Vascular and Skeletal Muscle Function in Gulf War Veterans Illness
Abstract
Rationale: Gulf War Illness (GWI) is a constellation of symptoms including fatigue, musculoskeletal pain, memory loss, and mood changes reported by Gulf War Veterans shortly after their return in 1991. Approximately 40% of Gulf War Veterans (over one-quarter million Veterans) have GWI by the Centers for Disease Control and Prevention (CDC) criteria for GWI (a recommended method for defining GWI). The underlying causes of GWI are poorly understood. The overall goal of our study is to determine if there are differences in blood vessels, skeletal muscle performance, and their controlling proteins and genes in Gulf War Veterans with and without GWI. Abnormalities in these factors may explain the symptoms of fatigue and muscle pain that are major parts of GWI. These insights could lead to new treatments for GWI as well as other illnesses with similar symptoms. Our pilot data show that we can assess blood flow to muscle, muscle strength and fatigue, and examine proteins and genes from a specimen of muscle in Gulf War Veterans. We will assess if abnormalities in these factors are potential explanations for GWI. Objective: We will invite Veterans participating in the Fort Devens Gulf War Illness Study to participate in this study to assess blood flow and blood vessel responses, muscle strength and exercise testing, and related genes. We will compare Veterans with and without GWI to see if these factors are related to GWI. Study Plan: Veterans in the Fort Devens study were assessed for GWI using the CDC criteria. In this proposal, we will use standard catheterization methods to assess blood vessel responses to several short-term medications. This test distinguishes normal from abnormal blood vessels. We will take a small biopsy of the thigh muscle to examine the muscle cells and genes that control muscle strength and fatigue. On a second visit, we will directly assess fatigue with muscle strength tests and a stress test. We will assess whether Veterans with GWI have abnormalities in blood flow, muscle strength or stamina, or their controlling proteins and genes compared to Veterans without GWI. Who This Helps: This study will assess whether abnormalities in blood vessels, muscle, or their regulating proteins and genes explain key symptoms of GWI. This knowledge could find targets for new treatments to improve these symptoms and in doing so, improve the overall well-being of Veterans with GWI. These insights may also help develop a better test to diagnose GWI. Additionally, it could help individuals with other similar symptoms related to specific occupations such as the pesticide industry, and patients with blockages in the leg arteries or chronic heart failure. Clinical Applications and Risks: This study may find abnormalities in proteins and genes that control muscle and blood flow that could be targets to develop new treatments for GWI. The risks of these studies includes small risks related to catheterization to examine blood vessels (less than 1/100 chance of damage to blood vessels or bleeding or bruising at the site of the catheter or biopsy) and risk of strained muscles during the muscle and exercise tests. However, the investigators are physicians who are experts in these tests and are trained in treating any complications. Veterans taking part in this study will have information on the health of their leg arteries and have a stress test, which indirectly assesses heart and leg health. Projected Time: We expect to complete this study in 3 years, by which time we hope to identify targets for new treatments. Contributions of this Study to the Field: This comprehensive assessment of patients with and without GWI will provide new insights into GWI that could lead to new treatments for GWI. It may also direct future research into abnormalities that could form the basis of an improved diagnostic test.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510216
Entities
People
- Scott Kinlay
Organizations
- Boston VA Research Institute
- United States Army