On Nov. 17, the Research Advisory Committee on Gulf War Veterans’ Illnesses released a 454-page report linking exposure to nervous-system toxins with the development of illness in Gulf War veterans.
Gulf War illness, or syndrome, which this report describes as a collection of symptoms typically including persistent memory and concentration problems, chronic headaches, widespread pain and gastrointestinal problems, affects at least 25 percent of the 697,000 U.S. veterans who served in the 1990-1991 Gulf War.
This syndrome is not ALS. However, the report also notes that veterans of the Gulf War have significantly higher rates of ALS and brain cancer than other veterans. The links, if any, among these conditions are unknown.
The advisory committee, made up of experts from several academic institutions and government agencies, stated in its report that “evidence strongly and consistently indicates that two Gulf War neurotoxic exposures are causally associated with Gulf War illness: 1) use of pyridostigmine bromide (PB) pills, given to protect troops from effects of nerve agents, and 2) pesticide use during deployment.”
These chemicals cause an abnormal and potentially toxic elevation of the chemical acetylcholine in parts of the nervous system and at the junction of nerve and muscle fibers. They’ve previously been suspected as possible culprits in the development of ALS in veterans of the Gulf War, in conjunction with genetic factors that interfere with the body’s ability to handle these substances.
Denise Figlewicz, who had MDA support for several ALS-related research projects at the University of Rochester (N.Y.) and the University of Michigan between 1994 and 2006, was part of a research group that in 2006 found that variants in the genes for the PON1 and the PON2 enzymes (known to help detoxify chemicals) were associated with ALS in a Polish population.
In 2008, MDA grantee Guy Rouleau at the University of Montreal and colleagues published findings showing that genetic variants in the PON genes are associated with ALS in France and Quebec.
Figlewicz notes that several additional studies also have found associations between ALS development and PON gene variants that may make PON enzymes less effective, but no two studies have fingered the same PON variant.
“It’s a mystery that still needs to be unraveled,” she says, adding that more research is needed to probe the possible connections between Gulf War illness, ALS, toxic exposures and PON gene and enzyme variations.
“There are many unanswered questions, but after reading this report on Gulf War illness, I don’t think anybody would say to stop this area of research because there’s nothing there. In fact, the credible identification of two causative factors for GWI represents the first page in the next chapter of investigations.”
The Research Advisory Committee on Gulf War Veterans’ Illnesses report can be seen at www1.va.gov/RAC-GWVI.