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

Daisymay

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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.

....................................................


http://jrsm.rsmjournals.com/gca?gca=jrsm;105/12/523&submit=Get+All+Checked+Abstracts

Abstract

Review:
I Boyd, GJ Rubin, and S Wessely

Taking refuge from modernity: 21st century hermits
J R Soc Med December 2012 105:523—529; doi:10.1258/jrsm.2012.120060

Idiopathic environmental intolerances, such as ‘multiple chemical sensitivity’ and ‘electrosensitivity,’ can drastically affect the quality of life of those affected. A proportion of severely affected patients remove themselves from modern society, to live in isolation away from the purported causal agent of their ill health. This is not a new phenomenon; reports of hermits extend back to the 3rd century AD. We conducted a literature review of case reports relating to ancient hermits and modern day reclusion resulting from idiopathic environmental intolerance, in order to explore whether there are similarities between these two groups and whether the symptoms of these ‘illnesses of modernity’ are simply a present-day way of reaching the end-point of reclusion. Whilst there were some differences between the cases, recurring themes in ancient and modern cases included: dissatisfaction with society, a compulsion to flee, reports of a constant struggle and a feeling of fighting against the establishment. The similarities which exist between the modern-day cases and the historical hermits may provide some insight into the extreme behaviours exhibited by this population. The desire to retreat from society in order to escape from harm has existed for many centuries, but in different guises.
 

alex3619

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I started writing a satirical rewrite of the abstract, but about Blue Smurf Disease, but decided I am too stuffed at the moment. If they want to make stuff up, and draw vague and unlikely comparisons without substantive evidence, that is their choice. I am hoping that the more they embrace weird extremes the more the lack of science in these views will be exposed. Its a pity there is no link to the full article here, I could use a chuckle right now. The real worry is that this stuff can get published. That says it all.
 

user9876

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How can the the editor justify not publishing Prof Pall's letter? I honestly don't believe it sometimes, you couldn't make it up.
The letter really points out a failure of the editors peer review process so I would expect the editor to reject it as it is embarassing. It does make a mockery of evidence based medicine when papers get away with ignoring a lot of evidence. My expectation is that for years journals have not published letters pointing out the obvious errors the difference now is that with the internet these rejected letters get widely known.
 

peggy-sue

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Is Professor Pall not the very highly distinguished researcher who discovered that EDRF is NO?
(endothelial relaxant factor is nitric oxide).

Quite an amazing discovery - given NO is not an organic chemical and hadn't even been considered as a potential candidate for EDRF!
 

Sasha

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Permission to repost.
Great stuff, daisymay! Unbelievable.

How is Prof. Pall getting this info out? Does he have a website or something?

Since that journal's editor is failing its readers, maybe there should be a site for rebuttals of poor papers generally...
 

SilverbladeTE

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he spouts crap that prevents people getting medical help!
After Camelford court case, he should be persona non grata in the medical world

I DESPISE the filthy system of the nation I live in, that promotes and uses this kind of crap
they way things are "manipulated" leaving lot sof wiggle room, doubt, easy ways to avoid criminal proceedings
bah!

user9876
as has been psoted by several folk, there is no true "peer review", no honesty, in much of the "journals" etc
are all about ego, making money form advertizing revenue often with the products of the ocmpanies they do items about!
Science and Democracy have FAILED. Not because they are wrong/bad, but because scum infest, poison and stiffle them, because honesty and change are complete anathema to SCUM :thumbdown:
"Science" as I keep saying, isn't some "wonder god being of pure remote cold truth!"
in reality it is a Human endeavour,and thus fraught by our failings like ANY system

there has to be a COMPLETE divorcement of Science form politics and money/power/big business, and rigorous creation and implementation for a legally binding "hippocratic Oath" for Science, world wide.
Sooner or later we will suffer a catastrophy which may end civilization, or our species itself, because of such sh*t.
 

Enid

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The Royal Society of Medicine fools none here until they can follow research without bias and get their facts right. We have a history here - eminents - members of royal this, royal that, fighting to oppose the evidence of Darwin once.

And now I know why my brother (Prof Neurology) took off for the US many years ago saying "here they even support each other when they know it to be wrong". IE the absence of the recognition of scientific findings to support favourites regardless. Why is it not perfectly evident SW et al are only there to promote psychiatry - nothing else.
 
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Is Professor Pall not the very highly distinguished researcher who discovered that EDRF is NO?
(endothelial relaxant factor is nitric oxide).
The answer would appear to be 'no'. At a glance Pall only seems to have published on EDRF/NO in the last ten years or so. Papers (e.g http://circres.ahajournals.org/content/61/6/866.short) linking EDRF to NO began appearing at least as early as the late 1980s. In any event the link is not certain see: http://www.nature.com/nature/journal/v345/n6271/abs/345161a0.html and more recently http://onlinelibrary.wiley.com/doi/10.1111/j.1476-5381.1987.tb11347.x/abstract

IVI
 

peggy-sue

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Thanks, IVI!
Apologies for me going off track a bit. I can remember when it came out about EDRF being NO, because I had a medical student doing his MBChB in my lab, trying to discover EDRF in the early 80s.
He's now Prof. Chim Lang, who is doing excellent work on ME here in Dundee with Dr. Faisel Khan and Professor Jill Belch, funded by MEResearchUK. :)
 

peggy-sue

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Not IVI, Enid, Professor Chim Lang - the medical student who worked in the same lab as I did, many years ago.
He is a brilliant Scientist. :)
He believes absolutely that ME is a real organic infectious disease. He (and this group in Dundee) have found evidence of ongoing infectious responses in both children and adults with ME/CFS. Their work is published.
 
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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.

.....................................................
I'm not surprised this didn't get published - there are a couple of things that are likely to have put the editor off. Firstly the personalised focus on Wessely, rather than the authors as a group sets a tone than would be unlikely to have been welcome. Secondly and although a small point, Pall claims no competing interest, yet on his own website acknowledges at least some level of compensation related to his own perspective, which he has in turn used to argue against the article. (http://thetenthparadigm.org/arg.htm). There is also the fact that a video of a seminar given by Pall was recorded at the Royal Society of Medicine no less, and which is on sale at £61.27 http://www.nleducation.co.uk/seminars/prof-martin-pall-updates-on-complex-disease-treatment/. The interests issue was no doubt an oversight but taken together with the tone of the letter, one can see why the editor may have felt it didn't qualify as justifiable criticism. Of course none of this validates the JRSM article.

IVI
 

user9876

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I'm not surprised this didn't get published - there are a couple of things that are likely to have put the editor off. Firstly the personalised focus on Wessely, rather than the authors as a group sets a tone than would be unlikely to have been welcome. Secondly and although a small point, Pall claims no competing interest, yet on his own website acknowledges at least some level of compensation related to his own perspective, which he has in turn used to argue against the article. (http://thetenthparadigm.org/arg.htm). There is also the fact that a video of a seminar given by Pall was recorded at the Royal Society of Medicine no less, and which is on sale at £61.27 http://www.nleducation.co.uk/seminars/prof-martin-pall-updates-on-complex-disease-treatment/. The interests issue was no doubt an oversight but taken together with the tone of the letter, one can see why the editor may have felt it didn't qualify as justifiable criticism. Of course none of this validates the JRSM article.

IVI
Wessely is the senior academic on the paper which seems utterly ridiculous the tone is deserving. I've heard and read much more insulting remarks in seminars and in academic papers.

I would have thought that the journal editor should be concerned on being told that a paper in his journal was missing references that disagreed with the argument that the authors and therefore is misleading. He should be looking to ensure the accuracy of what is in the journal. If he didn't like the tone of the letter i'm sure he could ask for a redrafting of it. Editors should have a duty to ensure the accuracy of papers in their journal.
 

Sparrow

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That Wessely paper makes me stabby. Seriously? You looked at the behaviour of hermits and then looked at the steps taken by MCS people to protect their health? What a terrible case of implying a connection that has no actual basis.
 
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Can this letter be edited and re-submitted?

Would be a shame for any valuable critique to be lost from the record, because somebody fell for the Wesselyan pantomime villain trap.