title: Cyanobacteria and BMAA exposure from desert dust: a possible link to sporadic ALS among Gulf War veterans.
abstract: Veterans of the 1990-1991 Gulf War have been reported to have an increased incidence of amyotrophic lateral sclerosis (ALS) compared to personnel who were not deployed. An excess of ALS cases was diagnosed in Gulf War veterans younger than 45 years of age. Increased ALS among Gulf War veterans appears to be an outbreak time-limited to the decade following the Gulf War. Seeking to identify biologically plausible environmental exposures, we have focused on inhalation of cyanobacteria and cyanotoxins carried by dust in the Gulf region, particularly Qatar. Cyanobacterial crusts and mats are widespread in the deserts of Qatar, occupying up to 56% of the available area in some microhabitats. These cyanobacterial crusts, which help bind the desert sands, are dormant throughout most of the year, but during brief spring rains actively photosynthesize. When disturbed by vehicular traffic or other military activities, the dried crusts and mats can produce significant dust. Using HPLC/FD, an amino acid analyzer, UPLC/MS, and triple quadrupole LC/MS/MS we find that the dried crusts and mats contain neurotoxic cyanobacterial toxins, including beta-N-methylamino-L-alanine (BMAA) and 2,4 diaminobutyric acid (DAB). If dust containing cyanobacteria is inhaled, significant exposure to BMAA and other cyanotoxins may occur. We suggest that inhalation of BMAA, DAB, and other aerosolized cyanotoxins may constitute a significant risk factor for the development of ALS and other neurodegenerative diseases.
authors.affiliation: Institute for Ethnomedicine, Jackson Hole, Wyoming 83001-3464, USA. paul@ethnomedicine.org
authors.forename: Paul Alan
authors.initials: PA
authors.lastname: Cox
authors.forename: Renee
authors.initials: R
authors.lastname: Richer
authors.forename: James S
authors.initials: JS
authors.lastname: Metcalf
authors.forename: Sandra Anne
authors.initials: SA
authors.lastname: Banack
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Codd
authors.forename: Walter G
authors.initials: WG
authors.lastname: Bradley
mesh_terms: D000599:Amino Acids, Diamino / Q000032:analysis / Q000633:toxicity*; D000600:Amino Acids, Dicarboxylic / Q000032:analysis / Q000633:toxicity*; D000613:Aminobutyrates / Q000032:analysis / Q000633:toxicity; D000690:Amyotrophic Lateral Sclerosis / Q000139:chemically induced* / Q000453:epidemiology*; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D000458:Cyanobacteria / Q000502:physiology*; D004196:Disease Outbreaks; D017753:Ecosystem; D004781:Environmental Exposure; D047830:Gulf War; D006801:Humans; D012189:Retrospective Studies; D012621:Seasons; D053719:Tandem Mass Spectrometry / Q000379:methods; D014728:Veterans
chemical_list: D000599:Amino Acids, Diamino; D000600:Amino Acids, Dicarboxylic; D000613:Aminobutyrates; C064612:alpha-N-carboxy-beta-N-methylaminoalanine; C005959:2,4-diaminobutyric acid