ReviewInternational journal of environmental research and public health2019
Gulf War Illness: Unifying Hypothesis for a Continuing Health Problem.
Review in International journal of environmental research and public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 57 citations in OpenAlex.
- A Placebo-Controlled, Pseudo-Randomized, Crossover Trial of Botanical Agents for Gulf War Illness: Reishi Mushroom (International journal of environmental research and public health · 2021Trial
- A Placebo-Controlled, Pseudo-Randomized, Crossover Trial of Botanical Agents for Gulf War Illness: Curcumin (International journal of environmental research and public health · 2021Trial
- The Association Between Self-Reported Types of Toxic Exposures and Symptom Severity Among Gulf War Era Veterans.Medical care · 2026Article
- Persistent enteric neuroinflammation chronically impairs colonic motility in a pyridostigmine bromide-induced mouse model of Gulf War illness.Biology open · 2025Article
- Gulf War Illness Is Associated with Host Gut Microbiome Dysbiosis and Is Linked to Altered Species Abundance in Veterans from the BBRAIN Cohort.International journal of environmental research and public health · 2024Article
- Biomarkers Associated with Depression Improvement in Veterans with Gulf War Illness Using the Low-Glutamate Diet.Nutrients · 2024Article
- Crisis in the gut: navigating gastrointestinal challenges in Gulf War Illness with bioengineering.Military Medical Research · 2024Review
- Exposure to Gulf war illness-related chemicals exacerbates alcohol-induced liver damage in rodents.Scientific reports · 2024Article
- Curcumin as a Multifunctional Spice Ingredient against Mental Disorders in Humans: Current Clinical Studies and Bioavailability Concerns.Life (Basel, Switzerland) · 2024Review
- Migraine Prevalence, Environmental Risk, and Comorbidities in Men and Women Veterans.JAMA network open · 2024Article
- Exposure to Gulf war illness-related chemicals exacerbates alcohol- induced liver damage in rodents.Research square · 2024Article
- Exposing the latent phenotype of Gulf War Illness: examination of the mechanistic mediators of cognitive dysfunction.Frontiers in immunology · 2024Review
- Delayed cognitive impairments in a rat model of Gulf War Illness are stimulus-dependent.Brain, behavior, and immunity · 2023Article
- Dysbiosis in gastrointestinal pathophysiology: Role of the gut microbiome in Gulf War Illness.Journal of cellular and molecular medicine · 2023Review
- Association of Gulf War Illness with Characteristics in Deployed vs. Non-Deployed Gulf War Era Veterans in the Cooperative Studies Program 2006/Million Veteran Program 029 Cohort: A Cross-Sectional Analysis.International journal of environmental research and public health · 2022Article
- Complementary/integrative healthcare utilization in US Gulf-War era veterans: Descriptive analyses based on deployment history, combat exposure, and Gulf War Illness.Complementary therapies in clinical practice · 2022Article
- Low glutamate diet improves working memory and contributes to altering BOLD response and functional connectivity within working memory networks in Gulf War Illness.Scientific reports · 2022Article
- Emerging Role of Nicotinamide Riboside in Health and Diseases.Nutrients · 2022Review
- The impact of post-traumatic stress on quality of life and fatigue in women with Gulf War Illness.BMC psychology · 2022Article
- Persistent exercise fatigue and associative learning deficits in combination with transient glucose dyshomeostasis in a mouse model of Gulf War Illness.Life sciences · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
An estimated 25%⁻32% of veterans of the 1991 Gulf War continue to experience multiple unexplained health problems known as Gulf War Illness (GWI). GWI encompasses chronic pain, musculoskeletal weakness, headache, fatigue, cognitive deficits, alterations in mood, and numerous multi-system complaints. Most potential exposures implicated in GWI were not well documented but included varying levels of several neurotoxicants as well as the anticholinergic drug pyridostigmine bromide (PB), which was routinely taken as prophylaxis against the nerve agent soman. While some veterans also took chloroquine as an antimalarial agent, the literature suggests an association between receipt of multiple vaccinations prior to or during the conflict (perhaps combined with other exposures), and GWI. In-theater exposures may account for any single individual veteran's ill health but many veterans of the same era who were not deployed overseas also suffer the same or similar symptoms. The features of GWI also overlap with those of fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity, in all of which liver dysfunction has been documented, suggesting a unifying hypothesis. It is proposed that multiple vaccinations, with concurrent or subsequent exposure to PB or additional chemical insults of a liver-damaging nature, plausibly explain the pathogenesis and the observed chronicity of GWI. The suggested mechanism for GWI is thus a chemically-induced impaired liver function, with the spillage of stored vitamin A compounds ("retinoids") into the circulation in toxic concentrations, resulting in an endogenous chronic form of hypervitaminosis A. Implications of the hypothesis are briefly reviewed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.