The Department of Veterans Affairs(VA) maintains some large automated databases that provide the opportunity for studying long-term health effects of military service. The Beneficiary Identification and Record Locator Subsystem(BIRLS) is an excellent source of vital status information on veterans. The VA Patient Treatment File(PTF) is a computerized hospital discharge abstract system of inpatient records, including patients' demographic data, surgical and procedural transactions, and patient movements and diagnosis. The computerized Agent Orange Registry data include veteran's name, address, some information on military service, and findings at the time of his physical examination. The US conducted 235 atmospheric nuclear tests from 1945 through 1962. Many of the 250,000 test participants were exposed to low levels of radiation. The overall average radiation dose was estimated as 0.6 rem per year. In 1976, a claim relating acute myelocytic leukemia to radiation exposure from nuclear weapon testing received extensive publicity. Several thousand "atomic veterans" have sought medical care and compensation from VA for medical conditions that they believe are related to the nuclear weapon testing. Many WWII veterans have contracted the US VA about health problems that they attribute to their exposure to mustard gas. From 1962 to 1971, 75 million liters of herbicides, including over 41 million liters of the phenoxy herbicide Agent Orange, were sprayed on almost 9% of Vietnam. Many studies have been conducted to determine the association of various cancers with military service in Vietnam. Some diseases have been compensated for Vietnam veterans. Health problems reported following the Gulf War include a wide variety of symptoms similar to those found in acute combat reaction, posttraumatic stress disorder, and chronic fatigue. Health problems associated with war have continued and in some ways intensified. Therefore, The United States developed a plan for establishing a national center for the study of war-related illnesses and post-deployment health issues.
Americas* ; Citrus sinensis ; Compensation and Redress ; Diagnosis ; Fatigue ; Gulf War ; Herbicides ; Humans ; Inpatients ; Leukemia, Myeloid, Acute ; Military Personnel ; Mustard Gas ; Nuclear Weapons ; Persian Gulf Syndrome ; Physical Examination ; Stress Disorders, Post-Traumatic ; United States* ; Veterans* ; Vietnam

INTRODUCTIONDuring the Arabian Gulf Wars of 1991 and 2003, the resident population of Kuwait sustained heavy exposure to environmental toxicants introduced by military activities. No comprehensive studies have been conducted to assess how exposure to the wartime and postwar environment may have altered the fundamental patterns of immune reactivity among Kuwaitis in ways that affect pathogenesis of disease. This present study addresses this issue by characterising immunological features of asthma and allergies in a Kuwaiti population that is unique and possibly correlates with toxicant exposures.

MATERIALS AND METHODSTwenty-fi ve long-term residents of Kuwait afflicted with bronchial asthma concurrent with rhinitis; and 2 healthy control groups: 18 long-term residents and 10 newcomers to Kuwait were evaluated by 2- and 3-colour fl ow cytometry for peripheral blood T cell subpopulation frequencies.

RESULTSRelative to healthy, long-term residents, significantly elevated frequencies of all activated cell phenotypes were observed in the blood of the asthmatic group (P <0.05 to P <0.001), except for CD8+HLA-DR+ cells and a presumed T-regulatory (Treg) subpopulation: CD4+CD25(high). The asthmatic group was also observed to have larger populations of CD3+ (pan-T cells), CD4+ (T helper cells) and CD8+ (cytotoxic T cells), CD3+CD56 (NKT-like cells) and CD56+CD16+ (NK cells) compared to healthy long-term residents. Compared to healthy recent immigrants, the blood of long-term residents contained elevated levels of CD3+CD56+ (NK-like), CD4+CD45RA+/ CD45RO+ (Naive-to-Memory Transitional), but lower CD4+CD25+(high) (Treg) (P <0.05).

CONCLUSIONSElevated representation of natural killer (NKT)-like and memory phenotypes may predispose long-term residents towards enhanced susceptibility for airway disease; while at the same time, reducing representation of Treg cells which are protective against airway disease, and this may increase vulnerability to these syndromes among the residents of Kuwait. These results may provide insight into the features of immunopathogenesis of asthma and allergies in Kuwait that arise as a result of the special environment of the country.

Adolescent ; Adult ; Asthma ; blood ; immunology ; CD3 Complex ; CD4 Lymphocyte Count ; CD56 Antigen ; CD8-Positive T-Lymphocytes ; Environmental Exposure ; adverse effects ; Female ; Gulf War ; Humans ; Iraq War, 2003-2011 ; Killer Cells, Natural ; Kuwait ; Lymphocyte Activation ; immunology ; Male ; Rhinitis ; blood ; immunology ; Risk Factors ; T-Lymphocytes ; immunology ; Time Factors ; Young Adult