The day before the last day of class, we had a visit to Val-de-Grâce, a military hospital that also has a museum dedicated to military medicine. While I was there, I saw many exhibits about things that we are currently familiar with being around us, like plastic surgery, or prosthesis… It is very interesting that these procedures were initially developed for the wounded soldiers and did not get their cosmetic place in the market until much later.
One exhibit that caught my attention was gas masks that were developed to protect soldiers from inhaling toxic agents. This made me wonder what type of neurotoxins are out there that the military has to deal with. There are many that I don’t even want to think about, but I found a paper that talks about the toxins that the soldiers at the Gulf War (GW) were exposed to. The pathology of the disease known as the Gulf War disease presents as multisymptomatic and can typically include cognitive dysfunction, tremors, migraine, and psychological disturbances such as depression and anxiety. Unfortunately, not very much is known about the disease, but autopsies have shown that it is due to the high levels of exposure to orthophosphate-based pesticides like chlorpyrifos (CPF) and the preventative use of pyridostigmine bromide (PB) as a treatment against neurotoxins. It is ironic how a drug that is meant to protect from neurotoxins ends up being a neurotoxin itself.
The Gulf-war agents most likely work by inhibiting the function of Acetylcholine Esterase enzyme (AchE), which helps breakdown extra Acetylcholine (Ach) in the brain. The increased amount of Ach leads to all kinds of neurological problems over time, targeting the most vulnerable areas of the brain first. In the paper, they use a mouse model and administer either saline, or just CPF, or a combination of these chemicals, at low enough doses to not cause immediate apparent toxicity, which is designed to mimic the consistent but low doses the soldiers at the GW received. They have found that within 3 days Ach levels in the basal brain increased. This increased also led to higher immune response in the piriform cortex, motor cortex and the basolateral amygdala, which receive connections from the basal brain (Ojo et al., 2013).
Going into so much neuroscience jargon may make it sound so very sophisticated to the common person, but imagining that back in the day, even before the Gulf War, people were finding new and better ways to improve care of wounded soldiers. The biggest revolution in healthcare believe it of not, was cleanliness and the belief that taking good simple care of a patient improves their likelihood to improve and survive.
Today, neuroscience finds significant funding from the military interest and continues to improve the care that is possible to be provided. And sure enough, those innovations will find their way to the main stream.
Citations:
Ojo, J., Abdullah, L., Evans, J., Reed, J., Montague, H., Mullan, M., & Crawford, F. (2013). Exposure to an organophosphate pesticide, individually or in combination with other Gulf War agents, impairs synaptic integrity and neuronal differentiation, and is accompanied by subtle microvascular injury in a mouse model of Gulf War agent exposure. Neuropathology, 34(2), 109-127. doi: 10.1111/neup.12061