Few awards in anything have the cachet and respect the Nobel Prizes in various disciplines possess. In my specialty, medicine, the Nobel Prize in Physiology or Medicine is quite properly viewed as the height of achievement. In terms of prestige, particularly in the world of science, the Nobel Prize is without peer. To win the Nobel Prize in Medicine or another scientific field, a scientist must have made a discovery considered fundamentally important to the point that it changes the way we think about one aspect of science or medicine. Winning the Nobel Prize in a scientific field instantly elevates a scientist from whatever he or she was before to the upper echelons of world science.
So how, one might ask, is it that seemingly so frequently Nobel Laureates embrace crankery or pseudoscience in their later years? They call it the Nobel Disease, and, indeed, it’s a term listed in the Skeptics’ Dictionary (where the term is attributed to me based on this post about Linus Pauling from four years ago, but I can’t claim credit for coining the term; it existed before I wrote that post) and Rational Wiki, complete with examples. What inspired me to take on this topic, dusting off some old knowledge and writings, is that we apparently have a new victim of the Nobel Disease. Well, perhaps “new” is not the right word, but he is the most recent example. I’m referring to Luc Montagnier, who with Françoise Barré-Sinoussi was awarded the Nobel Prize in Medicine for the discovery of HIV in 2008.
Unfortunately, it didn’t take Montagnier very long to devolve into crankery. Until 2009, to be precise. Since then, Montagnier has embraced concepts like DNA teleportation and ideas very much like homeopathy. And then, just last month, his journey to the dark side was complete. Yes, Luc Montagnier presented at the yearly quackfest I discussed last week, the one in which there was much enthusiasm among the attendees for a treatment that involves administering bleach enemas to autistic children. He presented at Autism One, a coup that caused much rejoicing in the antivaccine movement.
The Nobel Disease and me
Given my interest in skepticism, science-based medicine, and pseudoscience, it’s always interested me how scientists and doctors become cranks. Even more interesting is how people who have achieved the pinnacle of scientific glory, people whom one would reasonable expect to be about as immune to pseudoscience and crankery as anyone on this planet, manage to fail so spectacularly into quackery. Of course, Linus Pauling is the prototypical example, which is why I’ve written about him before multiple times, both here on SBM and elsewhere. A brilliant chemist who won two Nobel Prizes, one for chemistry and the Nobel Peace Prize, in his later years Pauling became convinced that high dose vitamin C was a highly effective treatment for cancer and the common cold and, expanding upon that, came to believe in the quackery that is orthomolecular medicine. As a result, Pauling’s reputation was tainted for all time, and he became known more for his crankery than his successes. Since his death, Pauling’s successors have continued to chase his dream with no real success because even massive doses of vitamin C have little or no effect on cancer and may even interfere with some chemotherapy regimens. I haven’t checked up on the latest research on vitamin C and cancer (perhaps that would be a subject for another post), but I have no doubt that Pauling’s acolytes are still out there, still trying to prove that giving multi-gram quantities of ascorbate can cure cancer.
Unfortunately, Pauling is not alone in becoming a crank. Linus Pauling might have been my first experience with the Nobel Disease, but it was not a personal experience. A few years ago, I actually got to confront the Nobel Disease, up close and personal so to speak, at a surgical meeting. The keynote speaker was Louis J. Ignarro, who was awarded the Nobel Prize in 1998 along with Robert F. Furchgott and Ferid Murad for their discovery that nitric oxide is a signaling molecule (a discovery, which, by the way, is far more important than just its role in providing a mechanism of action for Viagra and all those other related drugs now used to treat erectile dysfunction, as one of our regular commenters will happily tell you).
Unfortunately, Ignarro didn’t even wait until his later years to descend into the swamp of dubious science. In 2006, I saw Ignarro give an ostensibly scientific talk at the Academic Surgical Congress in San Diego, a talk whose second half was dominated by a discussion of arginine supplementation as a heart disease cure-all. Ignarro started by weaving a fascinating story of the experiments, reasoning, and evidence that led to the discovery of nitric oxide and its importance as a signaling molecule. He is a captivating speaker, and I was enjoying the talk immensely. As his talk progressed, I thought he was a great speaker for the American Association for Academic Surgery, one of the two surgical societies sponsoring the Academic Surgical Congress. (The Society of University Surgeons is the other). The AAS is an organization dedicated to encouraging academic and research careers in young surgeons. Indeed, one can only be an active voting member for 10 years after taking one’s first faculty position or until age 45, whichever is longer. After that, AAS members are required to superannuate (become “emeritus” non-voting members). Consequently, at the yearly conferences, one of the goals is to invite scientists of some renown to talk good science and fire up the troops, and usually one of these is a basic scientist rather than a surgeon. Dr. Ignarro seemed to be doing an admirable job.
And then there was a change.
With about 10 or 15 minutes to go in his talk, he changed gears abruptly, and it was like the grinding of metal on metal — to me at least. I saw a few looks of puzzlement among the young surgeons sitting around me, but for the most part everyone took this change without any evidence that it bothered them.
What happened is that Dr. Ignarro started delving into what sounded to me like woo about diet and heart disease, discussing evidence that he had developed that arginine supplementation increases nitric oxide levels and protects against heart disease. It was somewhat interesting, and he might have been on to something. However, he was clearly vastly overselling it, indeed outright advocating that everyone should be taking arginine supplementation because it would greatly reduce the risk of developing heart disease through its generation of nitric oxide. I might not have thought about it much again, but then he did something that I’ve never seen a scientific speaker do before at an invited scientific talk at a conference. He started discussing (hawking, actually) a diet book he had written called No More Heart Disease: How Nitric Oxide Can Prevent — Even Reverse — Heart Disease And Stroke. In a single — if you’ll excuse the term — stroke during the last 15 or 20 minutes of his talk, Ignarro turned what should have been an inspiring talk given to a bunch of young surgeon-scientists to fire them up to want to be great researchers and push the boundaries of surgical science into little more than an infomercial for his book and a forum to pontificate about his dubious ideas regarding nutrition. Even if his work on arginine ever panned out (which to my knowledge it has not yet in the 6 years since the meeting), when he gave his talk it was clearly not ready for prime-time, and it’s not as though various alternative medicine practitioners hadn’t been pushing arginine supplementation and various other nutritional “treatments” for a long time already. Ignarro gave them a seemingly scientific basis for these claims. He might turn out to be right, but even if he is, he had no business making the claims that he did based on the evidence that he had.
I was greatly disturbed and quite disappointed, as I sensed another Linus Pauling in the making. This concern was further amplified when I later heard about his inventing and promoting a dubious dietary supplement with HerbaLife and publishing a PNAS article touting arginine supplementation in which he failed to disclose his financial interest with HerbaLife. At the time, I was worried at the effect his talk might have on a bunch of idealistic young surgeons who are desperately trying to do good science, even in the face of having to maintain a clinical practice in surgery. Worse, as I found later when discussing the talk with colleagues, many of them didn’t recognize the dubiousness of the last part of the talk. They were a bit taken aback by his peddling of his book, but seemed willing to accept the whole package, including the last part of the talk. The Nobel Prize halo is strong indeed. I still remember how betrayed I felt as his talk progressed and wondered if the meeting organizers felt a similar sense of betrayal or whether they were too in awe of the Nobel aura to notice.
I couldn’t help but compare Ignarro to Nikolaas Tinbergen, whose adoption of the “refrigerator mother” hypothesis as the cause of autism in his actual Nobel lecture led Prometheus to quip that Tinbergen’s Nobel acceptance speech represented a “nearly unbeatable record for shortest time between receiving the Nobel Prize and saying something really stupid about a field in which the recipient had little experience.” Unfortunately, these days, Ignarro has teamed up with a naturopath named Andrew Myers to promote his practice. Myers, it turns out, is the President and Chief Science officer of NutraGenetics, a company Ignarro founded to sell his arginine supplements. Ignarro is even blogging on Myers’ blog and promoting a book they wrote together, Health Is Wealth: Performance Nutrition, complete with Myers on the cover, lab coat, stethoscope, and all, trying to look like a real doctor. From my perspective, if you’re a Nobel laureate whose scientific acumen has fallen to the point where you think it’s a good idea to appoint a naturopath as the chief science officer of your company, the Nobel committee should consider revoking your prize. In my opinion, of course.
It took Ignarro only a few years to go from Nobel Laureate to borderline, if not outright, crank. Sadly, took Montagnier only a year, if even that.
The Nobel Disease strikes Luc Montagnier
Luc Montagnier shared the Nobel Prize in 2008 for his discovery of the human immunodeficiency with Harald zur Hausen, who discovered the link between the human papilloma virus and cervical cancer, an event that Steve Novella took note of when Montagnier received the award. Then, earlier this summer, Montagnier appeared to endorse homeopathy:
French virologist Luc Montagnier stunned his colleagues at a prestigious international conference when he presented a new method for detecting viral infections that bore close parallels to the basic tenets of homeopathy.
Although fellow Nobel prize winners — who view homeopathy as quackery — were left openly shaking their heads, Montagnier’s comments were rapidly embraced by homeopaths eager for greater credibility.
Montagnier told the conference last week that solutions containing the DNA of pathogenic bacteria and viruses, including HIV, “could emit low frequency radio waves” that induced surrounding water molecules to become arranged into “nanostructures”. These water molecules, he said, could also emit radio waves
He suggested water could retain such properties even after the original solutions were massively diluted, to the point where the original DNA had effectively vanished. In this way, he suggested, water could retain the “memory” of substances with which it had been in contact — and doctors could use the emissions to detect disease.
Our very own Harriet Hall commented on one of Montagnier’s studies that was embraced by homeopaths as “proof” that homeopathy “works.” Montagnier may not beat Tinbergen’s record for shortest time to descend into pseudoscience after winning the Nobel Prize, but he’s definitely in contention. As if drifting into concepts that resemble those of homeopathy weren’t enough, Montagnier has also made a name for himself, such as it is, by appearing in the HIV/AIDS denialist film House of Numbers stating that HIV can be cleared naturally through nutrition and supplements:
Meanwhile, Montagnier patented a device to detect these fantastical radiowaves allegedly emitted by bacterial and viral DNA in water. This he did after publishing a paper in a journal that for which himself is the editor after a mere three days between submission and acceptance, which prompted Le Canard Noir to nominate him for an Ignobel Prize. So, as of around 2010, Luc Montagnier had already racked up an impressive list of crankery in a very short time after winning his Nobel Prize.
He wasn’t done, however.
Montagnier, autism quackery, and the antivaccine movement
Upon learning that Montagnier was going to present at Autism One, I decided that I would try to find his talk and then blog about it, given that AO usually posts video of all the talks. After all, I had no trouble last week finding the video for Kerri Rivera’s talk at AO about using bleach enemas to cure autism, and Mark and David Geier’s talk is posted. Now, a week later, links to saved streams of pretty much every talk appears to be posted at the Autism One website. Even Jenny McCarthy’s keynote speech is there.
Unfortunately, thus far I have not been able to find the video for Montagnier’s keynote talk. However, take a look at the description of his talk, entitled, The Microbial Track (an extended version of the abstract is here):
Our group of researchers and physicians from European countries, Chronimed, is studying chronic diseases. Our recent observations may lead to new approaches of treatment and prevention. These observations are of two types: biological and clinical. There is in the blood of most autistic children — but not in healthy children — DNA sequences that emit, in certain conditions, electromagnetic waves. The analysis by molecular biology techniques allows us to identify these electromagnetic waves as coming from already known bacterial species. This correlation, which is based on more than one hundred children of European origin, naturally does not prove a causal relationship. However, a therapy first started by a group of independent clinicians and now performed in conjunction with laboratory observations reinforces the idea that systemic bacterial infections play a role in the genesis of symptoms of autism.
Our GPs have observed that a long-term therapy consisting of successive antibiotic treatments with accompanying medications induced in 60% of cases a significant improvement — sometimes even a complete resolution of symptoms. These children can now lead a normal school and family life. In conjunction with these treatments resulting in amelioration of symptoms is the disappearance of electromagnetic signals associated with the plasma bacterial DNA.
Our working hypothesis is that immune dysfunction associated with inflammation of the intestinal mucosa leads to the introduction of bacterial components, including neurotoxins, into the bloodstream, creating oxidative stress as well as microvascularities, especially affecting meningeal vessels and finally specific neuronal damage.
Of course, much research is still needed to strengthen this hypothesis, but our goal here is to have the medical community and the parents be aware of these opportunities for immediate treatment that can improve or cure more than half of autistic children. It is expected that, in the future, similar approaches will be applied to other serious chronic conditions of children and adults, including rheumatological disorders.
So let me get this straight: Montagnier is now claiming that there exist in the blood of autistic children DNA sequences that emit radio waves that come from bacteria? Based on this, he is treating autistic children with long term antibiotics? Really?
I also note that he also claims that the same sequences are found in the blood of patients with Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, various neuropathies, chronic Lyme syndrome, and rheumatoid arthritis. Never mind that the results of Montagnier’s experiments suggesting that DNA emits radio waves are far more likely to be due to contaminants in his PCR reactions than they are to be due to anything else. In any case, since I can’t evaluate the talk itself (perhaps I will once the video finally surfaces, as I have no doubt that it will), I will go back in time to when the clinical trial Montagnier proposed was first hitting the news. I first learned about it from Gimpy and Anthony Cox. Unfortunately, the pseudoscience that Montagnier appears to have embraced with respect to autism was combined with a highly unethical study in a manner that would put Andrew Wakefield to shame.
The trial was sponsored by the Autism Treatment Trust (ATT) and the Autism Research Institute (ARI), both institutions that are — shall we say? — not exactly known for their scientific rigor. Montagnier teamed up with a Dr. Corinne Skorupka, who is a DAN! practitioner from France, and a Dr. Lorene Amet, who is described as a neuroscientist but is a PhD and not an MD (i.e., not a clinician). The study that, together, the Nobel Prize winner and quacks propose is described thusly:
We are finally in a position to run some very exciting investigations/interventions with the support of Professor Montagnier, Nobel Prize winner for Medicine (for the discovery of HIV) and Dr. C. Skorupka a DAN! practitioner from Paris and long time friend. The project proposes to look at potential bacterial and viral chronic infections in autism. Prof Montagnier is of the view that some abnormalities in autism as well as in a whole range of neurological conditions, such as chronic fatigue and multiple sclerosis may be caused by potential infective agents. These would be difficult to the immune system to track down and would affect cell function thereby contributing to the development of the pathologies. He has developed a new technique that detects, by resonance, the genetic material of these potential infective agents. Additionally, using a very sensitive PCR assay, he can screen for a range of gram positive and gram negative bacteria as well as mycoplasma and Borrelia (Lyme disease). He can also look at viruses (PCR assays under development). We are not alone in believing that this approach can help develop our understanding of the causes of autism and enable it to be treated more effectively. The proposed treatment combines a succession of antibiotics with basic biomedical supplements and probiotics. These antibiotics block cell division rather than kill bacteria, thereby avoiding potential side effects. Unfortunately, at the moment, there is no funding available to cover the costs of this project, but we are hoping to use the data collected to help us obtain funding for future research.
One reason I’m quoting liberally and am not directly linking to the web pages for these quotes is because the original links are dead, and they do not appear to exist in the Wayback Machine. It rather makes you wonder, doesn’t it? You’ll see why I say this in a minute. In the meantime, before I discuss the “study” itself, let me just say one thing here. Whenever you see an “investigator” charge patients to undergo an experimental protocol, be very, very afraid. In general, with very few exceptions, reputable medical researchers do not ask patients to pay to undergo experimental protocols; their studies are funded with grants from the government, private foundations, or pharmaceutical companies. Yet here we have Montagnier and colleagues charging the parents of autistic children (also summarized here):
We offer your child the opportunity to be part of this project and to access to the Montagnier Infection Screen protocol. There will be medical follow up from Dr. Skorupka. The details of the project are outlined below. The total cost per child is likely to be around £1800, spread over a six-month period (details below). The antibiotic treatment is not included and may cost some £30- £60 a month, depending of the particular antibiotic selected. Every two months each child’s progress will be reviewed by Dr. Skorupka and Dr. Amet at ATT with interim progress reviews carried out by phone.
It would appear to be the results of this “clinical trial” that Montagnier reported at Autism One. Because the original sources describing the trial appear to have been thrown down the memory hole, I rely on people like Anthony Cox to show just how badly designed this experimental protocol is. Here are its specific aims:
- Investigate the possibility that some cases of autism are associated with a range of bacterial infections, based on laboratory testing and clinical examination conducted by Dr. C. Skorupka in Edinburgh.
- Assess the ASD children for the presence of nanobacteria following Prof Luc Montagnier’s protocol of investigations. The protocol would require a blood draw conducted at the clinic with the help of our nurse. The blood normally has to be centrifuged immediately and the supernatant extracted, then frozen to -80C and shipped on carboice to France.
- Evaluate the efficacy of antibiotic intervention as well as behavioural evaluations (ATEC and ADOS). This would involve meeting with Dr Skopurpka and Dr. Amet every 2 months and reviewing progress over the phone in the interim month.
- Report outcomes.
How is this study unethical? Let me count the ways. First, as I mentioned, it charges the patient for an experimental protocol. More importantly, it tests a hypothesis that is highly implausible from a biological standpoint. That bacterial or viral infection might cause or contribute to autism does not reach homeopathy-level implausibility, but it also doesn’t reach the level of plausibility where it can be considered ethical to subject human subjects to a prolonged regimen of antibiotic treatment based on it. One reason is that there are no convincing preclinical data to support the idea that bacterial or viral infections either cause or contribute to autism. Quite the opposite, in fact. Of course, where scientists note that there is no relationship between specific infections and autism, no doubt Montagnier would claim that any old bacterial infection will do. After all, his magic device, at least according to him, detects any bacterial or viral DNA, even after it’s been diluted to nonexistence and the water filtered so that no DNA could be left behind.
But it gets even worse than that.
Based on an unsupported hypothesis that bacterial infections cause autism, Montagnier has subjected autistic children to blood draws and prolonged treatment with antibiotics. The former cause unnecessary pain and suffering, and the latter has the potential to cause well-known complications. These include antibiotic-induced diarrhea and even C. difficile colitis, as well as a variety of other problems that can be caused when a child’s normal bacterial flora are killed off with antibiotics. Even if children avoid that problem, there is the issue of selecting for resistant bacteria, leaving the child’s bacterial flora altered to contain a higher proportion of bacteria resistant to antibiotics. Since there is no reason to suspect that these children have any sort of clinical infection that needs treatment, giving them antibiotics for several months is all risk, no potential benefit. It’s completely unethical.
But it gets even worse than that.
The study proposed was poorly designed even for a pilot study. There was no control group, for one thing. Unless Montagnier radically changed the protocol, the children got the regimen, and the parents paid the practitioners to administer it. Moreover, because the selection criteria for the study were not specified, there is no way of knowing how much selection bias might have been operative, given that Montagnier now apparently claims that 60% of his subjects improved almost completely on long term antibiotics. Apparently he has also greatly expanded his study, which was originally supposed to be of only 12 subjects. However, now he reports that he’s helped over 200 children. I’d really love to see the evidence he uses to support that claim. Hopefully the video will show up at Autism One soon.
While I’m waiting, though, I want to know how quacks like this can get away with doing such unethical clinical trials. In the U.S., we have Mark and David Geier, who created an Institutional Review Board at their own “research institute” with cronies. The likely reason they could get away with it was because their research wasn’t federally funded, nor did their “research institute” receive federal funds. Thus they could skirt the Common Rule, which applies only to research being carried out at institutions receiving federal funds or research being used to support an application for FDA approval, although many states require any human subjects research carried within their borders to adhere to the Common Rule regardless of funding source. I’m not sufficiently familiar with the U.K. to know exactly how its ethical oversight of human subjects research works, but fortunately Gimpy was there to explain. Given that Montagnier’s trial used medicinal compounds (antibiotics), it clearly required oversight from an ethics board. Did it get it? What ethics board oversaw this trial? In the UK, clinical trials are regulated by the Medicines and Health Care products Regulatory Agency (MHRA), which enforces regulations that dictate that clinical trials of medicinal products in human subjects requires authorization by the MHRA and authorization by an ethics committee much like IRBs in the United States. Not only is there no indication that this trial has obtained the necessary approvals from the MHRA and an applicable ethics committee. In other words, it’s bad science and bad ethics, all rolled into one.
The Nobel Disease redux
I’ve wondered how some Nobel Laureates, after having achieved so much, proving themselves at the highest levels by making fundamental contributions to our understanding of science that they rate the highest honors, somehow end up embracing dubious science (Ignarro) or even outright pseudoscience (Pauling or Montagnier). Does the fame go to their head? Do they come to think themselves so much more creative than other scientists that their fantastical ideas become plausible to them? Does winning the Nobel Prize lead some scientists to think that the genius they showed in their own area of expertise that allowed them to win such an exalted prize also applies to other areas of science outside their area of expertise? Who knows? What I do know is that Montagnier has become the latest Nobel Laureate to become a crank. He even has the requisite persecution complex, as demonstrated in this post on his own blog from April entitled To autistic children, in which he complains about criticism and then, in essence, says, “They thought me mad — mad, I tell you! — but I’ll show them!” (Well, actually, he laments how the “country of Claude Bernard and Louis Pasteur” has become the “land of Diafoirus in an intellectual dictatorship that sterilizes any medical advance that upsets the establishment.” Then comes the prediction:
This work was not born today. It follows from patient observations made over the years by doctors, who dared not to follow mainstream antibiotic use. The very rapid progress resulting from careful use of antibiotics in these autistic children exceeded the expectations of both the doctors and the parents, attested by numerous videos and testimonials.
Of course this approach does not always work. We must confirm this breakthrough by controlled double blind clinical trials, but within the rules of medical ethics.
I support this approach even more as it coincides with another breakthrough, the science that I am developing, supported by an international network of physicists and biologists : detection with biophysical methods of latent infections by viruses and bacteria. These very infections are identified in autistic children, and also in neurodegenerative diseases, joint diseases, and certain cancers. Early detection will allow new approaches to prevention of these diseases so very prevalent in our population.
I really do need to see Montagnier’s Autism One video.
Through his work in isolating and identifying the human immunodeficiency virus, Luc Montagnier contributed to a major advance in science that ultimately led to effective treatments for AIDS and chronic HIV infection. He deserved his Nobel Prize. That’s why it makes me very sad to see him fall so far so fast. Presenting at Autism One is almost the bottom of the barrel as far as science goes. After palling around and sharing the podium with the likes of Andrew Wakefield, Mark and David Geier, Kerri Rivera, Mark Blaxill, Dan Olmsted, and the like, the only way Montagnier could fall lower would be if he were to take up a writing gig on NaturalNews.com.
I really hope I don’t see that next year, but, sadly, it wouldn’t surprise me if I did.