J Neurol Surg B Skull Base 2025; 86(S 01): S1-S576
DOI: 10.1055/s-0045-1803585
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Analysis of Inflammatory Cytokine Levels in Sinonasal Secretions of Gulf War Veterans with and without Gulf War Illness

Authors

  • Jivianne T. Lee

    1   University of California, Los Angeles, California, United States

  • Nancy Klimas

    2   Miami Veterans Affairs Medical Center, Miami, Florida, United States

  • Bhavani Shankara Gowda

    3   Greater Los Angeles Veterans Affairs Healthcare Administration, Los Angeles, California, United States

  • Saroj B. Basak

    3   Greater Los Angeles Veterans Affairs Healthcare Administration, Los Angeles, California, United States

  • Eri Srivatsan

    1   University of California, Los Angeles, California, United States

  • Monica Cappelletti

    1   University of California, Los Angeles, California, United States

  • Kimberly Sullivan

    4   Boston University, Boston, Massachusetts, United States
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Background: Gulf war illness (GWI) is a chronic, multisystemic disease that has been reported to impact one third of Veterans from the Persian Gulf War (1990–1991). Symptoms of chronic rhinosinusitis (CRS), including nasal congestion and fatigue, have been identified as the 1st (47%) and 3rd (41%) most common complaints associated with GWI. Although the precise etiology is unknown, chronic inflammation has been postulated to contribute to its pathogenesis.

Objective: The purpose of this study was to compare inflammatory cytokine levels of sinonasal secretions from Gulf War Veterans with and without GWI associated CRS.

Methods: Sinonasal secretions were collected from 13 GWV with associated GWI CRS, 11 GWV without GWI, 4 patients without GW exposures but with CRS, and 4 patients without GW exposures or CRS. The Luminex 38-plex assay was performed for chemokine/cytokine analysis and levels compared among the various groups.

Results: Significantly higher levels of the proinflammatory cytokines gamma-IFN, IL-4, IL-5, IL-7, IL-10, IL-12, IL-13, IL-15, IL-17F, IL-22, TNFb, MIG/CXCL9, and IP-10 in GWV with GWI versus GWV without GWI (p ≤ 0.05). In addition, when comparing GWV with GWI associated CRS to non-GWV with CRS, there were significantly higher levels of MCP1, IL-4, IL-10, IL-17F, IL-22, TNFb, M-CSF, and IP-10 in GWI patients. These findings indicate that GWI associated CRS is characterized by a more severe inflammatory response than what could be attributed to CRS alone. Furthermore, when comparing non-GWV without CRS to GWV without GWI/CRS, GWV had significantly higher IL-10 but lower M-CSF levels (p < 0.05). These findings suggest that GW exposures alone may alter the sinonasal milieu even without manifestation of GWI .

Conclusion: To the best of our knowledge, this pilot study is the first to demonstrate differences in inflammatory signatures of the sinonasal milieu in GWV with and without GWI, and is consistent with the hypothesis that chronic inflammation contributes to the underlying pathophysiology of GWI.


No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025

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