Improving Diagnostics and Treatments for GWI Females by Accounting for the Effects of PTSD
Abstract
Rationale: Gulf War illness is a complex condition associated with deployment to the Persian Gulf between 1990-91 that presents with autonomic dysfunction, musculoskeletal pain, cognitive dysfunction, chemical sensitivity, and unexplained fatigue. Gender differences have been observed in this illness, as well as in post-traumatic stress disorder. Since both post-traumatic stress disorder and Gulf War illness affect immunity and can result in a set of similar symptoms, we ask how post-traumatic stress disorder may change the nature and severity of Gulf War illness in women. Objective: We propose to disentangle the effects of post-traumatic stress disorder from Gulf War illness to understand the role that post-traumatic stress plays in the symptoms and perpetuation of Gulf War illness in women. To accomplish this, we will re-analyze a pre-existing set of data obtained under previous Department of Defense and Veterans Affairs awards. This dataset is comprised of female Gulf War era Veterans. Some of the Veterans in this set are healthy individuals that will serve as a control group. The remaining subjects have Gulf War illness. Of the Veterans with Gulf War illness, a smaller subset of subjects also has post-traumatic stress disorder. Consistent with our group s previous work, we will analyze the changes in the immune and stress responses in women across time following a graded exercise challenge using a dynamic modeling approach. Applicability: Overall, this research will allow for improved characterization of women with Gulf War illness as a condition in and of itself, and the identification of subgroups of Gulf War illness based on the presence or absence post-traumatic stress disorder resulting from time on the battlefield. Additionally, this project will identify new candidate treatment targets and predict an optimize treatment course of immune and endocrine modulating agents for re-establishing healthy endocrine-immune regulation in women with Gulf War illness with and without the confounding condition of post-traumatic stress. What types of patients will it help and how will it help them? This proposal is directly focused on improved treatment modalities for women with Gulf War illness in the context of post-traumatic stress, a condition commonly found in returning Veterans. The proposed research will determine if and how post-traumatic stress contributes to the nature and severity of Gulf War illness in women, and provide distinguishing patterns of blood-borne markers to delineate subtypes of female Gulf War illness based on the presence or absence of post-traumatic stress. Additionally, this research aims to identify new candidate treatments for women specific to each subtype while optimizing the effectiveness of immune and endocrine modulating pharmacologic interventions to reset endocrine-immune balance to normal in Gulf War illness. What are the potential clinical applications, benefits, and risks? Direct clinical application includes the identification of the interactions between immune markers and symptoms, providing knowledge of how post-traumatic stress disorder influences the symptomatology of Gulf War illness in women informing clinicians and allowing for the benefit of subtype-specific care. Risks involve misclassification of subtype specific immune symptom profiles; however, our classification methods are designed to minimize this risk. The identification of new candidate treatments for women and the test of the identification of putative treatment courses will inform clinicians of potential intervention options. These will of course require further clinical testing before clinical use, but will provide a basis for informed decisions. At the stage of inquiry proposed in this research project, the risk to patients is negligible. What is the projected time it may take to achieve a patient-related outcome? At the end of this 3-year project, endocrine-immune profiles and accompa
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610552
Entities
People
- Travis Craddock
Organizations
- Nova Southeastern University
- United States Army