A Pilot Study of Bioenergetic Marker Relationships in Gulf War Illness: Phosphocreatine Recovery vs. Citric Acid Cycle Intermediates

Beatrice A. Golomb, Hayley J. Koslik, Jun Hee Han, Anna Helena Preger Guida, Gavin Hamilton and Richard I. Kelley
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Beatrice A. Golomb: Department of Medicine, School of Medicine, University of California, San Diego, CA 92093-0995, USA
Hayley J. Koslik: Department of Medicine, School of Medicine, University of California, San Diego, CA 92093-0995, USA
Jun Hee Han: Department of Medicine, School of Medicine, University of California, San Diego, CA 92093-0995, USA
Anna Helena Preger Guida: Department of Medicine, School of Medicine, University of California, San Diego, CA 92093-0995, USA
Gavin Hamilton: Department of Radiology, University of California, San Diego, CA 92093-0995, USA
Richard I. Kelley: Department of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA

IJERPH, 2021, vol. 18, issue 4, 1-11

Abstract: Impaired bioenergetics have been reported in veterans with Gulf War illness (VGWIs), including prolonged post-exercise recovery of phosphocreatine (PCr-R) assessed with 31 Phosphorus magnetic resonance spectroscopy. The citric acid cycle (CAC) is considered the most important metabolic pathway for supplying energy, with relationships among CAC markers reported to shift in some but not all impaired bioenergetic settings. We sought to assess relations of CAC markers to one another and to PCr-R. Participants were 33 VGWIs and 33 healthy controls 1:1 matched on age–sex–ethnicity. We assessed seven CAC intermediates, and evaluated PCr-R in a subset of matched case–control pairs (N = 14). CAC markers did not significantly differ between cases and controls. Relationships of alpha-ketoglutarate to malate, isocitrate, and succinate were strongly significant in cases with materially weaker relationships in controls, suggesting possible shifts in these markers in concert in VGWIs. PCr-R correlated strongly with five of seven CAC markers in controls (succinate, malate, fumarate, citrate, isocitrate, range r = ?0.74 to ?0.88), but bore no relationship in VGWIs. In summary, PCr-R related significantly to CAC markers in healthy controls, but not VGWIs. In contrast, relations of CAC markers to one another appeared to shift (often strengthen) in VGWIs.

Keywords: Gulf War illness; veterans; bioenergetics; citric acid cycle; 31-phosphorus magnetic resonance spectroscopy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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