Wednesday, January 23, 2013

Professor Martin Pall's Response to Wessely et al, J Roy Soc Med paper

Permission to repost.

In December, the "Journal of the Royal Society of Medicine" published an article titled "Taking refuge from modernity: 21st century hermits" authored by I Boyd, G J Rubin and S Wessely (see abstract below)

In response, Professor Martin Pall submitted the following letter to the editor but it was rejected.

Here is Professor Pall's letter:

Taking refuge from modernity: 21st century travesty?

Wessely and colleagues argue that multiple chemical sensitivity (MCS) and electromagnetic field (EMF) hypersensitivity (EHS) are simply contemporary ways that allow people to isolate themselves from society, arguing that these are not true sensitivities to chemicals or EMFs1.

I was honored to be chosen to write an authoritative review on MCS, by three eminent toxicologists (the editors2). It was clear that they thought that MCS was a disease of toxic exposure. Why else ask for such a paper? Among the papers that convincingly show that are studies of Schnakenberg3,4, showing that four polymorphic genes involved in the metabolism of chemicals implicated in MCS had highly significant roles in determining MCS susceptibility (p<10-15 for all four occurring by chance!). These followed studies by McKeown-Eyssen, implicating three such chemical metabolism genes and by Haley implicating one such gene. In all, seven such genes were implicated, all having roles in chemical metabolism. How can all this be true if chemicals have nothing to do with MCS? Wessely has no answers1.

The seven classes of MCS-implicated chemicals act to produce elevated NMDA activity2. Six other types of evidence suggest NMDA elevation has roles in MCS2,5 ; one of these involves two genetic polymorphism studies, both showing that alleles of the CCK-B receptor gene that produce an elevated NMDA response are associated with increased MCS susceptibility.

There are many other studies showing real physiology in MCS, including 25 studies on objectively measurable changes in response to chemical exposure, where MCS patients differ from normals. 24 of these are completely incompatible with psychological interpretations2. Many human studies and 38 animal model studies show physiological changes with apparent causal roles2. Shouldn't Wessely inform readers of the vast evidence that argues against his hypothesis?

Reference 2 is 50 pages, containing 427 citations. Letters limited to 300 words, 5 citations.

Martin L. Pall, Professor Emeritus of Biochemistry and Basic Medical Sciences, Washington State University, 638 NE 41st Ave., Portland, OR 97232-3312 USA; Email: martin_pall@wsu.edu

Competing interests: none declared.

References

1. Boyd I, Rubin GJ, Wessely S. Taking refuge from modernity: 21st century hermits. J R Soc Med 2012:105:523-529.
2. Pall ML. Multiple chemical sensitivity: toxicological questions and mechanisms. In: Bryan Ballantyne, Timothy C. Marrs, Tore Syversen, editors. General and Applied Toxicology, 3rd Edition. London: John Wiley and Sons, Ltd., 2009 p. 2303-2352.
3. Schnakenberg E, Fabig KR, Stanula M, et al. A cross-sectional study of self-reported chemical-related sensitivity is associated with gene variants of drug metabolizing enzymes. Environ Health 2007;6:6 .
4. Müller KE, Schnakenberg E. Die Bedeutung de Glukuronidierung bei unweltmedizinischen Erkrankungen am Beirspeil der UDP-Glukuronosyltransferase 1A1. Umwelt-Medizin-Gesellschaft 2008;21:295-300.
5. Pall ML. NMDA sensitization and stimulation by peroxynitrite, nitric oxide and organic solvents as the mechanism of chemical sensitivity in multiple chemical sensitivity. FASEB J 2002;16:1407-1417.

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