Intestinal Hyperpermeability in Gulf War Veterans With Chronic Gastrointestinal Symptoms.
Intestinal Hyperpermeability in Gulf War Veterans With Chronic Gastrointestinal Symptoms.
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DOI：
10.1097/mcg.0000000000001135
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发表时间：
2019-08
影响因子：
2.9
通讯作者：
Zhou Q
中科院分区：
文献类型：
--
作者：
Zhang B;Verne ML;Fields JZ;Verne GN;Zhou Q
70多万美国军事人员参加了波斯湾战争，他们在战争中患上了病因不明的慢性健康疾病。多达25%的退伍军人有持续和慢性胃肠道症状，他们怀疑这与他们在海湾的军事服务有关。当前研究的总体目的是评估在波斯湾服役期间出现慢性胃肠道症状的海湾战争退伍军人的肠道通透性。方法：为了实现这一目标，我们使用尿乳果糖/甘露醇试验来评估肠道通透性（IP）。然后将肠通透性的测量结果与所有退伍军人的每日腹痛、排便频率和布里斯托大便量表中排便一致性的平均评分相关联。共有73名退伍军人有慢性胃肠道症状（腹泻、腹痛），并被纳入研究。共有29/73（39%）退伍军人的IP值升高，平均日排便次数增加（p<0.05）；布里斯托大便评分升高表明患者液便增多（p<0.01）；M-VAS腹痛评分较高（p<0.01）。Pearson相关系数显示，IP增加与大便频率、Bristol大便量表和M-VAS腹痛评分呈正相关。我们的研究表明，有持续胃肠道症状的海湾战争退伍军人通常有肠道通透性增加，这加剧了腹痛、腹泻和大便粘稠度的严重程度。我们研究中的这些新发现很重要，因为它们可能会为患有慢性功能性胃肠道疾病的海湾战争退伍军人提供新的诊断生物标志物。这些进步对于现在在波斯湾服役的越来越多的退伍军人来说也很重要，他们患这些慢性疼痛疾病的风险很高。
Well over 700,000 United States military personnel participated in the Persian Gulf War in which they developed chronic health disorders of undetermined etiology. Up to 25% of Veterans had persistent and chronic GI symptoms, which they suspected were related to their military service in the Gulf. The overall aim of the current study was to evaluate intestinal permeability in previously deployed Gulf War Veterans who developed chronic GI symptoms during their tour in the Persian Gulf. Methods: To accomplish this, we evaluated intestinal permeability (IP) using the urinary lactulose/mannitol test. Measurements of intestinal permeability were then correlated with mean ratings of daily abdominal pain, frequency of bowel movements, and consistency of bowel movements on the Bristol Stool Scale in all Veterans. A total of 73 veterans had documented chronic GI symptoms (diarrhea, abdominal pain) and were included in the study. A total of 29/73 (39%) of veterans has increased IP and had a higher average daily stool frequency (p<0.05); increased liquid stools as indicated by a higher Bristol Stool Scale (p<0.01); and a higher mean M-VAS abdominal pain rating (p<0.01). Pearson correlation coefficients revealed that there was a positive correlation between increased IP and stool frequency, Bristol Stool Scale, and M-VAS abdominal pain rating. Our study demonstrates that deployed Gulf War Veterans with persistent GI symptoms commonly have increased intestinal permeability that potentiates the severity of abdominal pain, diarrhea, and stool consistency. These new findings in our study are important as they may lead to novel diagnostic biomarkers for returning Gulf War Veterans who suffer from chronic functional gastrointestinal disorders. These advances are also important for an increasing number of veterans who are now serving in the Persian Gulf and are at a high risk of developing these chronic pain disorders.