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As Dr. Robert Haley nears his 25^th year of investigating Gulf War illness, the Chief of Epidemiology at UT Southwestern remains as optimistic and determined as ever to ultimately reveal and understand the underpinnings of the various physical and neurological manifestations that have affected more than 100,000 U.S. soldiers returned from the Gulf War. 

Since 1994, the mission for the Gulf War illness research program has been to bring the best approaches of modern medical science to bear on the neurologic illness affecting U.S. veterans of the 1991 war. Their goal is to understand the illness and develop objective diagnostic tests and treatments to cure or relieve its symptoms and disability. Integral to the mission has been to adapt the latest medical technology and to invent new theory and technology necessary to gain novel insights into a most complex and difficult-to-study brain illness. 

Investigations have unfolded in a series of nine phases, each building on the findings of the previous phases, an approach that has led to a gradual peeling back of the mystery that initially enshrouded the illness and promises to create understanding of it as a chronic neurotoxic encephalopathy with an accepted diagnostic test and treatment.  

“Throughout our work, our success has been largely due to a wide array of research collaborators here at UT Southwestern. Our current genomic studies are being done in collaboration with the Genomics and Microarray Core under Drs. Quan-Zhen Li and Ward Wakeland,” Dr. Haley said. “On other fronts, we are providing research subjects and materials for studies of brain neuroinflammation at Johns Hopkins Neuroimaging Center; treatment with transcranial magnetic stimulation at UT Dallas; and additional genomic and epigenetic studies at the University of Florida.” 

Dr. Li is an Associate Professor of Immunology and Internal Medicine. Dr. Wakeland is Director of the Genomics and Microarray Core facility and a Professor of Immunology. 

Dr. Haley considers the next step to secure the support needed to investigate a potential blood test to better reveal those affected.  

In previous studies funded by the Department of Veterans Affairs, researchers collected and preserved blood and DNA samples from a representative sample (2,100 veterans in all) of the 1991 U.S military population.  

“We want to test the DNA samples for evidence of damage from chemical exposures known to have occurred in the 1991 Gulf War,” he said. “The latest genomic technology allows us to test for damage indicated by abnormal methyl groups attached to the DNA, a toxic process called DNA methylation.” 

Finding a unique pattern of methylation in the ill veterans would provide a powerful diagnostic test for this condition and identify the damaged metabolic pathways that underlie the symptoms of Gulf War illness. 

“These findings could lead to important advances in both diagnosis and treatment,” said Dr. Haley, a Professor of Internal Medicine who embarked on this mission in 1994. 

“We also are now bringing back the cases and controls from all our past studies to obtain RNA and DNA to look for evidence of how sarin nerve gas altered gene function to produce the crippling symptoms of Gulf War illness. We developed laboratory protocol to stimulate portions of the cells with different drugs to bring out the abnormal gene functions which we test by measuring over 100,000 RNA levels.” 

Findings from this research provide hints at the next likely compass point to follow. 

“All our future research directions will turn entirely on what we find in the current wave of studies,” Dr. Haley said. “We hope that the next phase will help lead us to developing and evaluating a blood test and treatment for Gulf War illness. But if the present studies prove negative, we will analyze the findings carefully for clues to greater success in the next phase.”