PDF(Pubmed)
Abstract：
Though it has been over 30 years since the 1990-1991 Gulf War (GW), the pathophysiology of Gulf War Illness (GWI), the complex, progressive illness affecting approximately 30% of GW Veterans, has not been fully characterized. While the symptomology of GWI is broad, many symptoms can be attributed to immune and endocrine dysfunction as these critical responses appear to be dysregulated in many GWI patients. Since such dysregulation emerges in response to immune threats or stressful situations, it is unsurprising that clinical studies suggest that GWI may present with a latent phenotype. This is most often observed in studies that include an exercise challenge during which many GWI patients experience an exacerbation of symptoms. Unfortunately, very few preclinical studies include such physiological stressors when assessing their experimental models of GWI, which creates variable results that hinder the elucidation of the mechanisms mediating GWI. Thus, the purpose of this review is to highlight the clinical and preclinical findings that investigate the inflammatory component of GWI and support the concept that GWI may be characterized as having a latent phenotype. We will mainly focus on studies assessing the progressive cognitive impairments associated with GWI and emphasize the need for physiological stressors in future work to create a more unified hypothesis that can identify potential therapeutics for this patient population.
摘要：
尽管自1990-1991海湾战争（GW）以来已有30多年了，海湾战争疾病的病理生理学（GWI），复杂的，进行性疾病影响大约30%的GW退伍军人，还没有完全描述。虽然GWI的症状很广泛，许多症状可归因于免疫和内分泌功能障碍,因为这些关键反应在许多GWI患者中似乎失调.由于这种失调是在对免疫威胁或紧张情况的反应中出现的，临床研究提示GWI可能存在潜在表型,这并不令人惊讶.这在包括运动挑战的研究中最经常观察到，在此期间许多GWI患者经历症状恶化。不幸的是,在评估GWI的实验模型时，很少有临床前研究包括这种生理应激源，这产生了可变的结果，阻碍了对介导GWI的机制的阐明。因此，这篇综述的目的是强调研究GWI炎症成分的临床和临床前发现,并支持GWI可能被表征为具有潜伏表型的概念.我们将主要关注评估与GWI相关的进行性认知障碍的研究，并强调在未来的工作中需要生理压力源，以创建一个更统一的假设，可以确定该患者人群的潜在治疗方法。
