|SUMMARY OF PERSIAN GULF WAR ILLNESS PILOT STUDY ON
MYCOPLASMAL INFECTIONS IN VETERANS AND FAMILY MEMBERS
Garth L. Nicolson, Ph.D. and Nancy L. Nicolson, Ph.D.
The Institute for Molecular Medicine, 15162 Triton Lane, Huntington Beach, California 92649-1041
Approximately 50,000-100,000 U.S. and ~3,500 British soldiers returned from Operation Desert Storm with unusual illnesses characterized by a variety of chronic signs and symptoms. Our step-daughter was one of these soldiers. Since we had some experience with a disease that caused similar complex signs and symptoms, we proposed that the Desert Storm or Persian Gulf War Illness (GWI) might be caused by a severe mycoplasmal infection and that it should be treatable with appropriate antibiotics. We conducted a pilot study of Desert Storm veterans and their families for the presence of unusual mycoplasmal infections. This study showed that 55/73 GWI patients, including symptomatic family members, responded to an antibiotic (doxycycline) that is effective against a variety of mycoplasmas, and these soldiers and their family members who were sick with the same symptoms eventually recovered from their illness (Nicolson, G.L. and Nicolson, N.L. Doxycycline treatment and Desert Storm J. Amer. Med. Assoc. 273: 618-619, 1995). Since this study we have continued to gather evidence that mycoplasmal infections, and probably other chronic infectious agents, are causing the chronic signs and symptomsof GWI that are similar to Chronic Fatigue Syndrome (Nicolson, G.L. and Nicolson, N.L. Chronic fatigue illness and Operation Desert Storm. J. Occup. Environ. Med. 38: 14-16, 1996).
Mycoplasmas are microorganisms whose genetic complexity and classification are similar to bacteria. These microorganisms are usually indolent in normal healthy individuals and are not often associated with severe diseases. In fact, most adults may have had mycoplasmal pneumonia or a urogenital tract infection caused by mycoplasmas. The mycoplasmas we have found in a sizable fraction of the Gulf War Illness patients are unlikely to be naturally occurring and could be Biological Weapons. We have based this notion on the observation that the mycoplasmas that we have found in clinical blood samples from Desert Storm veterans contain unusual DNA sequences that they probably did not obtain in the wild. For example, we have detected mycoplasma DNA sequences from Mycoplasma fermentans (incognitus strain) and a few soldiers with modified Mycoplasma genitalium in veterans and their family members with GWI as well as the HIV-1 envelope or env gene. The former type of mycoplasma was studied by Dr. Shyh Lo, formerly of Tanox Biosystems, a spin-off biotechnology company from the Baylor College of Medicine, but now affiliated with the Armed Forces Institute of Pathology in Washington, DC. Two points need to be clarified regarding our identification of HIV-1 genes and mycoplasma sequences in the soldiers and symptomatic family members that have GWI:
1. We detected HIV-1 genes in the same nucleoprotein fractions as the mycoplasma genes but we did not detect the complete HIV-1 virus genome. Thus these patients do not have the complete HIV-1 virus that is associated with AIDS. This virus must contain the entire HIV-1 genome to replicate.
2. We observed a very small subset of soldiers who had another gene sequence, the HIV-1 polymerase gene. Thus GWI patients contain individual genes of the HIV-1 virus genome but not the complete virus.
What this might mean:
1. Mycoplasmas possessing the HIV-1 env gene could allegedly have been engineered to make them more invasive and pathogenic and more difficult to find. The HIV-1 env gene encodes a surface glycoprotein, gp120, that is involved in virus attachment and entry into cells through receptors on the cell surface. This could result in opportunistic cell attachment and penetration of many types of cells and most tissues.
2. It is unlikely that our experiments are incorrectly detecting these unusual genes in biological samples. We used highly specific oligonucleotide probes for our studies. The probes are themselves unique complimentary DNA sequences and are analogous to probes used in studies called DNA hybridization analyses. Such techniques are well accepted in the forensic field. If the DNA sequence from a particular infectious agent is present, we can specifically identify its presence. Since the DNA probe is radiolabeled, it will interlock with a specific DNA sequence from the infectious agent to produce a radioactive signal (if the infectious DNA sequence is present). In our case the agent DNA is detected in cell nuclear fractions, and we detect the radioactive signal by X-ray autoradiography using Nucleoprotein Gene Tracking (Nicolson, N.L. and Nicolson, G.L. The isolation, purification and analysis of specific gene-containing nucleoproteins and nucleoprotein complexes. Methods Mol. Genetics 5: 281-298, 1994).
In our ongoing studies involving several thousand Desert Storm Veterans and their families, we have detected a preliminary pattern that may be associated with unit deployment. Approximately one-half of the American soldiers involved in the deep insertions into Iraq--such as the US Army's 101st Airborne Division and 5th Special Forces Group that are suffering from GWI and Chronic Fatigue Symptoms--were positive for mycoplasmal infections, and most have the Mycoplasma fermentans (incognitus strain) as well as HIV-1 env gene sequences. A pilot study on the diagnosis and treatment of 30 Gulf War Illness patients has now been published in an international peer-reviewed medical journal (Nicolson, G.L. and Nicolson, N.L. Diagnosis and treatment of mycoplasmal infections in Persian Gulf War Illness-CFIDS patients. Int. J. Occup. Med. Immunol. Tox. 5: 69-78, 1996). In this study almost all GWI patients recovered after multiple (3-7) cycles of antibiotic therapy. Although they are probably not cured of the infection, they are able to perform normal functions such as fulfilling normal employment duties.
There are additional points that require some explanation:
1. One could be suffering severely from this type of mycoplasmal infection and less sensitive tests, such as antibody tests, could be negative. Since the mycoplasma that we have detected is present deep inside the cell, the usual antibody tests for extracellular mycoplasmas may be relatively useless.
2. The most sensitive type of DNA test, the polymerase chain reaction (PCR) technique, could also prove negative in an infected individual, because the DNA chains of the invading mycoplasma may be be tightly complexed with nucleoproteins and might not be accessible for the PCR reaction.
3. Gulf War Illness appears to be a collection of illnesses produced as a result of multiple chemical and biological exposures from endogenous and exogenous sources such as Chemical/Biological Weapons (CBW).
The Iraqi Armed Forces deployed CBW to forward positions and were operating under the concept of Integrated War Strategy, a Soviet war doctrine that proposes use of mixtures of Chemical and Biological Weapons to confuse diagnosis and treatment. Some soldiers from the Gulf War were probably exposed to endogenous and exogenous chemicals, such as smoke, fuel, insecticides, etc., and have Multiple Chemical Sensitivity Syndrome (MCS) induced by exposure to various chemical agents, some may have been exposed to CBW, or both.
The hypothetical dissemination and exposure to Biological and Chemical agents could have been accomplished by the following possible means:
In our Testimony to the U.S. Congress (April 4, 1996) we listed some possible ways that soldiers could have exposed to Chemical/Biological Weapons in Desert Storm:
1. Bombing of targets in Iraq thought to be Chemical/Biological Weapons facilities. This caused plumes of smoke that could have transported CBW down wind into our lines. Improper fluids and procedures for aircraft decontamination and failure to decontaminate other vehicles returning from various operations could have resulted in exposure.
2. Exposure to SCUD B (SS-1) skyburst warheads equipped to deliver CBW. There were several types of SCUD warheads used in the conflict, and there were many eyewitness accounts of the skyburst type that are usually used for CBW exploding over Saudi and Western Kuwait.
3. Exclusionary zones may have been created with CBW agents. Military Intelligence units reported that some areas of Southern Iraq contained posted zones where nothing was alive (dead animals, humans, etc.). These could have been created by spraying CBW agents on the sand.
4. The vaccines used before Desert Storm have come into question, because some soldiers who were not deployed came down with Gulf War Illness. (But some soldiers who were deployed and civilians who did not receive vaccines have also come down with Gulf War Illness). Vaccine contamination, although uncommon, can occur, and some individuals may have obtained their infections by this route.
We have concentrated on the chronic illnesses associated with Desert Storm, especially those involving immediate family members who also became ill. That some Gulf War Illness patients with immediate family members who have become sick with similar chronic signs and symptoms indicates that these diseases are similar and are contagious. In addition, these infectious diseases may have been transmitted to some unborn children, and this could explain along with chemical exposures the higher apparent rates of infantile death and birth defects in Gulf War Illness families.
For your information, we have also been studying personnel working in the Texas Department of Criminal Justice (TDCJ) who presented with an array of signs and symptoms that are, as assessed by environmental physicians, identical to Gulf War Illness. These individuals were tested (like the Desert Storm veterans) using Nucleoprotein Gene Tracking. Preliminary results parallel our observations in Desert Storm veterans and suggest that these illnesses were present in the U.S. before the Gulf War. We strongly suspect that TDCJ prisoners were illegally used in Biological Weapons testing. Thus the modified mycoplasmas detected in Gulf War Veterans may have their origin in the U.S. It is interesting that before Desert Storm some Texas biotechnology companies were developing vaccines (apparently under U.S. Army contracts) and testing them in TDCJ prisons.
If detected early, the diseases associated with invasive mycoplasmal infections are treatable with multiple cycles of antibiotics, but the confusing panorama of signs and symptoms, and current political policies make it extremely difficult to help veterans and their families. We have relayed the above information to the Israeli, Syrian, Pakistani, Iraqi, Egyptian, Turkish and French governments and their Armed Forces, and anyone else who has asked us for assistance. Some officials associated with the governments above have thanked us, but have also told us that their hands were diplomatically tied in publicly discussing this issue. The manufacture, sale, deployment and use of Biological Weapons were theoretically rendered illegal by the 1972 Geneva Convention. Certain governments, however, have flaunted these international agreements and have participated in atrocious human experimentation for decades. In the U.S. this build-up began as early as 1980, and its expansion was proposed in a 180 page secret report by CIA Director John Deutsch when he was an Undersecretary of Defense. The impact of Gulf War Illness on our societies will probably take decades to assess. Biological Weapons are uncontrollable, and if we don't quickly identify and effectively treat these infections, they will continue to spread in the military and civilian populations.
Garth L. Nicolson, Ph.D.
Director and Research Professor
Institute for Molecular Medicine and Office Address:
Professor of Pathology and Laboratory Medicine 16371 Gothard St. H, Huntington Beach, CA 92647
Professor of Internal Medicine
The University of Texas Medical School at Houston Direct Phone: (714) 596-6636
Nancy L. Nicolson, Ph.D.
CEO, Institute for Molecular Medicine