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The Simple Truth about multiple chemical sensitivity.

Renee Twombly's news article "The Simple Truth about MCS" (Twombly 2003) ignores the plausible physiologic mechanism (described in the same issue of EHP) that answers each of the major questions about multiple chemical sensitivity (MCS) (Pall 2003). Given the many puzzling features of MCS and the previous claims that there cannot be a plausible physiologic mechanism to explain it, the finding of a physiologic mechanism (Pall 2002, 2003; Pall and Satterlee 2001) is a landmark in our understanding of this illness.

This mechanism provides answers to each of the most important and previously intractible questions about MCS (Pall 2003), such as:

* How can the reported exquisite (approximately 1,000-fold) sensitivity to chemicals be produced?

* How are the two main classes of chemicals--acetylcholinesterase inhibitors (organophosphates and carbamates) and hydrophobic organic chemicals--involved?

* How can previous chemical exposure induce such sensitivity?

* Why is MCS chronic?

* How are the characteristic symptoms of MCS generated?

* Why does MCS have multiple overlaps with chronic fatigue syndrome and fibromyalgia?

* How might neurogenic inflammation be generated as part of the MCS mechanism?

* How can lowering of several steps in porphyrin synthesis occur as a consequence of the MCS mechanism? (Classical porphyria is caused by lowering a single step in the pathway, whereas in MCS, several steps in the pathway are low.)

We look to articles such as Twombly's to connect the most important dots and produce for the reader the essence of the resultant pattern. I hope that Twombly's failure to do so for MCS will be a temporary lapse.

The author declares he has no competing financial interests.

Martin L. Pall

Washington State University

Pullman, Washington

E-mail: martin_pall@wsu.edu

REFERENCES

Pall ML. 2002. NMDA sensitization and stimulation by peroxynitrite, nitric oxide and organic solvents as the mechanism of chemical sensitivity in multiple chemical sensitivity. FASEB J 16:1407-1417.

Pall ML. 2003. Elevated nitric oxide/peroxynitrite theory of multiple chemical sensitivity: central role of N-methyl-Daspartate receptors in the sensitivity mechanism. Environ Health Perspect 111:1461-1464.

Pall ML, Satterlee JD. 2001. Elevated nitric oxide/peroxynitrite mechanism for the common etiology of multiple chemical sensitivity, chronic fatigue syndrome and posttraumatic stress disorder. Ann NY Acad Sci 933:323-329.

Twombly R. 2003. The simple truth about MCS. Environ Health Perspect 111:A658-A659.
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Title Annotation:Correspondence
Author:Pall, Martin L.
Publication:Environmental Health Perspectives
Date:Apr 1, 2004
Words:373
Previous Article:Grand Rounds in Environmental Medicine: information on MCS needed.
Next Article:Multiple chemical sensitivity: response to Pall.
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