In a world first, Australian researchers have identified a significant defect in the cells of Gulf War participants they believe explains an array of mystery health issues that have plagued many of the veterans for decades.
The discovery, by Griffith University scientists, has given hope to the veterans that their often-debilitating symptoms will finally be recognised as Gulf War Illness by the medical profession and the Australian government.
It may also have international ramifications, with almost a million people serving in the US-led coalition of countries against Iraq in 1990-91, including more than 1,800 Australians.
Up to a third are estimated to suffer Gulf War Illness.
Australian Gulf War Veterans’ Association president Ian Allwood, a NSW police sergeant, says the research has opened up the possibility of a treatment, more than three decades after the Persian Gulf battle.
Mr Allwood, who is Newcastle-based, was only 19 when he served in the Gulf War on HMAS Darwin as an upper deck lookout, manning 50-calibre machine guns.
“I remember during the smoke oil and dust fires, at 10 o’clock in the morning, as being in absolute darkness,” he recalled.
“My eyes were watering. For years, I coughed up a mucous that tasted like smoke, oil, and dust.
“The yucky burning oil taste still comes out of my lungs if I get a knock in the chest. It’s still there.”
Mr Allwood, who took part in the Gulf War Illness study, said he gets goosebumps when he thinks about how it may help improve veterans’ lives after years of their symptoms being doubted by doctors.
“There’s nothing worse than going to a doctor and you have a symptom, or multi-symptoms, and they don’t know what’s wrong with you.
“Ultimately, it comes back to ‘well, perhaps you’re imagining those symptoms’. From a veteran’s point of view, the effect of having someone say to you that they don’t believe you, is very detrimental.
“To be believed, means the world.”
Dysfunction in ‘cell doors’
In a laboratory on the Gold Coast, the Griffith University study’s lead researcher Sonya Marshall-Gradisnik and her team have identified faulty cell function in veterans which she suspects is caused by their exposure to hazardous biological and chemical agents during their Gulf War service.
They compared the natural killer cells, a type of immune cell, in six Gulf War veterans with six healthy participants of similar age and gender in a pilot study recently published in the scientific journal, PLOS ONE.
The team has since replicated their findings in another 10 veterans.
Professor Marshall-Gradisnik, director of Griffith University’s National Centre for Neuroimmunology and Emerging Diseases (NCNED), said they found crucial dysfunction in specific ion channels on the veterans’ cells — or cellular doors that in healthy people, allow calcium to enter.
The immunologist said the doors are faulty in veterans, meaning calcium is unable to get into their cells at normal levels — explaining key symptoms of Gulf War Illness, such as fatigue, headaches, rashes, memory problems, joint and muscle pain, poor sleep, respiratory and gut issues.
“If we take, for example, brain function, where these doors are located are in specific areas of the brain that control cognition, memory, sleep, wake cycle,” Professor Marshall-Gradisnik said.
“We find in Gulf War Illness veterans they have cognitive disturbances, cognitive difficulties, as well as other difficulties in the gastrointestinal tract and cardiovascular system where these faulty doors may be located on those cells as well.”
Professor Marshall-Gradisnik said the Australian scientists are the first to identify ion channel impairment as a potential explanation for Gulf War Illness.
She said the scientists have found the same “faulty doors” in patients with long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
The specific ion channels, or faulty doors, are also known as threat receptors.
Exposure to ‘threats’ can add up
In the case of Gulf War veterans, the Griffith University scientists believe they have become overwhelmed, and damaged, by being exposed to so many threats during their Persian Gulf service, including insecticides, depleted uranium, and smoke from hundreds of oil-well fires.
Mr Allwood said the veterans were also given mandatory medicines to protect against feared nerve gas attacks and deadly diseases, such as anthrax and the black plague.
“I do remember being quite unwell,” he said.
Professor Marshall-Gradisnik suspected an individual’s genetic makeup, plus environmental exposures have combined to trigger Gulf War Illness.
“If you think of it like a seesaw, you can load up a seesaw on one end a lot and in the end, it can flip and be out of balance,” she said.
“It’s the load and the exposure of all of these threats and how they all come to converge on that individual that may then be the turning point.
“There’s potentially a real algorithm, if I can use that, to how people may have developed it versus those that did not develop it.”
Hopes study will lead to greater recognition
Australia’s Gulf War veteran community hopes the research will trigger recognition of Gulf War Illness here, including within the Repatriation Medical Authority (RMA), an independent statutory body made up of a panel of medical and scientific experts.
The RMA, which is responsible to the Minister for Veterans’ Affairs, fails to recognise the illness, saying there is insufficient evidence to designate a disease specific to the Gulf War.
Instead, the authority has accepted there is a “grouping of medically unexplained symptoms experienced by veterans of various deployments, as well as people in various civilian settings, and that these symptoms may cause significant distress and disability”.
To establish a causal link between a medical condition and military service, the Department of Veterans’ Affairs (DVA) is required to refer to determinations made by the RMA.
“Veterans and their representative organisations are entitled to request that the RMA review new evidence,” the department states.
“We encourage them to bring any new evidence to the RMA’s attention.”
The RMA’s expert members will evaluate the Griffith study at its next meeting in August.
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Calls for results to be replicated
UK-based psychiatrist Professor Simon Wessely, who was not involved in the Griffith University research, said the existence of a Gulf War “health effect” in a “substantial minority” of the veterans is not in dispute.
“We showed 25 years ago that by looking at those thousands of people that served in the Gulf, comparing them to those who’d served in other UK conflicts, or who have been in the military and not deployed, that something was different about the Gulf and it affected health.”
But he said a cause has been elusive.
While welcoming the Griffith University discovery, Professor Wessely, Regius chair of psychiatry at King’s College London, has called for much more research to replicate the findings in many more veterans with Gulf War Illness.
He said that should include a comparison with people who served in the conflict who remain well.
“I don’t think there will be that light bulb moment when suddenly all is revealed,” Professor Wessely said.
“In the meantime, we just have to help the veterans as best we can.”
University of California, San Diego professor of medicine Beatrice Golomb, who researches Gulf War Illness, said the Griffith University study is a useful addition to the literature surrounding the condition.
She said the Australian research adds to the “massive number of studies” that support environmental exposures as being tied to Gulf War Illness.
“This is a real problem, and these veterans are suffering,” she said.
“They frankly deserve acknowledgement and recognition.”
Rashes, broken sleep
Like Mr Allwood, Troy O’Keefe was still a teenager when he was deployed to the Gulf as a sailor in 1990 on HMAS Brisbane.
He spent 27 years with the Australian Defence Forces before being medically discharged, diagnosed with post-traumatic stress disorder, major depression, and anxiety.
The 51-year-old said other symptoms, such as a big, raised rash, have never been acknowledged by doctors as Gulf War Illness, but he’s convinced that is what he has.
“I can’t sleep. I can’t sleep for any longer than four hours a night. And it’s never full sleep. It’s always broken sleep,” Mr O’Keefe said.
“I get bad headaches at times, just pounding headaches. I get sick easily. If there’s a virus going around, I cop it very easily.
“But no, I have not had it recognised as Gulf War Illness because the Australian government has not recognised it as Gulf War Illness.
“It makes me feel angry, very angry. If the United States have recognised it, shouldn’t we be listening to them?”
The former sailor went to the Gulf as a quartermaster gunner and spent a lot of his waking hours at the front of the ship with a pair of binoculars, scouring the sea for mines.
“The threat was definitely there, it was never too far from the back of your mind that something could happen.
“You may hit a mine, you may get a missile from Iraq, or even from Iran, get past the other ships that were in the area.”
Treatment possible
PhD student Etianne Martini Sasso, co-lead on the Griffith University study, said the researchers are already studying potential treatments for Gulf War Illness.
“Now that we know this molecular pathway is faulty in people suffering with Gulf War Illness, we can investigate how to restore this,” she said.
“It’s opened the option of different treatments. I believe it’s a new start not just for treatment but help with ease of diagnosis.”
Clinical trials of low dose naltrexone on patients with ME/CFS and long COVID are planned after “rigorous” experiments in Queensland showed the drug can repair the “faulty doors” of their cells in the test tube.
In new laboratory experiments, the Griffith University scientists are also testing whether naltrexone, a medication used to decrease cravings in people who are alcohol dependent, and other drugs, can restore calcium ion channel function in the damaged cells of veterans with Gulf War Illness.
Queensland’s first standing sailor statute has been erected at Brisbane’s South Bank to honour the contribution of Navy personnel, such as Ian Allwood and Troy O’Keefe.
The statue features a young sailor, complete with a sea bag and bell-bottoms.
Mr O’Keefe, one of an estimated 1,600 Australian Gulf War veterans still alive, stands before the stature, an old sailor whose life has been forever changed by his service.
A group of Australian scientists may finally have explained why.