Posted November 11, 2021

The Gulf War Illness Research Program (GWIRP) awarded two major projects to the Boston University School of Public Health and Principal Investigator Kimberly Sullivan, Ph.D. Recently, both projects issued new publications, one of which reports a clinical assessment of ill Gulf War Veterans from a large cohort, while the other describes a resource to benefit the Gulf War illness (GWI) research community.

In fiscal year 2012 (FY12), the GWIRP funded the multidisciplinary, multi-institutional Gulf War Illness Consortium (GWIC) to consolidate resources around the concept of brain-immune interactions as a basis for GWI pathobiology. The core of the GWIC was a case-control clinical study that assessed 269 Gulf War Veterans through clinical sampling, neuropsychological testing, and brain imaging. Data were collected at three clinical sites – Boston University, the Miami Department of Veterans Affairs (VA) Medical Center, and Baylor College of Medicine in Houston – between 2015 and 2020. After a screening interview, participants were administered neuropsychological assessments including executive system functioning, attention, motor function, memory, mood, and motivation, followed by a clinical psychiatric interview. In addition, at the Boston and Houston sites, study participants with no safety contraindications received a magnetic resonance imaging scan of the brain. A descriptive assessment of the cohort was recently reported in the journal Brain Sciences and found that GWI cases (223) were similar to controls (46) on most demographic, military, and deployment characteristics, although on average were 2 years younger, with a higher proportion of enlisted personnel versus officers. Veterans with GWI scored significantly worse than controls on standardized assessments of general health, pain, fatigue, and sleep quality and had higher rates of diagnosed conditions that included hypertension, respiratory and sinus conditions, gastrointestinal conditions, and depression or post-traumatic stress disorder. The study identified two significant risk factors for developing GWI – extended use of skin pesticides in theater and experiencing mild traumatic brain injury during deployment. Gulf War experiences associated with intense stress or trauma (e.g., participation in ground combat) were not found to be associated with developing GWI. Future reports will present detailed findings on brain structure and function, immune function, and association of neuroimmune measures with characteristics of GWI and Gulf War service.

Recognizing the volume of biological samples and clinical data collected under GWIRP-funded studies and a need for a widely accessible biorepository resource, the GWIRP offered the Biorepository Resource Network Award in FY17. Through this award, Boston University School of Public Health received funding to establish the Boston Biorepository, Recruitment, and Integrative Network (BBRAIN) to centralize holding, cataloguing, and coordination of retrospective and prospective biological samples, specimens, and data related to human GWI research studies. The primary objective of BBRAIN is to establish a biorepository network from existing BBRAIN collaborators’ stored specimens, cognitive data, and brain imaging data. Common data element datasets from these studies are also being recommended to improve power for new analyses. An additional research goal of the BBRAIN is to energize diagnostic biomarker development for GWI and validate prior results in well-characterized cohorts. For this goal, the network is performing an ongoing prospective study of 300 GWI cases and 200 Gulf War Veteran controls as well as comparisons of biospecimens and data from previous studies. Recruitment sites include the Miami VA Medical Center and Nova Southeastern University in Florida, the Bronx VA Medical Center in New York, and the San Francisco VA Medical Center as part of the BBRAIN network. A recent publication in Life Sciences describes recent activities of the BBRAIN including the merging of multiple datasets, collation of data and samples, and creation of common data elements. Data and biospecimens are made available to the research community through an online request reviewed by the BBRAIN steering committee members. Dr. Kimberly Sullivan and the other authors of the publication state that “[t]he BBRAIN repository network serves as a much needed resource for GWI researchers to utilize for identification and validation of objective diagnostic and pathobiological markers of the illness.”

References:

• Steele L, Klimas N, Krengel M, Quinn E, Toomey R, Little D, Abreu M, Aenlle K, Killiany R, Koo BB, Janulewicz P, Heeren T, Clark AN, Ajama J, Cirillo J, Buentello G, Lerma V, Coller JK, Sullivan K. Brain-immune interactions as the basis of Gulf War Illness: Clinical assessment and deployment profile of 1990-1991 Gulf War Veterans in the Gulf War Illness Consortium (GWIC) multisite case-control study. 2021 Brain Sci 11(9):1132. doi: 10.3390/brainsci11091132. PMID: 34573153.
• Keating D, Zundel CG, Abreu M, Krengel M, Aenlle K, Nichols MD, Toomey R, Chao LL, Golier J, Abdullah L, Quinn E, Heeren T, Groh JR, Koo BB, Killiany R, Loggia ML, Younger J, Baraniuk J, Janulewicz P, Ajama J, Quay M, Baas PW, Qiang L, Conboy L, Kokkotou E, O'Callaghan JP, Steele L, Klimas N, Sullivan K. Boston Biorepository, Recruitment and Integrative Network (BBRAIN): A resource for the Gulf War Illness scientific community. 2021 Life Sci 284:119903. doi: 10.1016/j.lfs.2021.119903. PMID: 34453948.

Links:

• https://sites.bu.edu/bbrain/
• Public and Technical Abstracts: Brain Immune Interactions as the Basis of Gulf War Illness: Gulf War Illness Consortium (GWIC)
• Public and Technical Abstracts: Boston Biorepository, Recruitment, and Integrative Network (BBRAIN) for GWI

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