WASHINGTON, DC—The time and effort spent determining the cause or causes of Gulf War illness is only beneficial if it can have a direct health impact on veterans, explained Dr Robert Haley, GWI researcher and University of Texas professor of internal medicine, when testifying at the House VA Committee last month. Veterans suffering from the group of multi-symptom illnesses identified as GWI need a way to be concretely diagnosed and expeditiously treated, Dr Hadley observed. Research could make these two things possible within a few short years.

Developing a Diagnosis

Surveys of veterans with GWI and reports released by the Institute of Medicine and other research agencies have shown that GWI patients are not improving over time. Thus, whatever treatments they are receiving are, in general, not working. Conducting research out of UT Southwestern, Dr Haley said that he and his fellow researchers’ goal is to move beyond figuring out what causes GWI and come up with solutions for how to treat it.

“First, we want to discover what is causing [these] symptoms and develop an objective diagnostic test,” Dr Haley said. “What we need in VA is for someone at a medical center to be able to perform an objective test to see who has this and who doesn’t, not just for service-connected purposes, but for triaging people to appropriate treatments. [Then we need to] develop a scientific basis for developing new treatments. We’re pretty optimistic that there will be treatments for this.”

Two of the major components of his research are neuroimaging and biomarker studies. Dr Haley and his fellow researchers have been repeating a set of brain imaging studies on groups of Gulf War veterans to see how GWI symptoms show up on brain scans. “With brain imaging studies, we can look at what exactly is happening to the brain [when patients are affected by these symptoms],” Dr Haley said. “Then we can develop diagnostic tests that we can give to VA medical centers around the country to diagnose Gulf War illness in the same way you can diagnose [other diseases].” Dr Haley said that such a diagnostic test should be available within the next year or so.

Strengthening the Basic Science

Dr Haley is also studying the basic science of how the agents that veterans might have been exposed to in-theater physically affect the brain. “We’re looking at what these chemicals—PB, pesticides, and sarin nerve agent—what do they do to brain cells,” Dr Haley said. “[If these are the cause], if we know that, we may be able to reverse-engineer this and come up with an antidote that reverses the symptoms.” He cited the discovery of the role dopamine plays in Parkinson’s disease and the subsequent creation of treatment as a model for success.

“We’ve also developed a mouse model in which we can give low doses of pesticides, PB, and sarin nerve agent, in collaboration with U.S. Army at Aberdeen Proving Ground,” Dr Haley explained. “We have been able to produce a behavioral disturbance in mice that interestingly, just like GW veterans, doesn’t come on immediately. It takes about 6 weeks or so for this [to present].”

Two different labs are currently examining the mouse models and subsequent changes in their brain chemistry 3 months after exposure. “If we get down to the molecular level of what has changed, might be able to [turn that] into a treatment,” Dr Haley said. The end goal is to make GWI a disease that can be recognized, diagnosed and expeditiously treated by physicians.

“What’s caused this, we’ll never be able to say that perfectly,” Dr Haley declared. “Veterans want to know how to get better. [VA physicians] need to be able to send veterans through a battery of tests and be able to say, ‘Oh, you’ve got type 1 Gulf War illness. Here’s the treatment for that.’ And we’ll send them over to the clinic and give them the medication or the rehab strategy. There’s been very little research on that. And that’s our total focus.”

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