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GULF WAR ILLNESS AND GCAQE – NEW DEVELOPMENTS Malcolm Hooper – PhD, B Pharm, MRIC, C Chem Emeritus Professor of Medicinal Chemistry University of Sunderland.

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Presentation on theme: "GULF WAR ILLNESS AND GCAQE – NEW DEVELOPMENTS Malcolm Hooper – PhD, B Pharm, MRIC, C Chem Emeritus Professor of Medicinal Chemistry University of Sunderland."— Presentation transcript:

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2 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 LONDON

3 SYNDROMES OF UNCERTAIN ORIGINS Merck Manual 1999, 17 th Edition STRESS - SOMATISATION- PSYCHIATRIC- IN THE MIND GULF WAR SYNDROME GWI/S = ME of MILITARY MULTIPLE CHEMICAL SENSITIVITY ME-CFS FMS OPs NEUROLOGICAL- ANS, PNS, CNS CARDIOVASCULAR IMMUNE SYSTEM GASTROINTESTINAL RESPIRATORY ENDOCRINE SYSTEM “Considering the extent of the patients’ complaints and disability, the results of ROUTINE laboratory tests were strikingly NORMAL” S Straus

4 B A T S N A P S Carb OCs N M R S E A OPs Pyreth CWs E U V T R A D g B A T S THE MOST TOXIC WAR IN WESTERN MILITARY HISTORY Jan Feb [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)

5 STRESSORS PSYCHE EMOTIONS ETC PHYSICAL/CHEMICAL VIRUSES BACTERIA, VACCINES LIGHT, SOUND ELECTRO- MAGNETISM TEMPERATURE CHEMICALS, OIL/SMOKE, DRUGS, CARCINOGENS

6 November pages references – many peer- reviewed Findings in Brief 1.GWI and Health of GWVs p What causes GWI- Effects of Experiences and Exposures. p Nature of GWI. p Federal Resources GWI and Health of GWVs. p Research Priorities and Recommendations. p Executive Summary- 15 pages A CONGRESSIONALLY-MANDATED REPORT –LORD MORRIS OF MANCHESTER

7 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)

8 1.GWI and the Health of Gulf War Veterans HIGHLIGHTS GWI is a serious condition multi-symptom condition resulting from service in the 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.

9 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 protect troops 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

10 CHOLINERGIC TRIPLE WHAMMY PARAOXONASE

11 Golomb B. Rand Report, 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

12 PESTICIDES USED IN GW-1 OPs - DIAZINON, MALATHION, CHLORPYRIFOS, SOME UNKNOWN OPs CARBAMATES – PROPOXUR, BENDIOCARB HSE TRAINED OPERATIVE NO PROPER PROTECTION - PYRETHROIDS LINDANEDEET SYNERGY DEMONSTRATED CNS DAMAGE TESTICULAR ATROPHY AGRICULTURE/ FISH CIVILIAN/AEROTOXIC SYNDROME- HIGH USAGE- CONTROVERSIAL INCL. GM HERBICIDES Abou Donia et al IDENTIFIED AS MAJOR FACTOR AMONG UK GWVs- Cherry et al 2001OEM 2001;58: ; ACUTE- CHRONIC-DELAYED EFFECTS KNOWN- NERVOUS, ENDOCRINE & IMMUNE SYSTEMS

13 BASAL GANGLIA-DEEP BRAIN STRUCTURES INCLUDE LENTIFORM AND CAUDATE NUCLEUS- CONTROL MOVEMENT SEQUENCES

14 BRAIN STEM THALAMUS MID BRAIN AMYGDALA OLFACTORY BULB MIDBRAIN HIPPOCAMPUS THE LIMBIC SYSTEM THE MAJOR SYSTEM AFFECTED BY CHEMICAL EXPOSURES

15 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

16 EXPOSURESEXPOSURES MULITPLEMULITPLE SYMPTOMSSYMPTOMS MULTIPLEMULTIPLE SMALLER NUMBER OF MECHANISMS UNDERSTANDING

17 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) ?

18 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

19 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

20 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

21 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


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