GULF WAR ILLNESS AND GCAQE – NEW DEVELOPMENTS Malcolm Hooper – PhD, B Pharm, MRIC, C Chem Emeritus Professor of Medicinal Chemistry University of Sunderland GCAQE – MEETING APRIL 29TH 2009 - LONDON
Apr 01, 2015
GULF WAR ILLNESS AND GCAQE – NEW DEVELOPMENTS
Malcolm Hooper – PhD, B Pharm, MRIC, C Chem
Emeritus Professor of Medicinal Chemistry
University of Sunderland
GCAQE – MEETING APRIL 29TH 2009 - LONDON
SYNDROMES OF UNCERTAIN ORIGINSMerck Manual 1999, 17th Edition
STRESS - SOMATISATION- PSYCHIATRIC- IN THE MIND
GULF WAR SYNDROME GWI/S = ME of MILITARY
MULTIPLE CHEMICAL
SENSITIVITY
ME-CFSFMS
OPs
NEUROLOGICAL- ANS, PNS, CNSCARDIOVASCULARIMMUNE SYSTEMGASTROINTESTINALRESPIRATORYENDOCRINE SYSTEM
“Considering the extent of the patients’ complaints and disability, the results of ROUTINE laboratory tests were strikingly NORMAL” S Straus
N A P S
CarbOCs
N M
R S
E A
OPs
Pyreth
CWs
E U
V T
RA Dg
BATS
THE MOST TOXIC WAR IN WESTERN MILITARY HISTORYJan. 16 - Feb. 28 1991- [Hooper 2000]
VACCINES
IoM 2000 >40 MAJOR EXPOSURES
USA-UK CONGRESS-PARLIAMENTARY HEARINGS 2000, 2002, 2004, 2008 (RACGWVI (USA-2002, 2004, 2008) AND LLOYD REPORT (UK- Nov 2004)
STRESSORS
PSYCHE EMOTIONS ETC
PHYSICAL/CHEMICAL
VIRUSES BACTERIA, VACCINES
LIGHT , SOUNDELECTRO- MAGNETISMTEMPERATURE
CHEMICALS, OIL/SMOKE, DRUGS, CARCINOGENS
November 2008
465 pages. 1840 references – many peer-reviewed
Findings in Brief
1. GWI and Health of GWVs p.23-56
2. What causes GWI- Effects of Experiences and Exposures. p.59-228.
3. Nature of GWI. p.229-288.
4. Federal Resources GWI and Health of GWVs. p.289-310.
5. Research Priorities and Recommendations. p.311-316.
Executive Summary- 15 pages
A CONGRESSIONALLY-MANDATED REPORT –LORD MORRIS OF MANCHESTER
SYNDROME – ILLNESS – ILLNESSES ?
A MATTER OF DEFINITION
…symptoms are remarkably consistent across diverse GWVs populations. Whether this Gulf War-related symptom complex represents several syndromes, or one syndrome with several subtypes, is an issue of taxonomy ……a consequence of military service, ………only observed in veterans who served in the 1991 Gulf War, p.41
For us GWI = GWS but NOT for MOD (umbrella term)
1. GWI and the Health of Gulf War Veterans
HIGHLIGHTS
GWI is a serious condition multi-symptom condition resulting from service in the 1990-1991 Gulf War, is the most prominent health issue affecting GWVs, but not the only one. p.1 Affects 25-32% GWVs
No effective treatments have been identified …….few GWVs recover over time
Studies consistently indicate that Gulf War illness is UNIQUE not the result of combat or other stressors and that Gulf War veterans have lower rates of posttraumatic stress disorder than veterans of other wars. No similar widespread, unexplained symptomatic illness has been identified in veterans from other war zones
Studies of Gulf War veterans consistently indicate that serving in combat and other psychological stressors during the war are NOT significantly associated with GWI, after adjusting for effects of other wartime exposures…. PTSD rates are LOWER in GWVs…. the large majority of veterans with Gulf War illness have NO psychiatric disorders.
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 protecttroops from effects of nerve agents, NAPS.
2) Pesticides, especially OPs- diazinon, chlorpyrifos used during deployment.
CHOLINERGIC AND RELATED NEUROTOXICANTS
An association with low-level exposure to nerve agents cannot be ruled out – Sarin and related compounds but NOT Soman
GCAQE – ROUTINE PESTICIDE EXPOSURE COULD INVOLVE CARBAMATE PESTICIDES- eg PROPOXUR, CARBARYL, BENDICARB etc.
OR PYRETHROIDS eg PERMETHRIN etc- SYNERGISM
CHOLINERGIC TRIPLE WHAMMY
PARAOXONASE
Golomb B. Rand Report,1999- 83 pages of references,
PB cannot be ruled out as a possible contributor to the development of unexplained or undiagnosed illness in some PGW (Persian Gulf War) veterans……...Uncertainties remain concerning the effectiveness of PB in protection of humans against nerve agents……… The use of PB may reduce somewhat the effectiveness of post-exposure treatment for NON-SOMAN nerve agents...
NAPS - PYRIDOSTIGMINE BROMIDE-IND!- CARBAMATE
The issue is a complex one, involving trading off uncertain health risks- but risks now shown to be biologically plausible- against uncertain gains from the use of PB in the warfare setting.
See also Cherry et al 2001
PESTICIDES USED IN GW-1
OPs - DIAZINON, MALATHION, CHLORPYRIFOS, SOME UNKNOWN OPs
CARBAMATES – PROPOXUR, BENDIOCARB
HSE TRAINED OPERATIVE NO PROPER PROTECTION -
PYRETHROIDS LINDANE DEET
SYNERGY DEMONSTRATED CNS DAMAGE TESTICULAR ATROPHY
AGRICULTURE/ FISH CIVILIAN/AEROTOXIC SYNDROME- HIGH USAGE- CONTROVERSIAL INCL. GM HERBICIDES
Abou Donia et al 1996-2002IDENTIFIED AS MAJOR FACTOR AMONG UK GWVs- Cherry et al 2001OEM 2001;58:291-298;299-306.
ACUTE- CHRONIC-DELAYED EFFECTS KNOWN-NERVOUS, ENDOCRINE & IMMUNE SYSTEMS
BASAL GANGLIA-DEEP BRAIN STRUCTURES INCLUDE LENTIFORM
AND CAUDATE NUCLEUS- CONTROL MOVEMENT SEQUENCES
BRAIN STEMTHALAMUS
MID BRAIN
AMYGDALAOLFACTORY
BULB
MIDBRAIN
HIPPOCAMPUS
THE LIMBIC SYSTEM
THE MAJOR SYSTEM AFFECTED BY CHEMICAL EXPOSURES
INFORMATION CENTRES- THALAMUS relay station for SENSORY NERVES BRAIN STEM, SPINAL CORD TO CEREBRUM-PAIN
BRAIN STEM REGULATES VITAL FUNCTIONS-HEART BEAT, RESPIRATION, BLOOD PRRESSURE, DIGESTION, SWALLOWING,
VOMITING etc
VISUAL AUDITORY
FACIAL EXPRESSION EYE MOVEMENT BALANCE
HEART RATE RESPIRATION BLOOD PRESSURE TEMPERATURE SWALLOWING VOMITING
EXPOSURES
MULITPLE
SYMPTOMS
MULTIPLE
SMALLER NUMBER OF MECHANISMS
UNDERSTANDING
IDENTIFIED PATHWAYS CAUSING DAMAGE
NEUROLOGICAL DAMAGE – PERIPHERAL, CENTRAL - DYSAUTONOMIA, ACUTE, DELAYED, OPIDN, CHRONIC,
OPICN
OXIDATIVE STRESS – WIDESPREAD DAMAGE, APOPTOSIS
IMMUNE SYSTEM DISORDERS – REDUCED ACTIVITY- AUTOIMMUNE DISORDERS.
CELLULAR NECROSIS – PRECIPITATE NEW ILLNESSES
LOOK OUT FOR PARKNISONISM, MS, MND(ALS) ?
DIAGNOSTIC TESTS
NEUROPSYCHOLOGICAL – SARAH McKENZIE-ROSS
NEURONAL ANTIBODIES – ABOU-DONIA
OXIDATIVE STRESS – ABOU-DONIA, SPENCE
IMMUNE SYSTEM – NANCY KLIMAS
DYSAUTONOMIA – JULIA NEWTON
ENDOCRINE – INSULIN STRESS TEST STEVE ATKIN
MITOCHONDRIAL FUNCTION –SARAH MYHILL JOHN McLAREN -HOWARD
ADVANCED MRI SCANS – HALEY et al
DECORATED PROEINS ANTIBODIES - FURLONG
TREATMENTS
UNDER INVESTIGATION – RACGWI REPORT
MIDRODRINE – DYSAUTONOMIA
ANTI-OXIDANTS – GLUTATHIONE etc
SARAH MYHILL PROTOCOL – Mg, NIACIN, CoQ 10, D-RIBOSE, N-ACETYL-L- CARNITINE
ATKIN – HORMONE REPLACEMENT – GH-TESTOSTERONE etc
SAMENTO ECUADOREAN HERB - PROMISING NEURONAL RESTORATION
ORGANOPHOSPHATES – PESTICIDES AND OTHERS
GWI/S
FISH FARMING
SHEPHERD
AGRICULTURE
WHEAT STORAGE
FRUIT GROWERS
CREWS
CAQ
PASSENGERS
MoD DEFRA
IN THE WINGS – HERBICDES- GLYPHOSATE, GLUFOSINATE PHOSPHONATES/NERVE AGENTS? – GM CROPS
COMNG FROM LEFT FIELD!!
THE PEOPLE’S PERMANENT TRIBUNAL IN THE HAGUE
The PPT is an international tribunal founded in 1979 in Italy. It uses rigorous conventional court format, and looks into human rights complaints submitted by communities facing abuses. It issues indictments, names relevant laws and documents findings.
It sets out to ensure that agrochemical corporations that produce, distribute and use pesticides are held accountable for the consequences of their actions