Gulf War illness: an overview of events, most prevalent health outcomes, exposures, and clues as to pathogenesis

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Kathleen J. Kerr
Keyword(s):  
Oxidant Stress ◽  
Gastrointestinal Symptoms ◽  
Epidemiologic Studies ◽  
Gulf War ◽  
Institute Of Medicine ◽  
Gulf War Illness ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans ◽  
The Usa

AbstractIntroduction:During or very soon after the 1990–1991 Persian Gulf War, veterans of the conflict began to report symptoms of illness. Common complaints included combinations of cognitive difficulties, fatigue, myalgia, rashes, dyspnea, insomnia, gastrointestinal symptoms and sensitivity to odors. Gradually in the USA, and later in the UK, France, Canada, Denmark and Australia, governments implemented medical assessment programs and epidemiologic studies to determine the scope of what was popularly referred to as “the Gulf War syndrome”. Attention was drawn to numerous potentially toxic deployment-related exposures that appeared to vary by country of deployment, by location within the theater, by unit, and by personal job types. Identifying a single toxicant cause was considered unlikely and it was recognized that outcomes were influenced by genetic variability in xenobiotic metabolism.Methods:Derived from primary papers and key reports by the Research Advisory Committee on Gulf War Veterans’ Illnesses and the Institute of Medicine, a brief overview is presented of war related events, symptoms and diagnostic criteria for Gulf War illness (GWV), some international differences, the various war-related exposures and key epidemiologic studies. Possible exposure interactions and pathophysiologic mechanisms are discussed.Results:Exposures to pyridostigmine bromide, pesticides, sarin and mustard gas or combinations thereof were most associated with GWI, especially in some genotype subgroups. The resultant oxidant stress and background exposome must be assumed to have played a role.Conclusion:Gulf War (GW) exposures and their potential toxic effects should be considered in the context of the human genome, the human exposome and resultant oxidant stress to better characterize this unique environmentally-linked illness and, ultimately, provide a rationale for more effective interventions and future prevention efforts.

scholarly journals Highlights in this issue

2002 ◽  
Vol 32 (8) ◽  
pp. 1333-1333
Keyword(s):  
Cluster Analysis ◽  
Statistical Technique ◽  
Gulf War ◽  
Gulf War Syndrome ◽  
Research Papers ◽  
War Veterans ◽  
Public Controversy ◽  
Gulf War Veterans ◽  
The Usa ◽  
The Subject

This issue features groups of papers on Gulf War syndrome, health service outcome assessment, somatization, personality disorders and depression.Gulf War syndrome has been the subject of much scientific research and public controversy. Two research papers, both from the group at the Institute of Psychiatry in London report studies. David et al. (pp. 1357–1370) find cognitive abnormalities in Gulf War veterans compared with military controls, most attributable to mood disturbances, except for impairment of constructional ability. Everitt et al. (pp. 1371–1378) employ the statistical technique of cluster analysis to search for a unique syndrome in Gulf War veterans but fail to find it. In an accompanying editorial two authorities, from the USA and Canada, examine the issues.

scholarly journals The Gut-Microbiome in Gulf War Veterans: A Preliminary Report

2019 ◽  
Vol 16 (19) ◽  
pp. 3751 ◽  
Author(s):  
Janulewicz ◽  
Seth ◽  
Carlson ◽  
Ajama ◽  
Quinn ◽  
...  
Keyword(s):  
Gut Microbiome ◽  
Gastrointestinal Symptoms ◽  
Gulf War ◽  
Gulf War Illness ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Gi Symptoms ◽  
The Central Nervous System ◽  
Stool Samples ◽  
Sleep Difficulties

Gulf War Illness (GWI) is a chronic multi-symptom disorder affecting the central nervous system (CNS), immune and gastrointestinal (GI) systems of Gulf War veterans (GWV). We assessed the relationships between GWI, GI symptoms, gut microbiome and inflammatory markers in GWV from the Boston Gulf War Illness Consortium (GWIC). Three groups of GWIC veterans were recruited in this pilot study; GWV without GWI and no gastrointestinal symptoms (controls), GWV with GWI and no gastrointestinal symptoms (GWI-GI), GWV with GWI who reported gastrointestinal symptoms (GW+GI). Here we report on a subset of the first thirteen stool samples analyzed. Results showed significantly different gut microbiome patterns among the three groups and within the GWI +/−GI groups. Specifically, GW controls had a greater abundance of firmicutes and the GWI+GI group had a greater abundance of the phyla bacteroidetes, actinobacteria, euryarchaeota, and proteobacteria as well as higher abundances of the families Bacteroidaceae, Erysipelotrichaceae, and Bifidobacteriaceae. The GWI+GI group also showed greater plasma levels of the inflammatory cytokine TNF-RI and they endorsed significantly more chemical weapons exposure during the war and reported significantly greater chronic pain, fatigue and sleep difficulties than the other groups. Studies with larger samples sizes are needed to confirm these initial findings.

scholarly journals Intestinal Hyperpermeability in Gulf War Veterans With Chronic Gastrointestinal Symptoms

2019 ◽  
Vol 53 (7) ◽  
pp. e298-e302 ◽  
Author(s):  
Buyi Zhang ◽  
Meghan L. Verne ◽  
Jeremy Z. Fields ◽  
G. Nicholas Verne ◽  
QiQi Zhou
Keyword(s):  
Gastrointestinal Symptoms ◽  
Gulf War ◽  
War Veterans ◽  
Gulf War Veterans

Visceral and cutaneous hypersensitivity in Persian Gulf war veterans with chronic gastrointestinal symptoms

Pain ◽  
2003 ◽  
Vol 102 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Rebecca C. Dunphy ◽  
Lee Bridgewater ◽  
Donald D. Price ◽  
Michael E. Robinson ◽  
Charles J. Zeilman ◽  
...  
Keyword(s):  
Persian Gulf ◽  
Gastrointestinal Symptoms ◽  
Gulf War ◽  
Persian Gulf War ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Cutaneous Hypersensitivity ◽  
Persian Gulf War Veterans

scholarly journals Lack of serological evidence for Mycoplasma fermentans infection in army Gulf War veterans: a large scale case-control study

2000 ◽  
Vol 125 (3) ◽  
pp. 609-616 ◽  
Author(s):  
S.-C. LO ◽  
L. LEVIN ◽  
J. RIBAS ◽  
R. CHUNG ◽  
R. Y.-H. WANG ◽  
...  
Keyword(s):  
Case Control Study ◽  
Gulf War ◽  
Serological Evidence ◽  
Gulf War Illness ◽  
War Veterans ◽  
Mycoplasma Fermentans ◽  
Desert Storm ◽  
Gulf War Veterans ◽  
Operation Desert Storm ◽  
Control Study

Mycoplasma fermentans is suspected in the development of ‘Gulf War illness’ in veterans of Operation Desert Storm. We conducted a matched case-control study for the prevalence of M. fermentans-specific antibodies before and after the operation, as well as seroconversion rates in veterans with and without complaints of ‘Gulf War illness’. Cases consisted of Gulf War veterans, who complained of various illnesses and were enrolled in the second phase of the health evaluation by the Army Comprehensive Clinical Examination Program (CCEP). Controls were selected from Gulf War veterans who did not participate in the registry and did not request a health evaluation by the CCEP. Before operation deployment, 34 out of 718 of the cases (4·8%) and 116 out of 2233 of the controls (5·2%) tested positive for M. fermentans-specific antibodies. There was no difference in rates of seroconversion between cases and controls (1·1 vs. 1·2%) to M. fermentans during Operation Desert Storm. Thus, there is no serological evidence that suggests infection by M. fermentans is associated with development of ‘Gulf War illness’.

scholarly journals Human Leukocyte Antigen (HLA) and Gulf War Illness (GWI): HLA-DRB1*13:02 Spares Subcortical Atrophy in Gulf War Veterans

EBioMedicine ◽  
2017 ◽  
Vol 26 ◽  
pp. 126-131 ◽  
Author(s):  
Lisa M. James ◽  
Peka Christova ◽  
Brian E. Engdahl ◽  
Scott M. Lewis ◽  
Adam F. Carpenter ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Gulf War ◽  
Gulf War Illness ◽  
War Veterans ◽  
Leukocyte Antigen ◽  
Gulf War Veterans

scholarly journals Reprogramming cells from Gulf War veterans into neurons to study Gulf War illness

Neurology ◽  
2017 ◽  
Vol 88 (20) ◽  
pp. 1968-1975 ◽  
Author(s):  
Liang Qiang ◽  
Anand N. Rao ◽  
Gustavo Mostoslavsky ◽  
Marianne F. James ◽  
Nicole Comfort ◽  
...  
Keyword(s):  
Cell Lines ◽  
Cell Types ◽  
Experimental Models ◽  
Gulf War ◽  
Gulf War Illness ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Chronic Headaches ◽  
The Persian Gulf ◽  
Impaired Sleep

Gulf War illness (GWI), which afflicts at least 25% of veterans who served in the 1990–1991 war in the Persian Gulf, is thought to be caused by deployment exposures to various neurotoxicants, including pesticides, anti–nerve gas pills, and low-level nerve agents including sarin/cyclosarin. GWI is a multisymptom disorder characterized by fatigue, joint pain, cognitive problems, and gastrointestinal complaints. The most prominent symptoms of GWI (memory problems, poor attention/concentration, chronic headaches, mood alterations, and impaired sleep) suggest that the disease primarily affects the CNS. Development of urgently needed treatments depends on experimental models appropriate for testing mechanistic hypotheses and for screening therapeutic compounds. Rodent models have been useful thus far, but are limited by their inability to assess the contribution of genetic or epigenetic background to the disease, and because disease-vulnerable proteins and pathways may be different in humans relative to rodents. As of yet, no postmortem tissue from the veterans has become available for research. We are moving forward with a paradigm shift in the study of GWI, which utilizes contemporary stem cell technology to convert somatic cells from Gulf War veterans into pluripotent cell lines that can be differentiated into various cell types, including neurons, glia, muscle, or other relevant cell types. Such cell lines are immortal and will be a resource for GWI researchers to pursue mechanistic hypotheses and therapeutics.

Coenzyme Q10 Benefits Symptoms in Gulf War Veterans: Results of a Randomized Double-Blind Study

2014 ◽  
Vol 26 (11) ◽  
pp. 2594-2651 ◽  
Author(s):  
Beatrice A. Golomb ◽  
Matthew Allison ◽  
Sabrina Koperski ◽  
Hayley J. Koslik ◽  
Sridevi Devaraj ◽  
...  
Keyword(s):  
Physical Function ◽  
Coenzyme Q10 ◽  
Gulf War ◽  
Small Sample ◽  
Controlled Study ◽  
Double Blind Study ◽  
Gulf War Illness ◽  
War Veterans ◽  
Double Blind ◽  
Gulf War Veterans

We sought to assess whether coenzyme Q10 (CoQ10) benefits the chronic multisymptom problems that affect one-quarter to one-third of 1990–1 Gulf War veterans, using a randomized, double-blind, placebo-controlled study. Participants were 46 veterans meeting Kansas and Centers for Disease Control criteria for Gulf War illness. Intervention was PharmaNord (Denmark) CoQ10 100 mg per day (Q100), 300 mg per day (Q300), or an identical-appearing placebo for 3.5 [Formula: see text] 0.5 months. General self-rated health (GSRH), the primary outcome, differed across randomization arms at baseline, and sex significantly predicted GSRH change, compelling adjustment for baseline GSRH and prompting sex-stratified analysis. GSRH showed no significant benefit in the combined-sex sample. Among males (85% of participants), Q100 significantly benefited GSRH versus placebo and versus Q300, providing emphasis on Q100. Physical function (summary performance score, SPS) improved on Q100 versus placebo. A rise in CoQ10 approached significance as a predictor of improvement in GSRH and significantly predicted SPS improvement. Among 20 symptoms each present in half or more of the enrolled veterans, direction-of-difference on Q100 versus placebo was favorable for all except sleep problems; sign test 19:1, [Formula: see text]) with several symptoms individually significant. Significance for these symptoms despite the small sample underscores large effect sizes, and an apparent relation of key outcomes to CoQ10 change increases prospects for causality. In conclusion, Q100 conferred benefit to physical function and symptoms in veterans with Gulf War illness. Examination in a larger sample is warranted, and findings from this study can inform the conduct of a larger trial.

Risk factors for continued illness among Gulf War veterans: a cohort study

2004 ◽  
Vol 34 (4) ◽  
pp. 747-754 ◽  
Author(s):  
M. HOTOPF ◽  
A. DAVID ◽  
L. HULL ◽  
V. NIKALAOU ◽  
C. UNWIN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Psychological Distress ◽  
Physical Functioning ◽  
Gulf War ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Initial Symptoms

Background. There are no prospective cohort studies of prognostic factors on the outcome of Gulf War veterans. We aimed to test the hypotheses that Gulf War veterans who were older; had more severe symptoms; had more exposures during deployment; had increased psychological distress and believed they had ‘Gulf War syndrome’ would experience greater fatigue and poorer physical functioning at follow-up.Method. Gulf War veterans who responded to an earlier retrospective cohort study were followed with a postal survey. More symptomatic individuals were oversampled. Outcome was measured on the Chalder fatigue questionnaire, the General Health Questionnaire and the Medical Outcome Study Short-Form 36.Results. Of those surveyed, 73·8% responded. We found some evidence for four of the five hypotheses. More self-reported exposures at baseline were not associated with poorer outcome, but older people, those with more severe symptoms at baseline, those with psychological distress and who believed they were suffering from ‘Gulf War syndrome’ had more fatigue at follow-up. Officer status was associated with a better outcome. A similar lack of association was found for exposures and physical functioning and GHQ-12 score. ‘Gulf War syndrome’ attribution was associated with a worse outcome for GHQ-12 and physical functioning even after controlling for severity of symptoms at baseline.Conclusions. This study suggests that while multiple vaccination and military exposures are important risk factors for the onset of symptoms in Gulf War veterans, these are not important risk factors for persistence of such symptoms. Instead the severity of the initial symptoms; psychological distress and attributions may be more important determinants of outcome.

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