Lyme disease vs Gulf War Illness: symptoms, biomarkers, trials and research
A data-driven comparison of Lyme Disease and Gulf War Illness built from the Open Source Medicine Foundation biomarker atlases, PubMed literature feeds, ClinicalTrials.gov registry extract and post-acute infection syndrome (PAIS) cohort database.
A tick-borne bacterial infection and a deployment-related exposure syndrome have little in common aetiologically, but both produce a chronic fatigue-pain-cognition phenotype and both have mature VA or NIH research programmes with long follow-up.
What each condition is
Lyme Disease
Also known as: Lyme borreliosis, Borrelia burgdorferi infection, Post-treatment Lyme disease syndrome (PTLDS), Chronic Lyme
Lyme disease is a tick-borne bacterial infection caused by Borrelia burgdorferi and related species. Early disease is diagnosed by the erythema migrans rash and two-tier serology, and treated with antibiotics. A minority of treated patients develop post-treatment Lyme disease syndrome (PTLDS): fatigue, musculoskeletal pain and cognitive symptoms lasting six months or longer. The OSMF literature feed for this condition focuses on the chronic and post-treatment phase, while the biomarker atlas spans acute serology through neuroborreliosis and persistent-symptom phenotypes.
Atlas scope: Serologic, cerebrospinal fluid, molecular, and inflammatory biomarkers in Borrelia burgdorferi infection — from early localized disease through disseminated, neuroborreliosis, and post-treatment persistent symptom phenotypes.
OSMF resources: biomarker atlas · literature feed
Gulf War Illness
Also known as: GWI, Gulf War Syndrome, Chronic Multisymptom Illness
Gulf War Illness is a chronic multisymptom condition affecting roughly a quarter to a third of the nearly 700,000 US and allied personnel deployed in the 1990-1991 Gulf War. It is defined by the Kansas or CDC criteria (fatigue, pain, cognitive and mood symptoms, gastrointestinal and respiratory complaints) rather than by a single exposure, though pyridostigmine bromide, pesticides and low-level nerve agents are the leading hypotheses. Unlike the other conditions compared here it has no infectious trigger, which makes its biomarker overlap with post-viral syndromes scientifically interesting.
Atlas scope: Inflammatory, autoimmune, metabolic, cholinergic, and exposure-related biomarker alterations in Gulf War Illness (GWI / chronic multisymptom illness) compared to healthy deployed and non-deployed Gulf War veterans.
OSMF resources: biomarker atlas · literature feed
Side-by-side summary
| Measure | Lyme disease | Gulf War Illness |
|---|---|---|
| Biomarkers catalogued | 36 | 41 |
| Biomarker categories covered | serologic (9), csf (6), inflammatory (6), molecular (4), coinfection (4), chronic (4), functional (3) | inflammatory (10), metabolic (8), exposure (7), autoimmune (5), neurological (4), functional (3), autonomic (2), ocular (2) |
| Markers with LOINC codes | 6 | 12 |
| Literature studies tracked | 75 | 75 |
| Most recent tracked study | 05 Jul 2026 | 25 Jun 2026 |
| Registered trials (all statuses) | 2 | 4 |
| Recruiting / not yet recruiting | 2 | 0 |
| Active, not recruiting | 0 | 0 |
| Completed | 0 | 4 |
| Terminated / withdrawn / suspended | 0 | 0 |
| Unknown status | 0 | 0 |
| Named cohorts in PAIS database | 1 | 0 |
| Therapeutic agents tracked | 8 | 10 |
Trial condition matching: Lyme disease uses keyword matching on registry condition and title fields; Gulf War Illness uses keyword matching on registry condition and title fields. Trials listing both conditions: 0.
Shared biomarkers (4)
Markers catalogued in both atlases, matched by normalised name or LOINC code. Rows marked direction differs are reported to change in opposite or inconsistent directions across the two literatures, which may reflect different comparison groups, assays or disease stages rather than true biology.
| Biomarker | Category | Direction in Lyme disease | Direction in Gulf War Illness | Matched by | Sources |
|---|---|---|---|---|---|
| Interleukin-6 (IL-6) | inflammatory | Increased vs HC | Increased vs HGV | LOINC 26881-5 | Lantos et al. 2021; Johnson et al. 2016 |
| Interferon-γ (IFN-γ) | inflammatory | Increased vs HC | Increased vs HGV | LOINC 14477-8 | Lantos et al. 2021; Maury & Holton 2024 |
| C-Reactive Protein (CRP) direction differs | inflammatory | Mixed / conflicting vs HC | Increased vs HGV | LOINC 1988-5 | Lantos et al. 2021; Johnson et al. 2016 |
| Heart rate variability (PTLDS) Heart rate variability (HRV) in Gulf War Illness | chronic / autonomic | Decreased vs HC | Decreased vs HGV | name | Aucott et al. 2014; Gean et al. 2021 |
Distinct biomarkers
Top 15 markers catalogued for one condition but not matched in the other. Full lists are on the Lyme disease atlas and the Gulf War Illness atlas.
Only in Lyme disease atlas (32)
- B. burgdorferi EIA (screening) Increased serologic
- IgG immunoblot (≥5 of 10 bands) Increased serologic
- IgM immunoblot (≥2 of 3 bands) Increased serologic
- C6 peptide ELISA (VisE) Increased serologic
- Anti-VlsE antibodies Increased serologic
- Anti-OspC antibodies Increased serologic
- Anti-OspA antibodies Increased serologic
- Anti-p41 (flagellin) antibodies Increased serologic
- CSF CXCL13 Increased csf
- CSF anti-Bb antibody index Increased csf
- CSF lymphocytic pleocytosis Increased csf
- CSF protein elevation Increased csf
- CSF oligoclonal bands Mixed / conflicting csf
- CSF glucose Mixed / conflicting csf
- Interleukin-10 (IL-10) Increased inflammatory
+17 more in the atlas.
Only in Gulf War Illness atlas (37)
- Tumor Necrosis Factor-α (TNF-α) Increased inflammatory
- Interleukin-1β (IL-1β) Increased inflammatory
- Interleukin-8 (IL-8 / CXCL8) Increased inflammatory
- Neopterin Increased inflammatory
- sCD26 (soluble DPPIV) Mixed / conflicting inflammatory
- sCD14 Increased inflammatory
- Homocysteine Increased metabolic
- Glutathione (GSH) Decreased metabolic
- GSH:GSSG ratio Decreased metabolic
- 8-isoprostane Increased metabolic
- Coenzyme Q10 Decreased metabolic
- PON1 (paraoxonase 1) activity Decreased exposure
- PON1 Q192R polymorphism Mixed / conflicting exposure
- Butyrylcholinesterase (BChE) Mixed / conflicting exposure
- Acetylcholinesterase (AChE) Mixed / conflicting exposure
+22 more in the atlas.
Overlapping therapeutics under investigation (0)
No therapeutic agent is currently tracked for both conditions. Lyme disease has 8 tracked agents and Gulf War Illness has 10; see the therapeutic agents index.
Research cohorts
Lyme disease cohorts (1)
- Johns Hopkins SLICE early-Lyme cohort (Aucott/Rebman) prospective inception, n=234, biobank active
Gulf War Illness cohorts (0)
No named cohort for this condition in the PAIS database yet.
Recent research
Latest Lyme disease studies
Latest Gulf War Illness studies
Frequently asked questions
Can you have both Lyme disease and Gulf War Illness?
They are not mutually exclusive. Both are diagnosed clinically, and a person can meet criteria for Lyme disease and Gulf War Illness at the same time. In the OSMF data the two conditions share 4 catalogued biomarkers, 0 registered trials list both conditions, and 0 cohorts in the PAIS database are relevant to both. Overlap in a dataset is not evidence that one condition causes the other.
How do the biomarker profiles differ?
Lyme disease has 36 catalogued markers, led by serologic (9), csf (6), inflammatory (6). Gulf War Illness has 41, led by inflammatory (10), metabolic (8), exposure (7). 4 markers appear in both atlases, and 1 of those are reported to move in different directions (C-Reactive Protein (CRP)). Categories unique to Lyme disease: chronic, coinfection, csf, molecular, serologic; unique to Gulf War Illness: autoimmune, autonomic, exposure, metabolic, neurological, ocular.
Which has more active clinical trials?
Lyme disease has more: 2 active or recruiting trials versus 0 for Gulf War Illness (registry snapshot 07 Oct 2026). Totals including completed, terminated and unknown-status studies are 2 for Lyme disease and 4 for Gulf War Illness. Condition matching for Lyme disease, Gulf War Illness relies on keyword matching of registry condition fields and may miss trials. Trial counts measure research attention, not treatment efficacy.
Which condition has more recent research?
OSMF tracks 75 recent PubMed-indexed studies for Lyme disease (latest 05 Jul 2026) and 75 for Gulf War Illness (latest 25 Jun 2026). The feeds hold a rolling window of recent publications, so they indicate current publication pace rather than lifetime output. See the Lyme disease feed and the Gulf War Illness feed for the full lists.
Are the same treatments being studied for both?
No therapeutic agent is currently tracked for both Lyme disease and Gulf War Illness in the OSMF trial registry or agent database. That reflects the small or non-overlapping evidence base rather than proof that treatments differ.
Which has larger research cohorts?
The PAIS cohort database lists 1 named cohort for Lyme disease and 0 named cohorts for Gulf War Illness, the largest being Johns Hopkins SLICE early-Lyme cohort (Aucott/Rebman) (234 enrolled). Cohorts with stored biospecimens and open external access are the most useful for cross-condition biomarker validation.
Related comparisons
Cite this page
@misc{osmf_lyme_vs_gulfwarillness,
author = {Open Source Medicine Foundation},
title = {Lyme disease vs Gulf War Illness: symptoms, biomarkers, trials and research compared},
year = {2026},
howpublished = {\url{https://research.opensourcemed.info/compare/lyme-vs-gulf-war-illness.html}},
note = {Data as of 2026-10-07}
}Get OSMF research updates
New biomarker, trial and cohort data, summarised for patients and researchers.
Last updated 07 Oct 2026 (page build). Underlying data: literature feeds 08 Jul 2026 / 09 Jul 2026; trial registry 07 Oct 2026; atlases 29 Jun 2026 / 29 Jun 2026. Generated by scripts/build_compare_pages.py.