Palmer Raymond F, Dempsey Tania T, Afrin Lawrence B
Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
AIM Center for Personalized Medicine, Purchase, NY 10577, USA.
J Xenobiot. 2023 Nov 12;13(4):704-718. doi: 10.3390/jox13040045.
: Chemical Intolerance (CI) is characterized by intolerances for chemicals, foods, and drugs with multi-system symptoms. As yet, the biomechanism remains unclear. One study reported converging lines of evidence supporting a substantive association between mast cell activation syndrome (MCAS) and CI. The purpose of this study is to (1) confirm a previous report demonstrating that 60% of MCAS patients report CI and (2) examine the parallels between symptoms and intolerances in CI and MCAS. : Five hundred forty-four MCAS patients were assigned a clinical MCAS score using a validated assessment instrument and were assessed for CI using the validated Quick Environmental Exposure Sensitivity Index. : Our outcomes confirm the previously published study where the majority of MCAS patients also have CI. There was a clear overlap between various ICD-10 diagnostic categories and CI symptoms, providing further support for a potential shared mechanism. : Exposures to pesticides, volatile organic compounds, combustion products, and mold have previously been reported as initiators of CI. However, until recently, little was known about the biological mechanism involved that could explain the multisystem symptoms associated with CI. This paper addresses a newly identified biomechanism for disease, which may underlie a host of "medically unexplained symptoms" triggered by xenobiotics.
化学不耐受(CI)的特征是对化学物质、食物和药物不耐受,并伴有多系统症状。目前,其生物机制尚不清楚。一项研究报告了一系列相互印证的证据,支持肥大细胞活化综合征(MCAS)与CI之间存在实质性关联。本研究的目的是:(1)证实先前的一份报告,该报告表明60%的MCAS患者报告有CI;(2)研究CI和MCAS在症状和不耐受方面的相似之处。
544名MCAS患者使用经过验证的评估工具进行临床MCAS评分,并使用经过验证的快速环境暴露敏感性指数评估CI。
我们的结果证实了先前发表的研究,即大多数MCAS患者也有CI。各种ICD-10诊断类别与CI症状之间存在明显重叠,为潜在的共同机制提供了进一步支持。
先前有报道称,接触杀虫剂、挥发性有机化合物、燃烧产物和霉菌是CI的引发因素。然而,直到最近,对于其中涉及的能够解释与CI相关的多系统症状的生物学机制仍知之甚少。本文阐述了一种新发现的疾病生物机制,它可能是由异种生物引发的一系列“医学上无法解释的症状”的基础。