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Immune" camps. Also evident was the absolute "distaste" for the mention of academics. I stand strongly behind the convictions expressed above. I would politely challenge anyone to produce a model that has succeeded for any disease in the past, without ultimate evolution and definition by defined studies, acceptable at Academic levels. Without objectivity, no therapy can be appropriately evaluated, nor will new therapies already in existence ; become accessible. While metabolic vs. immune discussions are interesting, the only major change on the near horizon, will be if the idea of immune-modulators agents already in existence, but for which we must provide an objective basis to open the doors to their usage ; can be tried, and is optimistically successful many researchers I have been involved with over the last five to ten years, believe success is likely, but remain skeptical till proven ; . While we "debate" other ideas and options, I believe it is urgent to accelerate efforts to make possible testing of these agents in autistic syndrome children as soon as possible! As noted, with increased discussions already appearing relating to "auto-immune", "inflammatory", origins for "sub-populations" of children, I would propose without hesitation, that "immunemodulating" agents if effective, will be far safer than steroids or other agents nodiscussed, and needless to say, a better alternative than discussing surgery or severe behavior therapies for these dysfunctional children. Examining the last ten to twelve years, it has become obvious we are looking at new patterns of disease and illness, that do not fit previously described syndromes, etc. Attending conferences over the last 7 years, being exposed to many "cutting edge" technologies and ideas, one trend emerges. We are looking at a process, appearing to decrease flow function in the temporal lobe of the brain other areas may be affected, but the temporal lobe I would propose is the key and common denominator in this process ; affecting individuals differently based on their age, and maturation of their immune system. The common denominator making sense through these discussions has been the immune system and a state of "dysregulation". I would propose to all of you, that while many metabolic and other phenomena, make sense when thought of in a state of or propensity for immune activation dysregulation, no known pediatric or adults metabolic process makes sense as a model for a "primary" metabolic defect in these children and related patients. Therefore, while we may to some degree help the body metabolicly, develop new markers, and even answer some very interesting questions over the next ten years, we are unlikely to make major medical changes or even approach a cure while focusing on and dealing with what appears to be "secondary" metabolic phenomena, explainable fully by altered cellular metabolism a fact brought out in many respectable articles over the last 5 years, and accepted at NIH Academic levels, etc. ; . This is a dysfunction that is logical secondary to altered cellular mitochondria and immune reactive phenomena. In this light, why are many physicians and researchers trying to "reinvent the wheel", when there are models andvolving technologies explaining all we are discussing logically and with more and more factual physiology. Because, there are still gaps in the above physiologic.

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