This info was forwarded by Jerry Ross MD, who first headed up the
Environmental Clinic in Nova Scotia. Susan Jannarone may be located in
Texas.

It's a little technical in places, but has very interesting info on
why certain people are more sensitive to chemicals.

The liver detox pathways it talks about are different in different
people with variable genetic makeup (genetic polymorphism); these are
referred to as "Cytochrome P450" and "the 2D6 variant" or "gene variant
of CYP2D6 ".

There are interesting details that relate to ..

* sensitivities to morphine compounds and other chemicals [see
"Neurally Mediated Hypotension,

* the significance and role of mercury,

* the need for different anesthesia instead of lidocaine (2D6) - see
"INDUSTRY MARCHES ON" - plus a mention of those ".. who cannot tolerate
morphine, hydrocodone, codeine, several antidepressants and even some
allergy medications .." - see "GUESTIMATING WITHOUT FUNDS" - and

* info on mechanisms on how chemicals pass the blood-brain barrier
(drinking plenty of fluids and increasing salt intake may be important).

I 'm just learning about the WSMCSN listserve, but it looks like an
excellent info service for those affected by MCS.

The full name for "PON-1" is Paraoxonase 1 gene -

Subject: Fw: CYPD2D6 Variant in Cytochrome P450: Tests inability to
metabolize pesticides] (fwd)

TO FRIENDS AND MEDICAL COLLEAGUES ON A BLINDED LIST: I KNOW THAT
THIS MATERIAL MAY NOT BE NEW TO SOME OF YOU, BUT IT WAS COMPOSED BY A
CHEMICALLY INTOLERANT PATIENT WHO HAS LINKED TOGETHER SOME VALUABLE
INSIGHTS AND REFERENCES ABOUT GENETIC POLYMORPHISM AND CHEMICAL
INTOLERANCE THAT MAY PROVE OF INTEREST TO YOU. --- REGARDS TO ALL,
JERRY ROSS, MD

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ FW:
CYPD2D6 Variant in Cytochrome P450: Tests inability to metabolize
pesticides] (fwd)

CYPD2D6 Variant in Cytochrome P450: Tests inability to metabolize
pesticides

FRENCH RESEARCH ON CYP2D6 VARIANT Recently a WSMCSN email reported
that French researchers found the following: "In the body many
pesticides are broken down and made less toxic by an enzyme called
cytochrome P450 D6 (CYP2D6). A certain variant in the CYP2D6 gene has
been shown to produce an enzyme that is 'less effective at breaking down
pesticides'. As a result people with this variant may be more
susceptible to pesticides that might cause Parkinson's disease."

CYTOCHROME P-450

"For those who are not aware of it, the cytochrome P450 roughly refers
to the liver and the paths through which toxins and other substances are
metabolized or broken down before they are eliminated.

(The book Cytochrome P450 is too heavy to pick up, the one found
behind Dr. Abou-Donia's desk at Duke University.)

Parkinson's may be in some of our futures, however, the article
addresses an inability to break down or metabolize pesticides due to the
2D6 variant.

GENELEX.COM AND PROOF Noting that the study reported that 2D6
anomalies/abnormalities (perhaps only an allelle) cause inability to
metabolize pesticides, and having been genetically tested years ago by
Genelex laboratories through genelex.com ( then click on health and DNA
at the homepage and then seek the lists of drugs to see "chlorpyrifos"
as one of the drugs in the list of adverse reaction drugs.)

Once I made the connection, I realized that my abnormal 2D6 genetic
testing offered the first "test" that proved that I could not metabolize
chlorpyrifos (Dursban) in pill form (that which would be given to AIDS
patients, for example) but I could prove nothing further.

Dursban has caused me years of solitude in safe rooms, along with the
usual fortune spent trying to get better. Also two moves, with another
one coming up, because I cannot tolerate any pesticides or the perfumes
and neurotoxins emanating from my neighbor's dryer vents.

OBTAINING THE TEST/ICD Codes I am fairly sure that I am the only
person with MCS who has had the Genelex genetic testing and found a 2D6
abnormality. I could be wrong. If we all have the test we might be
well on our way to establishing some criteria from which ICD codes can
be derived. To be absolutely sure my cheek swab was not wrong, I am
ordering the DNA blood test. The test that is given through genelex.com
requires either a cheek swab or blood test and can cost a couple of
hundred dollars to several hundred dollars.

CONTACTING ATTORNIES FOR HELP My 1998 attorney will receive the
information, as well, although we have not been in touch since he
stopped suing Dow Chemical Company in cases of horrendous damage to
health.

READING THE GENELEX SITE FOR COMPARISON One can read the adverse drug
reaction test drug list. I have found probably 15 drugs that I have
"tried" over the years and found myself either vomiting or vomiting and
in the hospital with central nervous system problems, including many
that mimic my severe reaction to all pesticides and other solvent
incitants. My reactions usually read exactly like the MSDS sheet for
over exposure to Dursban, Lorsban and their toxic relatives, with my
heart and brain target organs as well.

NEURALLY MEDIATED HYPOTENSION Although we would be far from proving
it, patients with neurally mediated hypotension could be tested for
this variant, should funding ever become available. NMH is caused by a
"miscommunication between the heart and the brain." Most of their
symptoms also read similar to the reactions on organophosphate MSDS
sheets such as for chlorpyrifos.

UBIQUITOUS ORGANOPHOSPHATES I have been told by the best friend of the
chemical industry (Dr. Wagner at the pesticide reporting center for the
country that 'pesticides are everywhere, even at the poles') and we all
know we are contaminated by organophosphates of which
Dursban/chlorpyrifos is one.

OTHER LEARNED OPINIONS Researchers such as Andrew Hall Cutler, a
Princeton University Ph.D. may attribute pesticide intolerance to
mercury and he may be absolutely correct (when I get around to asking
him). Others may suggest heredity, injury in the womb, or injury by
pesticides or other toxins themselves such as mercury. In the end,
establishing that a large number of MCS'ers have one "genetic test" in
common will open doors for us -- doors hitherto closed in our faces.

INDUSTRY MARCHES ON I am concerned however, that hospitals, the
pharmaceutical and chemical industries will march onward as usual and
this "proof" may be laid aside. Even after telling the hospital about
this 2D6 problem during three hospital stays spanning 10 days, only one
doctor used a different anesthesia for my broken nose last year, instead
of lidocaine (2D6). Dr. Rea managed my anesthesia for surgery. A nurse
put two drugs into my PICC line that are metabolized through the 2D6
route. I suffered the adverse consequences of an anti-nausea 2D6 drug
for hours, including seeing wallpaper that did not exist.

GUESTIMATING WITHOUT FUNDS Patients who are without funds can read the
adverse drug list and "find themselves pictured"--those who cannot
tolerate morphine, hydrocodone, codeine, several antidepressants and
even some allergy medications come to mind that are found on the 2D6
list.

OUR LARGEST ORGAN--THE SKIN Patients may then begin to connect the
dots--that a drug taken internally is very similar to a chemical taken
into the body through our largest organ--our skin, or through the lungs.
As was said in "Our Stolen Future" if one does not believe that we
absorb everything around us, wear garlic in your sock and wait the few
minutes required to taste it in your mouth. Some researchers I met with
in Maryland sporting organic cotton in their ears have told me our
"ears" are one of the ways in which we absorb toxins around us.

FUTURE PATIENT ADVOCACY (CFS = Chronic Fatigue Syndrome) I intend
to research and write more about this including codes people might use,
but given the urgent need for a diagnosis for care and disability funds,
I am providing this information now. It may be that CFS codes will work
for us, but I have not looked into that. Johns Hopkins clearly states
that a subset of CFS patients are chemically sensitive.

READING THE LINK (hj note: I have removed many "=" signs in this text
before sending it; the one in the link below may not belong there, so
try it without the = sign) Recognizing this link has been the first
really sound test that I have come across in five years of research on
this topic. The French research (Full article at:
http://www.healthypages.net/newspage.asp?newsid=4174) really seems to
solidify potential proof that individuals do react adversely to
pesticides in small doses. The LD40 method used by the (EPA/Chemical
industry in disguise) may be overturned with more and more genetic
testing becoming available to patients.

MY REACTIONS TO PESTICIDES VIS A VIS 2D6 VARIANT A very small dose of
any of the drugs on the list cause me to feel as though I am dying, and
cause my blood pressure to plunge, and sometimes soar
uncharacteristically high once I hit severe dehydration from vomiting,
along with an array of symptoms with which we are all
familiar--cognitive dysfunction, pounding heart, flaming face, ears and
shoulders, dehydration, frequent urination, abnormal CNS sensations,
hallucinations, vomiting, fatigue, food intolerance, and neuropathies
that come and go on my upper legs and the bottom of my feet, etc.
Although we may vary in our ability to metabolize pesticides, many of us
share similar symptoms. Often my first signal of an exposure is burning
around my lips. A large exposure can cause up to two years of exquisite
sensitivity to solvents.

FUTURE GENETIC TESTS FOR TOXINS Dr. Rea and I talked at length a few
years ago about a "gene" that would "prove" MCS and he told me that a
researcher at NIH had done work in that area and it had been lost after
the researcher's death. I then began to get DNA testing, and it was
only by looking at all the drugs that are on the Genelex site that I
spotted chlorpyrifos (Dursban). I could not generalize the test to some
or all pesticides until the French research appeared on WSMCSN. Now I
believe that pesticides (that include herbicides and fungicides) may be
scientifically linked to individual health problems that do not
necessarily include the development of Parkinson's disease. Research
linking Parkinson's with pesticides (by tracking golf course residents)
came out pre-1980, so this is no news to me.

However genetic progress may allow many of us to "name the toxin,"
rather inexpensively.

LOW PON-1 As an aside, the test at Washington State that Clement
Furlong worked on for low PON-1 and bodily harm from Dursban is another
good indicator.

Because this test predicts cardio-vascular disease as well, it may be
that the blood brain barrier is easily breached due to opening of the
olfactory blood brain barrier--a barrier that Dr. Abou-Donia describes
as interlaced fingers of blood vessels. I have surmised that once these
vessels open at about age 19 (according to Dr. Abou-Donia), damage from
pesticides may begin, even at low doses.

The PON-1 test required about one or two thousand dollars when I took
it. It is a blood test, shipped overnight. I have failed to continue
to track his research, particularly after chlorpyrifos was
"discontinued" in 2002, as I recall.

In addition to the work done by Furlong on pesticides, he determined
that low PON-1 and cardiovascular disease are linked. We have
determined by putting together Johns Hopkins work and the suggestions of
Dr. Abou-Donia, that the blood brain barrier breach is part of the
problem of pesticide poisoning. Drinking plenty of fluids and
dramatically increasing salt intake may actually close the openings = in
the blood brain barrier. Salt tablets, salting table food before,
during and after cooking may increase blood pressure and actually help
to close the "interlocking fingers" that comprise the BBB.

ENGAGING OUR DOCTORS Some of the doctors who are more involved in our
care might contact Genelex and seek an ICD code at this time and meet
with more success than we have ever had before in this arena--a test. I
will certainly send information to Dr. Rea, who may order the test for
individuals who have MCS and cite pesticide exposures as the cause.

FUTURE USE OF THIS AND OTHER GENETIC VARIANTS In the future this
variant "may" or "could be" be linked to xylene, chlorine, benzene,
toluene, perchlorethelene, flame retardants, burned hydrocarbons,
trichlorethelene, formaldehyde and other toxins to which many of us have
been exposed. Or other genes may be found that can prove a
variant-victim sort of scenario. Bill Moyers' televised interview with
the head of what was called the Chemical Manufacturer's Association (now
creatively renamed the American Chemistry Council) did state that we
could already "name the toxin" two years ago but I have not looked into
the possibility because I am not Bill Moyers.

THE GOOD WORK OF WSMCSN I could never have made this connection
without the stalwart soldering of WSMCSN, especially sunergos@....,
my attorney who paid for genetic testing and my husband, who funds my
genetic testing. I can say with certainty that having stuck with
research for so long I simply got "lucky."

Serendipity.

MY FUTURE ADVOCACY WORK When my injuries are completely healed I
intend to contact the pesticide researchers that I know already such as
Dr. Abou-Donia, Furlong and others and the doctors I know and have heard
about. I will write a formal paper and mail letters regarding these
findings. Should I ever get the strength post-accident, I may approach
someone in government, although I put that last on the agenda.

I have contacted Genelex and was given further leads, but after my
surgery many memories were lost, so I'll have to begin again with
Genelex's lead, during which I asked for testing labs for environmental,
rather that drug-related adverse reactions.

CONTINUING THE GENETIC VARIANT LEAD Anyone who wishes to continue this
lead may do so without feeling as though they are intruding on my work,
intended for the good of all MCS patients. I may not be hardy enough to
do what I intend for months or more. As usual we will face the
laboratory being attacked by the chemical industry, but we should not
let that deter us.

Again, WSMCSN was the way in which I made this connection. Without it
I would have never read the literature on the gene variant of CYP2D6 and
pesticides.

Sincerely, Susan Jannarone (817-354-6191) MCS patients only

==============

I found this article on PON-Q and PON-R:

http://www.sciencedaily.com/releases/1999/06/990617072520.htm

And,

Paraoxonase 1 gene (PON-1):

http://www.osti.gov/energycitations/product.biblio.jsp?osti_id=465996