Gulf War Veterans: Evidence for Chromosome Alterations and their Significance

A significant portion of veterans who were deployed to the 1990 Gulf War developed Gulf War Illnesses (GWI), which are mainly characterised by persistent muskuloskeletal pain, fatigue, and cognitive problems (concentration, memory, and attention difficulties), and a large number of other signs and symptoms (1). In addition, Gulf War veterans who developed chronic abdominal pain and diarrhea exhibited visceral hypersensitivity in response to experimental visceral pain stimuli, as seen in patients with irritable bowel syndrome (2). Compared with non-Gulf War veteran controls, Gulf War veterans showed significantly higher rates of both Chronic Fatigue Syndrome (odds ratio = 4.8; 95% confidence interval (CI) 3.9-5.9) and post-traumatic stress disorder (odds ratio = 3.1; 95% CI 2.7-3.4) (3). These epidemiological data, however, were based solely on surveys of 15,000 Gulf War veterans and 15,000 non-Gulf War veteran controls, and were not validated by an extensive examination required for the diagnosis of Chronic Fatigue Syndrome. From a systematic review and meta analysis, the authors concluded that compared to service personnel who had not been deployed to the Persian Gulf Theatre of Operations, Gulf War veterans had an increased risk for both post-traumatic stress disorder (odds ratio = 3.17; 95% CI 2.16-4.65) and common mental disorders (odds ratio = 2.04; 95% CI 1.94-2.15) (4). However, the authors support the view that other factors must be contributing to GWI, in addition to any increase in psychiatric disorders (4). Others are convinced that GWI reflect pathophysiologic and biochemical processes (5,6), a view that is supported by the observed higher prevalence of birth defects (tricuspid valve insufficiency, aortic valve stenosis, renal agenesis, and hypospadias) among infants conceived postwar to Gulf War veterans of both sexes (7). A pathophysiologic nature for GWI might explain why both cognitive behavioral therapy and aerobic exercise provide only modest relief from symptoms in GWS (8,9).