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Multiple chemical sensitivity (MCS) is characterised by non-specific and recurring symptoms affecting multiple organs and associated with exposure to chemicals, even at low concentrations, which are, under normal circumstances, harmless to the general population. Symptoms include general discomfort, cardiovascular instability, irritation of the sensory organs, breath disorders, hypersensitivity affecting the skin and epithelial lining of the gut, throat and lungs, anxiety, and learning and memory loss. Chemical intolerance is a key distinguishing feature of MCS, limiting considerably patients’ lifestyle with serious social, occupational and economic implications. Since no specific diagnostic markers are currently available for chemical intolerance, the diagnosis relies on clinical symptoms. Despite the formulation of several hypotheses regarding the pathophysiology of MCS, its mechanisms remain undefined. A person-centred care approach, based on multidisciplinary and individualised medical plans, has shown promising results. However, more definite treatment strategies are required. We have reviewed the main experimental studies on MCS pathophysiology, focusing on the brain networks involved, the impact of environmental pollution on the olfactory system and the correlation with other pathologies such as neurodegenerative diseases. Finally, we discuss treatment strategies targeting the olfactory system.

Introduction: Alterations of the renal microcirculation have been documented in animal models of hypertensive renal damage. Traditionally, the retina has been considered the easiest accessible window to study the systemic microcirculation, even though the choroid is the most important vascular layer of the eye. The introduction in the past few years of advanced optical coherence tomography (OCT) techniques has greatly increased our understanding of the choroid. Although the renal resistive index (RRI) was initially considered to reflect intrarenal vascular pathological processes, this index is actually regarded as the result of complex interaction between renal and systemic vascular wall properties and hemodynamic factors, and it is endowed with prognostic implications.Aim: To analyse the relationships between choroidal thickness (CT) and RRI in a group of hypertensive patients. Methods: We enrolled 66 nondiabetic essential hypertensives (67% men; mean age: 52 ± 12 years), consecutively attending our Hypertension Centre. Results: The glomerular filtration rate (GFR) estimated by the CKD-EPI equation was 78 ± 2 ml/min/1.73 m2, and the RRI 0.64 ± 0.07. Splitting the study population into 2 groups on the basis of the 75th percentile of the distribution of RRI, we found lower choroidal thickness in the group with greater values of RRI (all p.001; Figure 3). We observed also significant inverse correlations between CT and RRI, that held even after adjustment for GFR, age and gender (Table 3). Conclusions: Our findings confirm the close relationships between changes in the ocular microcirculation and renal dysfunction and suggest that intrarenal hemodynamic alterations are involved in these relationships.

To evaluate the LG involvement, through the measurement of the LG herniation by of magnetic resonance imaging (MRI), in patients with different GO activity

Our aime was to investigate the correlation between GO ocular parameters obtained by MRI with contrast administration and the well-know clinical indicators of GO and to examine the relationship between the clinical course of hyperthyroidism and GO severity

The introduction in last years of advanced techniques of optical coherence tomography (OCT) has greatly increased our understanding of the choroid, that is the most important vascular layer of the eye. Our study was aimed to assess choroidal thickness by using Swept-Source OCT (SS-OCT) in essential hypertensive patients (EHs) with and without subclinical renal damage (SRD). We enrolled 100 EHs of which 65 without kidney damage and 35 with SRD. In all the participants SS-OCT and a routine biochemical workup were performed. Glomerular filtration rate (GFR) was estimated by the CKD-EPI equation (eGFR). SRD was defined, by the presence of microalbuminuria or eGFR between 30 and 60 mL/min/1.73 m2. OCT measurements were performed according to the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol, that divides the macula into 9 subfields. The circular grid consists of 3 concentric rings. EHs with SRD showed thinner choroidal thicknesses than those without kidney damage (all p < 0.05), even after adjustment for age. Overall choroidal thickness correlated significantly and directly with eGFR (r = 0.36) and negatively with urinary albumin excretion (r = – 0.39). The association of choroidal thickness with SRD was confirmed in multiple logistic regression analyses once the effect of age, antihypertensive therapy and triglycerides was accounted for. The odds ratio of having SRD associated with a standard deviation increase of overall choroidal thickness was 0.43 (0.24–0.75, 95% confidence interval; p = 0.007). In conclusion, our study confirms the close relationships between changes in ocular microcirculation and renal dysfunction.