title: Persistent symptoms in former UNTAC soldiers are not associated with shifted cytokine balance.
abstract: BACKGROUND
  The pathogenesis of post-combat syndromes, such as Gulf War syndrome, is poorly understood. Recently, it has been postulated that the symptoms of veterans with such syndromes are due to a disturbed cytokine balance shifted towards a T-helper (Th) 2 profile. We investigated this hypothesis in 21 symptomatic former UNTAC soldiers and compared their results with those obtained in 21 healthy former UNTAC soldiers matched for age, sex and military force.
  
  
  METHODS
  The numbers of intracellular interleukin 4 (IL-4) and interferon gamma- (IFN-gamma) producing CD4+ and CD8+ T lymphocytes (CD3+) were determined after in vitro stimulation with phorbol myristate acetate and calcium ionophore in the presence of brefeldin to block secretion of induced cytokines. Circulating concentrations and lipopolysaccharide- (LPS) or phytohaemagglutinin- (PHA) stimulated whole-blood production of the proinflammatory cytokines IL-1beta, IL-1ra, tumour necrosis factor alpha (TNF-alpha) and IL-10 and IFN-gamma were measured.
  
  
  RESULTS
  The numbers of CD4+ and CD8+ T lymphocytes positive for IL-4 or IFN-gamma production were not significantly different in patients and control subjects. After stimulation with LPS or PHA, the in vivo circulating concentration and concentration of IL-10 and IFN-gamma were also similar.
  
  
  CONCLUSIONS
  The present study demonstrates that there is no shift in cytokine balance towards a Th2 profile in former UNTAC soldiers with symptoms similar to those of the Gulf War syndrome.
authors.affiliation: St Radboud University Hospital, Nijmegen, the Netherlands P.Soetekouw@aig.azn.nl
authors.forename: P M
authors.initials: PM
authors.lastname: Soetekouw
authors.forename: M
authors.initials: M
authors.lastname: De Vries
authors.forename: F W
authors.initials: FW
authors.lastname: Preijers
authors.forename: R
authors.initials: R
authors.lastname: Van Crevel
authors.forename: G
authors.initials: G
authors.lastname: Bleijenberg
authors.forename: J W
authors.initials: JW
authors.lastname: Van Der Meer
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002160:Cambodia; D016207:Cytokines / Q000097:blood*; D005221:Fatigue; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D008889:Military Personnel; D009426:Netherlands / Q000208:ethnology; D018923:Persian Gulf Syndrome / Q000097:blood / Q000276:immunology*; D012016:Reference Values; D011795:Surveys and Questionnaires; D018418:Th2 Cells / Q000276:immunology*; D014480:United Nations
chemical_list: D016207:Cytokines; D015847:Interleukin-4; D007371:Interferon-gamma