Unveiling Gulf War Illness: Duke Study Reveals Key Insights and Diagnostic Measures

Traditionally, Gulf War Illness (GWI) has been diagnosed based on self-reported symptoms such as fatigue, indigestion, dizziness, insomnia, and memory problems. A recent study led by Duke University, which was published in PLOS ONE, reveals groundbreaking insights into GWI, a condition affecting around 250,000 US veterans. The study introduces a significant advancement by identifying measurable biochemical differences in veterans with the illness. Led by Joel Meyer, a professor of environmental genomics at Duke's Nicholas School of the Environment, the research establishes that GWI markedly diminishes the energy-producing capacity of white blood cells.

The research team, comprising experts from Duke University, the US Department of Veteran Affairs' War-Related Illness and Injury Study Center, and the New Jersey Medical School, delved into the role of mitochondria—the cell's energy-producing structures—in GWI. Observing similarities between GWI symptoms and those associated with mitochondrial diseases, the team analyzed mitochondrial respiration and extracellular acidification in the white blood cells of 114 Gulf War veterans, 80 of whom had GWI. The results revealed impaired mitochondrial function, indicated by lower levels of extracellular acidification and oxygen consumption in the white blood cells of veterans with GWI.

"We enrolled 121 veterans and excluded seven due to potentially confounding health issues. Of the remaining 114, 80 met Kansas criteria for GWI, and 34 did not. 27 GVs returned for a second visit and 26 for a third visit, allowing us to assess the consistency of measured parameters over time. In a small number of cases, specific analyses failed for some samples, resulting in smaller "n" s for specific assays," said researchers. The study addresses a critical gap in the diagnostic process by providing objective biochemical and molecular measurements accessible through blood samples. While not a stand-alone diagnostic test, these measurements offer a potential tool for evaluating treatment effectiveness by allowing doctors to assess changes in white blood cell energy production throughout treatment. This novel approach could enhance the ability to tailor treatments to individual veterans, providing more targeted and effective interventions.

Despite finding no evidence of DNA damage, the study unveiled a consistent pattern of decreased energy production in the cells of veterans with GWI. Follow-up blood tests confirmed variability in some levels over time, emphasizing the need for repeated assessments during treatment. This discovery underscores the potential for blood tests to gauge treatment response, offering a valuable tool for monitoring the progress of veterans with GWI.

The study also explored potential environmental factors contributing to GWI, with a focus on veterans' self-reported exposures to pesticides and pyridostigmine bromide—a drug used during the Gulf War to protect troops from nerve agents. Interestingly, those who reported exposure to these substances were more likely to develop GWI post-deployment.

"We hope that our results will be informative concerning reducing potentially deleterious chemical exposures in the future, and to the extent that such exposures are unavoidable, minimize them and support treatment for any resulting toxicity," said researchers.

Reference

Meyer JN, Pan W, Ryde IT, et al. Bioenergetic function is decreased in peripheral blood mononuclear cells of veterans with Gulf War Illness. PLOS ONE. 2023;18(11):e0287412-e0287412. doi:https://doi.org/10.1371/journal.pone.0287412