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Golomb BA, Kelley RI, Han JH, Miller B, Bui L. Gulf war illness: a tale of two genomes. BMC Res Notes 2024; 17:230. [PMID: 39169443 PMCID: PMC11337741 DOI: 10.1186/s13104-024-06871-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/18/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION Gulf War illness (GWI) is an environmentally-triggered chronic multisymptom illness typified by protean symptoms, in which mitochondrial impairment is evident. It has been likened to accelerated aging. Nuclear genetics of detoxification have been linked to GWI. OBJECTIVE To see whether mitochondrial (mt) haplogroup U - a heritable profile of mitochondrial DNA that has been tied to aging-related conditions - significantly predicts greater GWI severity; and to assess whether GWI severity is influenced by mitochondrial as well as nuclear genetics. 54 consenting Gulf War veterans gave information on GWI severity, of whom 52 had nuclear DNA assessment; and 45 had both nuclear and mitochondrial DNA assessments. Regression with robust standard errors assessed prediction of GWI severity as a function of nuclear genetics (butyrylcholinesterase variants), mitochondrial genetics (haplogroup U, previously tied to aging-related conditions); or both. RESULTS BChE "adverse" variants significantly predicted GWI severity (β(SE) = 23.4(11.4), p = 0.046), as did mt haplogroup U (β(SE) = 36.4(13.6), p = 0.010). In a model including both, BChE was no longer significant, but mt haplogroup U retained significance (β(SE) = 36.7(13.0), p = 0.007). This is the first study to show that mitochondrial genetics are tied to GWI severity in Gulf-deployed veterans. Other data affirm a tie to nuclear genetics, making GWI indeed a "tale of two genomes."
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Affiliation(s)
- Beatrice A Golomb
- Department of Medicine, University of California, San Diego, La Jolla, 92093, CA, U.S.A..
| | - Richard I Kelley
- Department of Genetics and Genomics, Boston Children's Hospital, 02115, Boston, MA, U.S.A
| | - Jun Hee Han
- Department of Medicine, University of California, San Diego, La Jolla, 92093, CA, U.S.A
| | - Bruce Miller
- Department of Medicine, University of California, San Diego, La Jolla, 92093, CA, U.S.A
| | - Leeann Bui
- Department of Medicine, University of California, San Diego, La Jolla, 92093, CA, U.S.A
- Department of Obstetrics and Gynecology, Santa Clara Valley Medical Center, 95128, San Jose, CA, U.S.A
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Golomb BA, Han JH, Fung A, Berg BK, Miller BJ, Hamilton G. Bioenergetic impairment in Gulf War illness assessed via 31P-MRS. Sci Rep 2024; 14:7418. [PMID: 38548808 PMCID: PMC10979028 DOI: 10.1038/s41598-024-57725-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024] Open
Abstract
Time for post-exercise phosphocreatine-recovery (PCr-R), deemed a robust index of mitochondrial function in vivo, was previously reported to be elevated (signifying impaired ATP production) in veterans with Gulf War illness (GWI). Here we sought to replicate the finding and assess the impact of contravening previous eligibility requirements. The replication sample comprised white males. Cases reported ≥ moderate muscle-weakness to match the organ assessed to an organ affected; controls lacked recent headache or multiple symptoms. The expansion sample added cases without muscle-weakness, controls with recent headache, females, nonwhites. PCr-R, following pedal-depression-exercise, was compared in veterans with GWI versus controls (sample N = 38). In the replication sample, PCr-R results closely matched the prior report: PCr-R veterans with GWI mean(SD) = 47.7(16.5); control mean(SD) = 30.3(9.2), p = 0.017. (Prior-study PCr-R veterans with GWI mean(SD) = 46.1(17.9), control mean(SD) = 29.0(8.7), p = 0.023. Combined replication + prior samples: p = 0.001.) No case-control difference was observed in the expansion sample. In cases, PCr-R related to muscle-weakness: PCr-R = 29.9(7.1), 38.2(8.9), 47.8(15.2) for muscle-weakness rated none/low, intermediate, and high respectively (p for trend = 0.02), validating desirability of matching tissue assessed to tissue affected. In controls, headache/multiple symptoms, sex, and ethnicity each mattered (affecting PCr-R significantly). This study affirms mitochondrial/bioenergetic impairment in veterans with GWI. The importance of careful case/control selection is underscored.
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Affiliation(s)
- Beatrice Alexandra Golomb
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0995, La Jolla, CA, 92093-0995, USA.
| | - Jun Hee Han
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0995, La Jolla, CA, 92093-0995, USA
| | - Alexander Fung
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0995, La Jolla, CA, 92093-0995, USA
- Clement Park Dental Care, Littleton, CO, 80123, USA
| | - Brinton Keith Berg
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0995, La Jolla, CA, 92093-0995, USA
| | - Bruce J Miller
- Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0995, La Jolla, CA, 92093-0995, USA
| | - Gavin Hamilton
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, USA
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Golomb BA, Berg BK, Han JH. Susceptibility to radiation adverse effects in veterans with Gulf War illness and healthy civilians. Sci Rep 2024; 14:874. [PMID: 38195674 PMCID: PMC10776672 DOI: 10.1038/s41598-023-50083-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024] Open
Abstract
We evaluated whether veterans with Gulf War illness (VGWI) report greater ionizing radiation adverse effects (RadAEs) than controls; whether radiation-sensitivity is tied to reported chemical-sensitivity; and whether environmental exposures are apparent risk factors for reported RadAEs (rRadAEs). 81 participants (41 VGWI, 40 controls) rated exposure to, and rRadAEs from, four radiation types. The relations of RadAE-propensity (defined as the ratio of rRadAEs to summed radiation exposures) to Gulf War illness (GWI) presence and severity, and to reported chemical-sensitivity were assessed. Ordinal logistic regression evaluated exposure prediction of RadAE-propensity in the full sample, in VGWI, and stratified by age and chemical-sensitivity. RadAE-propensity was increased in VGWI (vs. controls) and related to GWI severity (p < 0.01) and chemical-sensitivity (p < 0.01). Past carbon monoxide (CO) exposure emerged as a strong, robust predictor of RadAE-propensity on univariable and multivariable analyses (p < 0.001 on multivariable assessment, without and with adjustment for VGWI case status), retaining significance in age-stratified and chemical-sensitivity-stratified replication analyses. Thus, RadAE-propensity, a newly-described GWI-feature, relates to chemical-sensitivity, and is predicted by CO exposure-both features reported for nonionizing radiation sensitivity, consistent with shared mitochondrial/oxidative toxicity across radiation frequencies. Greater RadAE vulnerability fits an emerging picture of heightened drug/chemical susceptibility in VGWI.
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Affiliation(s)
- Beatrice Alexandra Golomb
- Department of Medicine, UC San Diego School of Medicine, University of California, San Diego, 9500 Gilman Dr. #0995, La Jolla, CA, 92093-0995, USA.
| | - Brinton Keith Berg
- Department of Medicine, UC San Diego School of Medicine, University of California, San Diego, 9500 Gilman Dr. #0995, La Jolla, CA, 92093-0995, USA
| | - Jun Hee Han
- Department of Medicine, UC San Diego School of Medicine, University of California, San Diego, 9500 Gilman Dr. #0995, La Jolla, CA, 92093-0995, USA
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Haley RW, Dever JA, Kramer G, Teiber JF. The effect of disease misclassification on the ability to detect a gene-environment interaction: implications of the specificity of case definitions for research on Gulf War illness. BMC Med Res Methodol 2023; 23:273. [PMID: 37986147 PMCID: PMC10659093 DOI: 10.1186/s12874-023-02092-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/03/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Since 1997, research on Gulf War illness (GWI) has predominantly used 3 case definitions-the original Research definition, the CDC definition, and modifications of the Kansas definition-but they have not been compared against an objective standard. METHODS All 3 case definitions were measured in the U.S. Military Health Survey by a computer-assisted telephone interview in a random sample (n = 6,497) of the 1991 deployed U.S. military force. The interview asked whether participants had heard nerve agent alarms during the conflict. A random subsample (n = 1,698) provided DNA for genotyping the PON1 Q192R polymorphism. RESULTS The CDC and the Modified Kansas definition without exclusions were satisfied by 41.7% and 39.0% of the deployed force, respectively, and were highly overlapping. The Research definition, a subset of the others, was satisfied by 13.6%. The majority of veterans meeting CDC and Modified Kansas endorsed fewer and milder symptoms; whereas, those meeting Research endorsed more symptoms of greater severity. The group meeting Research was more highly enriched with the PON1 192R risk allele than those meeting CDC and Modified Kansas, and Research had twice the power to detect the previously described gene-environment interaction between hearing alarms and RR homozygosity (adjusted relative excess risk due to interaction [aRERI] = 7.69; 95% CI 2.71-19.13) than CDC (aRERI = 2.92; 95% CI 0.96-6.38) or Modified Kansas without exclusions (aRERI = 3.84; 95% CI 1.30-8.52) or with exclusions (aRERI = 3.42; 95% CI 1.20-7.56). The lower power of CDC and Modified Kansas relative to Research was due to greater false-positive disease misclassification from lower diagnostic specificity. CONCLUSIONS The original Research case definition had greater statistical power to detect a genetic predisposition to GWI. Its greater specificity favors its use in hypothesis-driven research; whereas, the greater sensitivity of the others favor their use in clinical screening for application of future diagnostic biomarkers and clinical care.
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Grants
- DAMD17-01-1-0741 U.S. Army Medical Research and Materiel Command
- DAMD17-01-1-0741 U.S. Army Medical Research and Materiel Command
- DAMD17-01-1-0741 U.S. Army Medical Research and Materiel Command
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- IDIQ contract # VA 549-P-0027 Department of Veterans Affairs North Texas Health Care System, Dallas, TX
- W81XWH-16-1-0740 Office of the Assistant Secretary of Defense for Health Affairs, through the Gulf War Illness Research Program
- W81XWH-16-1-0740 Office of the Assistant Secretary of Defense for Health Affairs, through the Gulf War Illness Research Program
- W81XWH-16-1-0740 Office of the Assistant Secretary of Defense for Health Affairs, through the Gulf War Illness Research Program
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Affiliation(s)
- Robert W Haley
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | | | - Gerald Kramer
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John F Teiber
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Meyer JN, Pan WK, Ryde IT, Alexander T, Klein-Adams JC, Ndirangu DS, Falvo MJ. Bioenergetic function is decreased in peripheral blood mononuclear cells of veterans with Gulf War Illness. PLoS One 2023; 18:e0287412. [PMID: 37910447 PMCID: PMC10619881 DOI: 10.1371/journal.pone.0287412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023] Open
Abstract
Gulf War Illness (GWI) is a major health problem for approximately 250,000 Gulf War (GW) veterans, but the etiology of GWI is unclear. We hypothesized that mitochondrial dysfunction is an important contributor to GWI, based on the similarity of some GWI symptoms to those occurring in some mitochondrial diseases; the plausibility that certain pollutants to which GW veterans were exposed affect mitochondria; mitochondrial effects observed in studies in laboratory models of GWI; and previous evidence of mitochondrial outcomes in studies in GW veterans. A primary role of mitochondria is generation of energy via oxidative phosphorylation. However, direct assessment of mitochondrial respiration, reflecting oxidative phosphorylation, has not been carried out in veterans with GWI. In this case-control observational study, we tested multiple measures of mitochondrial function and integrity in a cohort of 114 GW veterans, 80 with and 34 without GWI as assessed by the Kansas definition. In circulating white blood cells, we analyzed multiple measures of mitochondrial respiration and extracellular acidification, a proxy for non-aerobic energy generation; mitochondrial DNA (mtDNA) copy number; mtDNA damage; and nuclear DNA damage. We also collected detailed survey data on demographics; deployment; self-reported exposure to pesticides, pyridostigmine bromide, and chemical and biological warfare agents; and current biometrics, health and activity levels. We observed a 9% increase in mtDNA content in blood in veterans with GWI, but did not detect differences in DNA damage. Basal and ATP-linked oxygen consumption were respectively 42% and 47% higher in veterans without GWI, after adjustment for mtDNA amount. We did not find evidence for a compensatory increase in anaerobic energy generation: extracellular acidification was also lower in GWI (12% lower at baseline). A subset of 27 and 26 veterans returned for second and third visits, allowing us to measure stability of mitochondrial parameters over time. mtDNA CN, mtDNA damage, ATP-linked OCR, and spare respiratory capacity were moderately replicable over time, with intraclass correlation coefficients of 0.43, 0.44, 0.50, and 0.57, respectively. Other measures showed higher visit-to-visit variability. Many measurements showed lower replicability over time among veterans with GWI compared to veterans without GWI. Finally, we found a strong association between recalled exposure to pesticides, pyridostigmine bromide, and chemical and biological warfare agents and GWI (p < 0.01, p < 0.01, and p < 0.0001, respectively). Our results demonstrate decreased mitochondrial respiratory function as well as decreased glycolytic activity, both of which are consistent with decreased energy availability, in peripheral blood mononuclear cells in veterans with GWI.
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Affiliation(s)
- Joel N. Meyer
- Nicholas School of the Environment, Duke University, Durham, NC, United States of America
| | - William K. Pan
- Nicholas School of the Environment, Duke University, Durham, NC, United States of America
| | - Ian T. Ryde
- Nicholas School of the Environment, Duke University, Durham, NC, United States of America
| | - Thomas Alexander
- Department of Veterans Affairs, War Related Illness and Injury Study Center, East Orange, NJ, United States of America
| | - Jacquelyn C. Klein-Adams
- Department of Veterans Affairs, War Related Illness and Injury Study Center, East Orange, NJ, United States of America
| | - Duncan S. Ndirangu
- Department of Veterans Affairs, War Related Illness and Injury Study Center, East Orange, NJ, United States of America
| | - Michael J. Falvo
- Department of Veterans Affairs, War Related Illness and Injury Study Center, East Orange, NJ, United States of America
- New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, United States of America
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