal immune markers in autism is Transforming Growth Factor-β1 (TGF-β1), a cytokine that plays a central role in immune tolerance, gut barrier integrity, and neurodevelopment.

Over the past 15 years, multiple research groups—particularly the MIND Institute at UC Davis—have shown that children with autism frequently have reduced blood levels of TGF-β1. What makes this finding stand out is the strong correlation with clinical features. The lowest levels of TGF-β1 are typically found in children who also have:

  • more severe social and communication impairments
  • increased irritability and repetitive behaviours
  • chronic gastrointestinal symptoms
  • food sensitivities and allergic tendencies
  • elevated pro-inflammatory cytokines (IL-6, TNF-α, IL-1β)
  • impaired regulatory T-cell function (Tregs)

TGF-β1 is required to generate and maintain Tregs, the immune cells responsible for shutting down unnecessary inflammation and maintaining tolerance to foods and gut microbes. When TGF-β1 is low, the immune system becomes biased toward inflammation and over-reactivity. This immune profile is exactly what many clinicians observe in the “GI + immune activation” subtype of autism.

The abnormalities are not limited to the peripheral blood. Smaller studies examining cerebrospinal fluid (CSF) have found altered TGF-β1 levels in some autistic individuals, with links to developmental regression and stereotypy. This suggests that dysregulation of TGF-β signalling is occurring both in the immune system and centrally in the brain.

Because TGF-β1 plays a major role in strengthening the intestinal barrier, promoting mucosal repair, and dampening inflammatory responses, low levels can help explain why so many autistic children experience gastrointestinal disturbances, eosinophilic inflammation, and reactions to specific foods. Several interventions commonly used in autism—such as lactoferrin, sodium butyrate, Bifidobacterium infantis, Lactobacillus reuteri, and vitamin A/retinoic acid—are known from the scientific literature to increase mucosal or systemic TGF-β activity, which may partly account for their benefits in responsive individuals.

Among the many immune abnormalities reported in autism, low TGF-β1 is one of the most reproducible and clinically meaningful findings. It provides a biologically plausible link between gut dysfunction, immune activation, and behavioural symptoms, and it highlights a subgroup of children who may benefit from treatments aimed at restoring immune tolerance and improving epithelial barrier function.


Back to Lactoferrin


Direct Neurodevelopmental and Neuroprotective Mechanism

Supporting Neurodevelopment via IGF-1Signaling:

o    Insulin-like Growth Factor-1, which is often found alongside lactoferrin  in sources like camel milk, is crucial for neuronal growth, differentiation, survival, and synaptic plasticity (the brain's ability to form and strengthen connections).

o    May directly counteract potential IGF- dysregulation linked to ASD etiology, promoting optimal brain maturation, connectivity, and cognitive function.

o    The IGF- in camel milk is theorized to be highly stable against gastric acid, allowing it to cross the blood-brain barrier (BBB) effectively.

 Reducing Neuroinflammation and Oxidative Stress:

o    Both lactoferrin and IGF-1 possess potent antioxidant and anti-inflammatory properties that help protect the brain. Lactoferrin has been shown in preclinical models to reduce inflammation in brain support cells (astrocytes) and shield the developing brain from injury.

o    Dampens the chronic neuroinflammation and high oxidative stress levels observed in the CNS of individuals with ASD, preventing neuronal damage.

 Enhancing Brain Trophic Factors:

o    Preclinical studies suggest lactoferrin can enhance the production of neurotrophins, such as Brain-Derived Neurotrophic Factor (BDN).

o    BDNF is vital for learning, memory, and the survival of neurons. Increasing its levels supports overall neurological health and development.

 

Beyond the Gut: Systemic Anabolic and Anti-Aging Signals

The benefits of lactoferrin extend far beyond the digestive tract, touching on areas of foundational health that are important across the lifespan. Research highlights its systemic anabolic (tissue-building) and regenerative potential:

 

1. Anabolic Signal to Bone

Lactoferrin is a known factor that promotes osteogenesis (bone creation) and bone health while inhibiting bone loss. It provides a crucial anabolic signal, making it a focus for research on improving bone density and fighting age-related bone decline.

2. Supporting IGF-1 Signaling

Lactoferrin has been shown to work through the Insulin-like Growth Factor 1 (IGF-1) signaling pathway. IGF-1 is a key hormone that:

  • Promotes cell growth and division (anabolism).
  • Is essential for neuroprotection and cognitive function.
  • Typically declines with age, with lower levels being linked to aging processes and poor metabolic health.

By supporting the IGF-1 pathway, lactoferrin may help maintain a critical regulatory signal for tissue regeneration, metabolism, and overall vitality, potentially counteracting some effects of aging and promoting optimal function.

  

Maximizing the Benefits: The Bioavailability Challenge

Lactoferrin is a protein, and like any protein, it is vulnerable to degradation by stomach acid and digestive enzymes. If the protein is broken down before it reaches the small intestine, its benefits are limited. This is the problem of bioavailability.

To maximize the therapeutic benefits of a lactoferrin supplement:

1.     Choose Liposomal Encapsulation: Look for liposomal lactoferrin. This technology encapsulates the lactoferrin molecule within a protective layer of fatty lipids (liposomes). This shield helps the protein survive the harsh acidic environment of the stomach intact, ensuring better delivery and absorption into the intestine.

2.     Timing is Key: For best absorption and targeted delivery, it is generally recommended to take lactoferrin on an empty stomach. Some suggest taking it before bed, as the digestive system is less active, allowing the protein longer contact time with the intestinal lining and minimizing competition with other food proteins for absorption.

 

Conclusion

Last year I did meet one of the Saudi authors of the research into camel milk, as an immunomodulatory treatment for autism.

If camel milk is impractical where you live, a little lyposomal lactoferrin might be an alternative. I do not think the benefits are limited to those with GI problems. It also looks interesting for older adults.

Camel milk not only contains ten times the level of lactoferrin than cow milk, but it appears to be more able to survive acid in the stomach. 

Camel milk also contains special protective proteins called immunoglobulins (which are essentially antibodies), but they are unique in the animal kingdom. Unlike the complex antibodies found in humans and cows, camel antibodies are missing half of their structure, making them incredibly small. These tiny, functional fragments are now known as nanobodies. Because they are so small, these nanobodies can reach tight spaces in the body that large antibodies cannot, helping them fight bacteria and viruses more effectively. Furthermore, they are very tough and stable, meaning they survive digestion even when consumed orally in the milk, which is why they are thought to help give camel milk its powerful health benefits. 


 



I think those people drinking camel milk in the Middle East are making a smart choice.









Wednesday, 8 May 2024

Immunotherapy from the desert

 



Today’s post revisits the idea of using immunotherapies to treat autism.

Some readers of this blog are already doing this and a significant percentage of those are using IVIG.

Intravenous immunoglobulin (IVIG) is a pooled antibody, and a biological agent used to manage various immunodeficiency states and a plethora of other conditions, including autoimmune, infectious, and inflammatory states.

IVIG is not a precision therapy, it is more a case of when all else fails try IVIG.

In the United States it seems that many insurance companies will cover the cost of long-term IVIG therapy. In other countries the cost greatly limits the use of this therapy.

An interesting observation is that IVIG products can vary significantly in their potency, depending on where they are made. Several readers of this blog have noted this.

I attended the Autism Challenges and Solutions conference recently in Abu Dhabi. I did have a chat with Laila Alayadhi, a researcher and clinician from Saudi Arabia who has been publishing papers about autoimmunity in ASD for decades. She also published a series of studies that examined the potential of camel milk as a therapy. She examined both changes in biological markers of oxidative stress and inflammation as well as measures of autism severity.

Her most recent study is here:-

 

Comparative Study on the Ameliorating Effects of Camel Milkas a Dairy Product on Inflammatory Response in Autism Spectrum Disorders

The link between nutrition and autism spectrum disorder (ASD), as a neurodevelopmental disorder exhibiting impaired social interaction, repetitive behavior, and poor communication skills, has provided a hot point of research that might help use nutritional intervention strategies for managing ASD symptoms. This study examined the possible therapeutic potency of raw and boiled camel milk in reducing neuroinflammation in relation to behavioral characteristics. A blinded study was conducted on 64 children with autism (aged 2–12 years). Group I (n = 23) consisted of children who received raw camel milk; Group II (n = 27) comprised children who received boiled camel milk; and Group III (n = 14) comprised children who received cow milk as a placebo. Changes in plasma tumor necrosis factor-alpha (TNF-α) as pro-inflammatory cytokine in relation to behavioral characteristics evaluated using the Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and gastrointestinal (GI) symptoms before and after 2 weeks of raw and boiled camel milk therapy. Significantly lower plasma levels of TNF-α were recorded after 2 weeks of camel milk consumption, accompanied by insignificant changes in CARS and significant improvements in SRS and GI symptoms. Alternatively, Group III demonstrated an insignificant TNF-α increase without changes in CARS, SRS, and GI symptoms. This study demonstrated the positive effects of both raw and boiled camel milk in reducing neuroinflammation in patients with ASD. The improvements in the SRS scores and GI symptoms are encouraging. Further trials exploring the potential benefits of camel milk consumption in patients with ASD are highly recommended.

 

 


Apparently camel milk tastes just fine, although Dr Alayadhi told us she had never tried it prior to her research. She has shown than both pasteurized and raw milk are equally effective. I did ask her about other types of milk like goat’s milk and she said they had tried other milks and that only camel milk has shown the immunomodulatory effect.  When asked how much you need to drink, the answer was three glasses a day.


The Dentist

I did chat to another Saudi professor, a pediatric dentist, who gave a presentation about treating children with ASD.  Having had some pretty bad experiences with getting dental treatment and then overcoming them, I did feel I had something in common with Ebtissam Murshid.  I did catch up with her later and shared details of the D-Termined program created by US dentist David Tesini. It is a video training program for dentists how to treat kids with autism. I have written about it previously in this blog. Tesini very much tries to make the visit to the dentist fun, with lots of distractions in his treatment room. Murshid purposefully has blank white walls, believing that autistic kids get upset by bright colors and patterns. Hopefully she watches Tesini’s videos.

Murshid has published a book to help parents prepare their children for their trip to the dentist and, like Tesini, had made a small trial to show that her method is effective.

Some dentists are naturally good at treating the most difficult kids, but most are not.  It is impossible to predict.

A really good dentist needs neither restraint, like a papoose board, or sedation. If general anesthetic is needed, then something is not being done right. Kids with severe autism can be treated with local anesthetic just like other kids, they just need to go through a familiarization training like Tesini/Murshid use.

 

Back to immunotherapy

I did have many conversations with Carmello Rizzo who is an Italian doctor interested in both diet and autoimmunity to treat autism. He is a feature at many autism conferences and is a great speaker. He was telling me about Enzyme Potentiated Desensitization (EPD), an overlooked way to treat allergy care.

EPD was invented in the 1960s by a British immunologist Dr Len McEwen, at St. Mary’s Hospital, Paddington. EPD is approved in the United Kingdom for the treatment of hay fever, food allergy and intolerance and environmental allergies.

It is an unlicensed product (i.e. not a drug), it is available only on a “named patient” basis.

EPD is not the same as allergy shots.

Allergy shots, also known as allergy immunotherapy, are injections used to treat allergies over a long period of time. They work by gradually desensitizing your body to the allergens that trigger your allergy symptoms.

Allergy shots typically involve two phases, buildup and maintenance.

It is an escalating dose immunotherapy, when you gradually increase the exposure level of the identified allergen.

The buildup phase lasts for 3 to 6 months. You receive shots 1 to 3 times a week. The doctor will gradually increase the amount of allergen in each shot to help your body build tolerance.

In the maintenance phase you need shots less frequently, usually about once a month. This phase can continue for 3 to 5 years or even longer depending on your progress.

I was never interested in allergy shots because there are so many injections needed.

I found EPD of interest because you take just two shots a year and the effect may potentially control the allergy after 2 or 3 years.

EPD is not expensive and I suppose that is why nobody wanted to invested the tens of millions of dollars to get approval by the FDA. It remains approved for use in the UK, which is ultra conservative when it comes to medicines.

Carmello Rizzo is offering EPD in Italy and elsewhere.

 

Gene therapy for autism?

I did go to a presentation with an interesting title:

Developing effective therapeutics for Autism Spectrum Disorder

It was not really what I was expecting. It was a young MIT researcher talking about the potential to develop gene therapies to replace mutated genes with a new ones. They are doing this in a model of autism caused by a mutated copy of the SHANK3 gene.

I called him Dr Viral Vector and did have a chat with him. The most interesting thing about his technology is that not only can he target a specific type of cell, but he can target a specific part of the brain, or indeed any part of the body.

At the moment they inject a virus carrying the new gene directly into the brain. That is not going to go down so well with human subjects. The next stage is to try injecting the virus into a vein.

I did talk about the two gene therapies for Rett syndrome now in human trials in my presentation. The ultimate problem is the likely $3 million cost. 

You can use gene therapy as an immunotherapy. 

 

Artemis

At the conference I was asked about a gene called DCLRE1C, it encodes the DCLRE1C protein, also known as Artemis.

 


Artémis (Diane), the huntress. Roman copy of a Greek statue, 2nd century. Galleria dei Candelabri

Source: By Jean-Pol GRANDMONT - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=18604889

 

The Artemis protein is named after the Greek goddess Artemis, who was associated with the hunt, wilderness, wild animals, childbirth, and protection. This connection likely comes from the crucial role Artemis plays in DNA repair, which is essential for maintaining the integrity of the genetic material, like a protector safeguarding the building blocks of life.

Complete loss of function in DCLRE1C typically causes severe combined immunodeficiency. This is called Artemis-deficient severe combined immunodeficiency (ART-SCID).

Fortunately many possible mutations only partially impair the function of the DCLRE1C gene. They can lead to a spectrum of conditions, including atypical SCID, Omenn syndrome, Hyper IgM syndrome, and even just antibody deficiency. These conditions may have milder symptoms compared to classic SCID.

IVIG is a beneficial therapy for immunodeficiency; but is very expensive and not curative.

Humans all have 2 copies of the DCLRE1C and it is theoretically possible to increase expression of the good copy. But that is another story.

 

A gene therapy already exists for full-on ART-SCID.

Lentiviral Gene Therapy for Artemis-Deficient SCID


Why not use it in less severe cases?

The problem is going to be money, both for a lifetime on IVIG or a “hopefully” one-off gene therapy.

One lady in the audience of my talk had herself taken an expensive gene therapy and was not impressed.

  

Other interesting presentations

Pierre Drapeau from McGill University spoke about trying to repurpose a cheap old drug, called Pimozide, to treat motor neuron disease /ALS.  This was interesting because the process is similar to repurposing a drug for autism.

Pimozide is an old antipsychotic drug and it seems to work in ALS through its effect on a type of calcium channel called the T-type. Yes, just as in much autism, calcium channels are misbehaving.

The drawback of Pimozide is that it also blocks dopamine receptors in the brain, which is good if you have Tourette’s, but if you have ALS you then get symptoms of Parkinson’s as a side effect.

The solution is to tinker with the molecule and find a version (an analog) that will do the business with the T channels without causing tremors.  It looks like, via trial and error, this is nearly solved.

The whole process has already been going on for many years, it will take many more.

Life expectancy with ALS is only 2-5 years and they struggle to find test subjects in Canada. It looks like they may do trials in China.

 

An eye opener

A presentation with a very hard to digest title was also an eye opener. You can take a picture of the cornea in your eye and accurately diagnose all kinds of disorders. They started with peripheral neuropathy in diabetics and most recently moved on to people with autism. Using artificial intelligence (AI) they can now make a diagnosis just based on the nerve loss they observe in the cornea. They also can potentially measure the effect of therapies by the regeneration of those nerve fibers.  This is really clever. When Rayaz Malik started down this path, all the neurologists thought he was mad. Many years later and corneal confocal microscopy is widely used around the world, but not yet for autism diagnosis.

Antonio Persico is a well known autism clinician, he appeared virtually. He was mainly talking about antipsychotics. I had expected rather more. 

 

Conclusion

Immunotherapy addresses one of the four problem areas in autism. There cannot be a one size fits all approach, but you can certainly try camel milk. Addressing food allergy and intolerance is relatively straightforward and you do not need any fancy expensive genetic testing, as Carmello Rizzo pointed out.

There are people for whom genetic testing and/or a spinal tap opens the door to a precise diagnosis and hopefully treatment. That proved to be an unexpected controversial issue in my presentation.

My talk at the conference was all about using personalized medicine to treat autism. The organizer of the event reads this blog and knows that I am rather an outsider, since I am more in treating autism than just researching it.

I had a two and a half hour time slot and I made sure to use it all. 

Advances in Personalized Medicine to Treat Autism

I should mention that I also had some long conversations with Paul Shattock, who pretty much founded the gluten and casein free diet years ago, back at the University of Sunderland. If you are interested in the history of autism, he is a great person to talk to. He is nearly 80 years old, but still has a sharp sense of humour. He has stumbled into more than his fair share of controversies. In Abu Dhabi his opinions and observations were widely shared by other speakers. One younger American speaker thought his views were dangerous; had he taken the time to talk to Paul, he would have found them pretty well thought out. I did ask Paul what has happened to his old friend Andew Wakefield – apparently making another film.