Gulf War treatment trials to begin
therapy will be tested along with an antibiotic as possible treatments for the complex and undiagnosed
symptoms known as Gulf War syndrome.
The clinical trials come eight years after the Gulf War. Thousands
of U.S., British and Canadian veterans who served in the Persian Gulf have complained of mysterious symptoms
similar to those of CFIDS at a much higher rate than those who did not serve in the Gulf. The Pentagon
and Department of Veterans Affairs are spending $20 million on randomized, controlled studies to begin
The U.S. program comprises two clinical trials at veterans' hospitals across the country,
using antibiotics in one study and exercise and behavior therapy in the other. The first will enroll 450
veterans with mycoplasma fermentans, which officials describe as a "hypothesized infectious cause" of
undiagnosed symptoms. They will take the antibiotic doxycycline for 12 months. The second trial will enroll
1,356 veterans suffering fatigue, memory problems, and muscle and joint pain, to be treated with behavior
therapy and exercise.
Nearly 697,000 Americans served in the Persian Gulf after Iraq's August 1990
invasion of Kuwait. A Centers for Disease Control study found that 45% of those who went to the Gulf complained
of an illness characterized by fatigue, cognitive problems and muscle pain, with 6% having severe symptoms.
Gulf War CFIDS a milder form
War veterans with CFIDS
tend to have a milder form of the illness than civilians with the illness and may have a better prognosis
for recovery, according to a study by C. Pollet, B. Natelson and a team of researchers from New Jersey.
The study was published in the Journal of Medicine (1998, 29(3-4):101-13). Of a group of 72 veterans
with complaints of severe fatigue or chemical sensitivity, 33 met the case definition for CFIDS with 14
also having multiple chemical sensitivity. Another six met the MCS definition but not that for CFIDS.
New hypothesis for CFIDS cause
at Ohio State
University have published a new theory that CFIDS is caused by both a low-level viral infection and the
body's immune response to it. The new theory by Ronald Glaser, professor of medical microbiology and immunology,
and Janice Kiecolt-Glaser, professor of psychology and psychiatry, published in the American Journal
of Medicine in October, arises from their research on the effects of stress on the human immune system.
data suggests that stress may be causing the expression of certain viral proteins and that these proteins
may be modulating the body's immune response, turning it on or off," Glaser said.
The theory holds
that various latent viruses can be partially reactivated, meaning that viral proteins could be produced
at levels high enough to cause a low-grade infection but too low to be seen using current laboratory assays.
The researchers suggest that CFIDS patients could have an infection that is "more like a smoldering fire
rather than a three-alarm blaze," which could be enough to increase production of various cytokines.
lot of the symptoms that you find in chronic fatigue syndrome are the same ones induced by cytokines during
our normal immune response," Glaser said. He admits that studies of patients have yet to show a pattern
of abnormal cytokine behavior that would substantiate their theory, but he believes that may be because
knowledge about cytokines is still emerging and new ones are being identified.
stress and depression may be playing a related role. Earlier research has repeatedly shown that increased
stress and depression can reactivate latent viruses, decrease the body's immune response and stimulate
the production of certain cytokines linked to some CFIDS symptoms.
"Part of this is a chicken-and-egg
problem," Kiecolt-Glaser said. "People diagnosed with CFIDS often are depressed since they're unable to
carry out normal, daily activities. What we don't know is whether the depression followed the diagnosis
of CFIDS or if it contributed to it. We do know, however, that this kind of depression can weaken our
Long-term effects on schooling
G. Dowsett, a
microbiologist, and Jane Colby, a former school principal, are beginning a new project to assess the long-term
effects of CFIDS on education. They're looking for PWCs up to age 30 to fill out a questionnaire. Participants
can remain anonymous. Get a questionnaire through the Young Action Online web site (www.jafc.demon.co.uk/yaonline)
or by writing to Jane Colby, PO Box 4347, Stock, Ingatestone, Essex, CM4 9TE, England.