The Tampa Tribune, April 22, 2001, ©2001 
Section: NATION/WORLD, Page: 13  

Veterans, Government Check Out Organism 

By GEORGE CORYELLThe Tampa Tribune 
George Coryell covers the military and veterans issues and can be reached at (813) 259-7966.

TAMPA - Some suspect a tiny organism is responsible for some Gulf War illness. 

The tiniest self-replicating life form, larger than a virus and smaller than bacteria, is at the center of a controversy about Gulf War illness.

Mycoplasma fermentans (incognitus strain) might be a slayer of the body's immune system that leads to symptoms like chronic fatigue in some Gulf War veterans. Or it might be nothing.

That is why the government is spending $8 million to see if treating patients with antibiotics will cure them.

"No one knows if it's even infectious," said Michael Kilpatrick, a physician and chief of staff for the Defense Department's Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military Deployments. "There's suggestions that it is, but no hard evidence."

Mycoplasma fermentans is a touchstone in a world where conspiracy battles with science. The organism, for which the U.S. Army holds a patent, has become a source of conflict between sick veterans and government medicine.

On one side are Gulf War veterans grown distrustful of a government slow to react to health complaints. They point to incidents of radiation testing on uninformed troops, the Tuskegee syphilis study that left black men unknowingly infected, and the CIA's secret use of LSD in the MK Ultra program.

On the other side is the Department of Defense, the Department of Veterans Affairs and agencies like the Centers for Disease Control and Prevention, which can find no common link in the symptoms of Gulf War illness.

The paranoia around Gulf War illness is a problem, Kilpatrick says. Honest scientific research has to bear out results before a cause can be claimed, much less a cure. Yet, he recognizes something is troubling veterans.

"Just because lab tests come back normal doesn't mean they aren't sick," he said.

THE MYCOPLASMA STUDY is being done because veterans have been turning to Garth Nicolson, a noted biochemist and cancer researcher, for help. Nicolson advocates the use of antibiotics in hopes of killing the organism, said Kelley Brix, a physician and assistant chief research and development officer for the Department of Veterans Affairs.

The departments of Defense and Veterans Affairs decided to test his findings.
"We want to see if [mycoplasma fermentans] causes human disease and if it is contagious," Brix said.

Scientists initially believed the mycoplasmas were harmless, said Kilpatrick. But researchers found one form causes a type of pneumonia, and another is connected to genital infections.

"The big question with mycoplasma fermentans is whether it's causing disease or is that organism there because people are sick," Kilpatrick said.

The blind study of 491 patients who tested positive for mycoplasma is being done at two military hospitals and 26 Veterans Affairs hospitals. Patients are treated with either doxycycline or a placebo.

The Statistical Assessment Service, a nonprofit research group in Washington, D.C., is critical. STATS analyst Howard Fienberg questions the need for the study, arguing Nicolson's research has not been sufficiently duplicated and nothing ties mycoplasma exposure to the Gulf War.

The study has the backing of the National Gulf War Resource Center, a veterans advocacy group, said executive director Pat Eddington, who is "deeply skeptical" of the organism as a direct cause of Gulf War illness.

Eddington says federal research has been too focused on finding a cause for Gulf War illness, with little consideration of a treatment for the ailments.

Joy Ilem, who handles Gulf War veterans issues for the Disabled American Veterans, commended the study. The organization has heard from veterans who said the antibiotic treatment had made them well. Ilem said research showed symptoms of Gulf War illness seem to mirror chronic fatigue syndrome or fibromyalgia. Mycoplasma infection also seems to mimic those conditions.

"Overall, from a health status, it seems promising," Ilem said.

Nicolson, who served on the external advisory board for the University of South Florida's H. Lee Moffitt Cancer Center from 1995-98, became interested in Gulf War illness when his stepdaughter, a helicopter crew chief in the war, returned with symptoms of memory loss and joint pain.

He was then chairman of tumor biology at the University of Texas M.D. Anderson Cancer Center in Houston. He thought his stepdaughter's symptoms resembled those caused by some bacterial infections.

ONE ANTIBIOTIC in particular, a drug called doxycycline, seemed to work. After taking it for almost a year, his stepdaughter recovered, he said.

But Nicolson's involvement with mycoplasma is even deeper.  He says he, his wife and the family cat also have been infected by the organism, which he believes is mildly contagious. His wife was exposed while she was working in a microbiology laboratory, he said. He speculates his infection came from handling blood samples from veterans or exposure to patients.

He is particularly troubled because the organism apparently can cross species lines. He says soldiers may have picked up mycoplasma fermentans through a contaminated vaccine or from Iraqi germ warfare. It could be bioengineered, he believes.

"This is what you do when you weaponize microorganisms," Nicolson said.

Nicolson, who now runs the Institute for Molecular Medicine in Huntington Beach, Calif., says Mycoplasma fermentans suppresses the immune system in ways similar to chronic fatigue syndrome or fibromyalgia.

However, Kilpatrick says tests by the CDC could not confirm the organism was being passed to animals. Scientists have trouble even capturing a live culture.

"We can't say how it can be spread," Kilpatrick said.  Kilpatrick says mycoplasma fermentans is an impractical choice for a biological weapon. It doesn't live outside the body, has no rigid cell wall, and it doesn't even survive well in the human bloodstream.

Kilpatrick said the Army tested whether vaccines could have been contaminated with mycoplasma fermentans, injecting it into anthrax vaccine and taking cultures over three days. The only one that survived was taken immediately after introduction because the vaccine killed the organism.

To find mycoplasma, Nicolson uses a blood test that extracts DNA from white blood cells and looks for specific genes from the organism. Nicolson has found 40 percent of veterans complaining of symptoms tested positive for mycoplasma infections, with 80 percent of those testing positive having the fermentans infection.

Participants in the Veterans Affairs study all tested positive for mycoplasma, either fermentans or one of two other varieties believed to be infectious. Brix said participants had to have two out of three symptoms - chronic fatigue, memory loss, or muscle or skeletal pain.

HALF THE VETERANS were given doxycycline for a year and half were given a placebo. The study follows them for six months after treatment to see if symptoms reappear. The outcome is expected to tell whether mycoplasma is making patients ill, if doxycycline made them well, or if the medicine isn't working and veterans are still infected.  Results are expected by the end of the year.

The treatment of mycoplasma fermentans with doxycycline gets support from an unusual source - the 1993 patent on the organism issued to Shyh-Ching Lo, working for the U.S. Army. Lo is chief of the Division of Molecular Biology at the Armed Forces Institute of Pathology in Washington, D.C. The patent is a continuation of one first filed in 1986.

Lo identified the Mycoplasma fermentans (incognitus strain) while doing AIDS research, finding it in infected patients. He said the Army patented mycoplasma so it could profit from any commercial royalties. The patent says mycoplasma could be used to detect AIDS or find a vaccine for mycoplasma.

"We were the first to identify it," Lo said.  In the patent, Lo writes mycoplasma fermentans incognitus is sensitive to antibiotics, and recommends doxycycline for treatment.

Four monkeys he infected with the mycoplasma during tests died; an uninfected monkey did not. The monkeys were directly infected through their bloodstreams. Lo held mycoplasma responsible for the deaths because no other infectious agent was present.

Lo doubts Nicolson's theory, saying the AIDS patients he studied showed infection in the urinary genital tract, rather than in the bloodstream. He thinks it is most likely transmitted through sexual contact, and causes illness only when the immune system is compromised, such as with AIDS.  Lo said theories about mycoplasma fermentans' use as a weapon by the Iraqis don't make sense because the organism doesn't have an immediate effect.

"It's a very fragile organism that's very difficult to grow," Lo said. "How could that be a good candidate as a biological warfare weapon?"

Regardless of what the new study finds, there are veterans who say Nicolson's treatment has helped them.

Craig Lynch, 42, of Utah was a captain in the Army's 3rd Armored Division during the Gulf War. He developed symptoms that baffled physicians and had him thinking he wouldn't survive the year.

"March is the beginning of the third month I've been on doxycycline and most of my symptoms are gone," Lynch said.

ONE LOCAL VET says the study can't help him. Bobby George, 51, of Auburndale served with the Florida National Guard in Saudi Arabia in 1990.

Apparently healthy before he left, he doesn't expect to live through the year. He tested positive for mycoplasma fermentans.

George tried doxycycline and other antibiotics several years ago. He was allergic to them. "They should have tested us, drawn blood and tested us thoroughly," George said. "I want something done. If the VA can't make me better, give me something to feel good."

(CHART) Is Mycoplasma a cause of Gulf War Illness?

Mycoplasma fermentans (incognitus strain) is a member of the smallest self-replicating life forms - mycoplasmas - which are smaller than bacteria and larger than a virus. The Veterans Administration is studying whether the organism is making Gulf War vets ill, and testing antibiotics as a treatment.

Symptoms
The participants in the study suffer the following:

chronic fatigue
memory loss
muscle or skeletal pain.

Sources: Departments of Veterans Affairs and Defense