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Pall proposed that MCS had a toxicological and biochemical cause, and that "seven individual chemicals or chemical classesorganophosphorus/carbamate, organochloride and pyrethroid pesticides, organic solvents, carbon monoxide, hydrogen sulphide and mercury/mercurial compoundscould initiate MCS through their ability to increase N-methyl-D-aspartate (NMDA) receptor activity." [4] [7] Pall hypothesized that overactivity of the NMDA receptors, coupled with stress-related increases in nitric oxide and the oxidative product peroxynitrite (known as the NO/ONOO cycle) caused MCS symptoms and worsened the condition

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However, inhibition of fungal glutaminases at high salt concentrations during fermentation leads to unwanted conversion of glutamine to pyroglutamic acid