A review of chemical warfare agents linked to respiratory and neurological effects experienced in Gulf War Illness

AbstractAbstractOver 40% of veterans from the Persian Gulf War (GW) (1990–1991) suffer from Gulf War Illness (GWI). Thirty years since the GW, the exposure and mechanism contributing to GWI remain unclear. One possible exposure that has been attributed to GWI are chemical warfare agents (CWAs). While there are treatments for isolated symptoms of GWI, the number of respiratory and cognitive/neurological issues continues to rise with minimum treatment options. This issue does not only affect veterans of the GW, importantly these chronic multisymptom illnesses (CMIs) are also growing amongst veterans who have served in the Afghanistan-Iraq war. What both wars have in common are their regions and inhaled exposures. In this review, we will describe the CWA exposures, such as sarin, cyclosarin, and mustard gas in both wars and discuss the various respiratory and neurocognitive issues experienced by veterans. We will bridge the respiratory and neurological symptoms experienced to the various potential mechanisms described for each CWA provided with the most up-to-date models and hypotheses.Keywords: Chemical warfare agentssarincyclosarinsulfur mustardGulf War Illnesschronic multisymptom illnessrespiratoryneurological effectsorganophosphorus compoundsnitrogen mustardCEES Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingThis research was supported by the National Institute of Environmental Health Sciences R01 ES019311S1, T32 ES029074, and U.S. Army Medical Research Grant W81XWH1810169 and Department of Biotechnology, Ministry of Science and Technology.