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患有海湾战争病和胃肠道症状的退伍军人存在躯体敏感性的证据。

Evidence for Somatic Hypersensitivity in Veterans With Gulf War Illness and Gastrointestinal Symptoms.

机构信息

Department of Medicine, Tulane University School of Medicine.

Department of Veterans Affairs, Malcom Randall VAMC, Gainesville, FL.

出版信息

Clin J Pain. 2018 Oct;34(10):944-949. doi: 10.1097/AJP.0000000000000611.

DOI:10.1097/AJP.0000000000000611
PMID:29570102
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6110965/
Abstract

INTRODUCTION

Over 25% of Persian Gulf War (PGW) veterans with Gulf War Illness (GWI) (chronic health symptoms of undetermined etiology) developed gastrointestinal (GI) (diarrhea and abdominal pain) and other somatic symptoms.

OBJECTIVES

Our study objective was to determine if veterans with GWI and GI symptoms exhibit heightened patterns of somatic pain perception (hypersensitivity) across nociceptive stimuli modalities.

METHODS

Participants were previously deployed GW Veterans with GWI and GI symptoms (n=53); veterans with GWI without GI symptom (n=47); and veteran controls (n=38). We determined pain thresholds for contact thermal, cold pressor, and ischemic stimuli.

RESULTS

Veterans with GWI and GI symptoms showed lower pain thresholds (P<0.001) for each stimulus. There was also overlap of somatic hypersensitivities among veterans with GI symptoms with 20% having hypersensitivity to all 3 somatic stimuli. Veterans with GWI and GI symptoms also showed a significant correlation between mechanical visual analog scale abdominal pain ratings and heat pain threshold, cold pressor threshold, and ischemic pain threshold/tolerance.

DISCUSSION

Our findings show that there is widespread somatic hypersensitivity in veterans with GWI/GI symptoms that is positively correlated with abdominal pain ratings. In addition, veterans with somatic hypersensitivity that overlap have the greatest number of extraintestinal symptoms. These findings may have a translational benefit: strategies for developing more effective therapeutic agents that can reduce and/or prevent somatic and GI symptoms in veterans deployed to future military conflicts.

摘要

简介

超过 25%的患有海湾战争综合征（GWI）（病因不明的慢性健康症状）的波斯湾战争（PGW）退伍军人出现胃肠道（GI）（腹泻和腹痛）和其他躯体症状。

目的

我们的研究目的是确定是否患有 GWI 和 GI 症状的退伍军人对各种伤害性刺激模式表现出更高程度的躯体疼痛感知（敏感性）。

方法

参与者是先前部署过海湾战争的患有 GWI 和 GI 症状的退伍军人（n=53）；患有 GWI 但无 GI 症状的退伍军人（n=47）；和退伍军人对照组（n=38）。我们确定了接触热、冷压和缺血性刺激的疼痛阈值。

结果

患有 GWI 和 GI 症状的退伍军人对每种刺激的疼痛阈值都较低（P<0.001）。GI 症状退伍军人之间也存在躯体超敏反应的重叠，有 20%的人对所有 3 种躯体刺激都有超敏反应。患有 GWI 和 GI 症状的退伍军人的机械视觉模拟量表腹部疼痛评分与热痛阈值、冷压阈值和缺血性疼痛阈值/耐受力之间也存在显著相关性。

讨论

我们的发现表明，患有 GWI/GI 症状的退伍军人存在广泛的躯体超敏反应，与腹部疼痛评分呈正相关。此外，重叠的躯体超敏反应的退伍军人具有最多的肠外症状。这些发现可能具有转化效益：开发更有效的治疗药物的策略，以减少和/或预防未来军事冲突中部署的退伍军人的躯体和 GI 症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/64d75279b481/nihms950486f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/9317d6f80213/nihms950486f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/32b0a8d31195/nihms950486f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/ae26f1343528/nihms950486f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/64d75279b481/nihms950486f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/9317d6f80213/nihms950486f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/32b0a8d31195/nihms950486f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/ae26f1343528/nihms950486f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ef/6110965/64d75279b481/nihms950486f4.jpg

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