{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:44:13Z","timestamp":1782513853217,"version":"3.54.5"},"reference-count":165,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T00:00:00Z","timestamp":1309478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Whilst facing a worldwide fast increase of food and environmental allergies, the medical community is also confronted with another inhomogeneous group of environment-associated disabling conditions, including multiple chemical sensitivity (MCS), fibromyalgia, chronic fatigue syndrome, electric hypersensitivity, amalgam disease and others. These share the features of poly-symptomatic multi-organ cutaneous and systemic manifestations, with postulated inherited\/acquired impaired metabolism of chemical\/physical\/nutritional xenobiotics, triggering adverse reactions at exposure levels far below toxicologically-relevant values, often in the absence of clear-cut allergologic and\/or immunologic involvement. Due to the lack of proven pathogenic mechanisms generating measurable disease biomarkers, these environmental hypersensitivities are generally ignored by sanitary and social systems, as psychogenic or \u201cmedically unexplained symptoms\u201d. The uncontrolled application of diagnostic and treatment protocols not corresponding to acceptable levels of validation, safety, and clinical efficacy, to a steadily increasing number of patients demanding assistance, occurs in many countries in the absence of evidence-based guidelines. Here we revise available information supporting the organic nature of these clinical conditions. Following intense research on gene polymorphisms of phase I\/II detoxification enzyme genes, so far statistically inconclusive, epigenetic and metabolic factors are under investigation, in particular free radical\/antioxidant homeostasis disturbances. The finding of relevant alterations of catalase, glutathione-transferase and peroxidase detoxifying activities significantly correlating with clinical manifestations of MCS, has recently registered some progress towards the identification of reliable biomarkers of disease onset, progression, and treatment outcomes.<\/jats:p>","DOI":"10.3390\/ijerph8072770","type":"journal-article","created":{"date-parts":[[2011,7,1]],"date-time":"2011-07-01T11:36:59Z","timestamp":1309520219000},"page":"2770-2797","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["The Search for Reliable Biomarkers of Disease in Multiple Chemical Sensitivity and Other Environmental Intolerances"],"prefix":"10.3390","volume":"8","author":[{"given":"Chiara","family":"De Luca","sequence":"first","affiliation":[{"name":"Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desanka","family":"Raskovic","sequence":"additional","affiliation":[{"name":"Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Pacifico","sequence":"additional","affiliation":[{"name":"Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey Chung Sheun","family":"Thai","sequence":"additional","affiliation":[{"name":"Natural Health Farm, 39 Jalan Pengacara U1\/48, Seksyen U1, Temasya Industrial Park, Shah Alam Selangor 40150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liudmila","family":"Korkina","sequence":"additional","affiliation":[{"name":"Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2011,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6047","DOI":"10.1016\/j.scitotenv.2010.08.047","article-title":"Sensitivity-related illness: the escalating pandemic of allergy, food intolerance and chemical sensitivity","volume":"408","author":"Genuis","year":"2010","journal-title":"Sci. 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