Experts See Possible RU486 Link to Infection Deaths.

If you happen to read news dispatches that covered the "Emerging Clostridial Disease Workshop" conference in Atlanta, you'd think that there was widespread disagreement and scientific uncertainty about the role that RU486 played in the infection deaths of at least five North American women. However, if you were at the conference and followed the presentations of some of the nation's top scientific experts, you'd get a much different story. (For additional coverage, see story page 11.)

Jointly sponsored by the Food and Drug Administration (FDA), the Centers for Disease Control (CDC), and the National Institute of Allergy and Infectious Diseases, the conference was convened to address the sudden outbreak of disease and death associated with two strains of Clostridial bacteria. They are C. difficile, a nasty infection turning up at nursing homes and hospitals all over the country, and C. sordellii, which is known to have killed at least four RU486 patients in California and one Canadian in the last five years.

The May 11 meeting featured several of the government's and private sector's top scientific experts. NRLC attended and observed.

Most of the researchers on the morning panel focused on the latest science regarding the C. difficile outbreak. However, three panelists, Dr. Jamie McGregor of Los Angeles Women's and Children's Hospital, Ralph Miech of Brown University, and researcher Esther Sternberg from the National Institutes of Health, looked directly at C. sordellii.

Their highly technical presentations dealt with a range of factorsenvironmental, genetic, hormonal, and biochemicalthat may be involved in the infections. However, all spoke about the role RU486 may have played.

Drawing on published animal studies, molecular pharmacologist Miech described how RU486 interfered with glucocorticoids produced by the adrenal cortex. This results in excessive secretion of ACTH and cortisol,1 and failure in the production and secretion of anti-inflammatory cytokines.2 Each disrupts the host's primary defense mechanism against bacteria such as C. sordellii.

This leads to the production of a lethal toxin in a woman's uterus by C. sordellii, which compromises the uterus's innate immune system. Once C. sordellii begins to grow uncontrollably in the uterus, the lethal toxin gets into a woman's circulatory system and septic shock and multiple organ failure ensues.