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Gastrointestinal problems, mechanisms and possible therapeutic directions in gulf war illness: a mini review

Military Medical Research 2022年第1期9卷 98-105页

作者： Diana A.Kimono NYU Langone Medical Center New YorkNY 10016USA

By its nature, gulf war illness(GWI) is multi-symptomatic and affects several organ systems in the body. Along with other symptoms, veterans who suffer from GWI commonly report chronic gastrointestinal issues such as constipation,pain, indigestion, etc. However, until recently, most attention has been focused on neurological disturbances such as cognitive impairments, chronic fatigue, and chronic pain among affected veterans. With such high prevalence of gastrointestinal problems among gulf war(GW) veterans, it is surprising that there is little research to investigate the mechanisms behind these issues. This review summarizes all the available works on the mechanisms behind gastrointestinal problems in GWI that have been published to date in various databases. Generally, these studies,which were done in rodent models, in vitro and human cohorts propose that an altered microbiome, a reactive enteric nervous system or a leaky gut among other possible mechanisms are the major drivers of gastrointestinal problems reported in GWI. This review aims to draw attention to the gastrointestinal tract as an important player in GWI disease pathology and a potential therapeutic target.

关键词： gulf war illness GWI Microbiome Enteric nervous system Gastrointestinal GI Leaky gut

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Lower blood malondialdehyde is associated with past pesticide exposure:findings in gulf war illness and healthy controls

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Military Medical Research 2022年第2期9卷 205-214页

作者： Beatrice Alexandra Golomb Sridevi Devaraj Alexis K.Messner Hayley Jean Koslik Jun Hee Han Barnabas Yik Department of Medicine School of MedicineUniversity of CaliforniaSan DiegoLa JollaCA 92093USA Department of Pathology and Immunology Baylor College of MedicineHoustonTX 77030USA Swedish Medical Center SeattleWA 98109USA Henry M.Jackson Foundation for the Advancement of Military Medicine San DiegoCA 92134USA Santa Clara Valley Medical Center San JoseCA 95128USA

Background: Malondialdehyde(MDA) is a candidate general marker of oxidative stress(OS). We sought to assess the relation of MDA to gulf war illness(GWI) and to a variety of ***: This is an observational study involving subjects from Southern California recruited from October 2011 to May 2014. MDA was assessed in 81 participants(41 GWI-cases, 40 controls). General and gulf-specific exposures were elicited. MDA case–control comparison was restricted to 40 matched pairs. The potential association between MDA and exposures was assessed using regression analyses. gulf-specific exposures were incorporated into a case-specific ***: Plasma MDA was significantly lower in GWI-cases than controls. Composite pesticide and fuel-solvent exposures negatively predicted MDA in the total sample, as well as in the analyses that included either GWI-cases or controls only. Self-reported exposure to organophosphate(OP) nerve gas was a strong predictor for lower MDA level in veterans with ***: Past pesticide exposures predicted lower MDA in both veterans with GWI and in healthy controls.

关键词： Malondialdehyde Oxidative stress Free radical gulf war veterans gulf war illness Pesticide

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Progression of intervention-focused research for gulf war illness

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Military Medical Research 2020年第1期7卷 104-121页

作者： Jeremy E.Chester Mazhgan Rowneki William Van Doren Drew A.Helmer war Related illness and Injury Study Center Veterans Affairs New Jersey Healthcare System385 Tremont AvenueEast OrangeNJ 07018USA war Related illness and Injury Study Center Veterans AffairsMedicalCenter50lrvingSt.WashingtonDCNW20422USA Rutgers University New Jersey Medical School185 South Orange AvenueNewarkNJ 07103USA

The Persian gulf war of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle ***-related exposures to toxic substances such as pesticides,nerve agents,pyridostigmine bromide(PB),smoke from burning oil wells,and petrochemicals may have contributed to medical illness in as many as 250,000 of those American *** cluster of chronic symptoms,now referred to as gulf war illness(GWI),has been studied by many researchers over the past two *** over$500 million has been spent on GWI research,to date,no cures or condition-specific treatments have been discovered,and the exact pathophysiology remains *** the 2007 National Institute of Health(NIH)Roadmap for Medical Research model as a reference framework,we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI *** GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous *** reviewing the published and ongoing registered clinical trials for cognitivebehavioral therapy,exercise therapy,acupuncture,coenzyme Q10(CoQ10),mifepristone,and carnosine in GWI patients,we identified only four treatments(cognitive-behavioral therapy,exercise therapy,CoQ10,and mifepristone)that have progressed beyond a phase II *** conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research *** of a standard case definition,prioritized GWI research funding for the characterization of the pathophysiology of the condition,and rapid replication and adaptation of early phase,single site clinical trials could substantially advance research progress and treatment discovery for this condition.

关键词： gulf war illness Chronic multisymptom illness gulf war veterans gulf war syndrome Persian gulf war Cognitive-behavioral therapy Exercise therapy Acupuncture Coenzyme Q10 Mifepristone Carnosine Mindfulness-based stress reduction

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