Health assessment of sulfur mustard-chemical veterans with various respiratory diseases: The result of a comparative analysis of biological health scores (BHS) through 50 biomarkers

• Published in: International immunopharmacology 2024-12, Vol.145, p.113767
• Main Authors: Nasiri, Leila, Hassanpour, Hossein, Ardestani, Sussan Kaboudanian, Ghazanfari, Tooba, Jamali, Davood, Faghihzadeh, Elham, Vaez-Mahdavi, Mohammad-Reza
• Format: Article
• Language: English
• ISSN: 1878-1705

Mustard gas as a chemical weapon has been used in wars and its long-term side effects are substantial in the human body. This study aimed to apply an extension of allostatic load, known as biological health score (BHS), including the wear-and-tear of four physiological systems (endocrine, inflammatory, cardiovascular, and metabolic systems) to estimate biological health caused by sulfur mustard (SM) toxicity. In this cross-sectional study, serum samples were collected from two distinct groups of male individuals including 1) 236 individuals who had been exposed to SM gas during the Iraq-Iran war in 1987. This group was divided into three subgroups based on their respiratory disorders (19 individuals with asthma, 92 individuals with bronchiolitis obliterans, and 125 individuals with chronic bronchitis); 2) 64 healthy members, at the same range of age and residence, as the non-exposed group. To estimate a modified BHS, 50 blood-derived biomarkers (or their ratios) of the mentioned systems were measured. The SM-exposed group and respiratory disease subgroups exhibited higher BHS than controls (P < 0.05). The endocrine and metabolic systems exhibited higher BHS in the SM-exposed group and its subgroups compared to the control group (P < 0.05). In contrast, the cardiovascular and immune/inflammatory systems did not show significant differences between the groups. Principal component analysis (PCA) identified several key biomarkers, including lymphocyte count, the LDH/lymphocyte ratio, cholesterol levels, and neutrophil count, as major contributors to interpatient variation among individuals exposed to SM and those with related respiratory diseases. The modified multisystem BHS could be useful in the more accurate evaluation of biological health in chronic SM toxicity. The dysregulation observed in the endocrine and metabolic systems underscores the complication of SM toxicity and its extensive consequences on physiological homeostasis.