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Chitotriosidase is a Biomarker for the Resistance to World Trade Center Lung Injury in New York City Firefighters

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Abstract

Purpose

World Trade Center (WTC) exposure caused airflow obstruction years after exposure. Chitinases and IgE are innate and humoral mediators of obstructive airway disease. We investigated if serum expression of chitinases and IgE early after WTC exposure predicts subsequent obstruction.

Methods

With a nested case–control design, 251 FDNY personnel had chitotriosidase, YKL-40 and IgE measured in serum drawn within months of 9/11/2001. The main outcome was subsequent Forced Expiratory Volume after 1 second/Forced Vital Capacity (FEV1/FVC) less than the lower limit of normal (LLN). Cases (N = 125) had abnormal FEV1/FVC whereas controls had normal FEV1/FVC (N = 126). In a secondary analysis, resistant cases (N = 66) had FEV1 (≥107 %) one standard deviation above the mean. Logistic regression adjusted for age, BMI, exposure intensity and post-exposure FEV1/FVC modeled the association between early biomarkers and later lung function.

Results

Cases and Controls initially lost lung function. Controls recovered to pre-9/11 FEV1 and FVC while cases continue to decline. Cases expressed lower serum chitotriosidase and higher IgE levels. Increase in IgE increased the odds of airflow obstruction and decreased the odds of above average FEV1. Alternately, increasing chitotriosidase decreased the odds of abnormal FEV1/FVC and increased the odds of FEV1 ≥ 107 %. Serum YKL-40 was not associated with FEV1/FVC or FEV1 in this cohort.

Conclusions

Increased serum chitotriosidase reduces the odds of developing obstruction after WTC-particulate matter exposure and is associated with recovery of lung function. Alternately, elevated IgE is a risk factor for airflow obstruction and progressive lung function decline.

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Author Contributions

conception and design, S.J.C, M.D.W., and A.N; analysis and interpretation, S.J.C., M.D.W., G.C.E., A.N., S.K.; drafting the manuscript for important intellectual content, S.J.C., M.D.W., A.N., S.K., E.S., J.T., D.J.P., W.N.R..

Disclosures

The authors of this manuscript have no actual or potential conflicts of interest to disclose.

Funding

K23HL084191 (AN), K24A1080298 (MDW), RO1HL057879; (MDW), HL090316, Al080298A, TL1RR029892; T32 ES007267 (BN, SJC); U01CA008617, RO1HL090316 (WNR), NIOSH/CDC (U10- OH008243, U10-OH008242), and 1 UL1RR029893. This work was also partially funded by the NYU-HHC Clinical and Translational Science Institute, supported in part by grant UL1TR000038 from the National Center for Advancing Translational Sciences of the National Institutes of Health. The funding agencies did not participate in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, NY, USA

    Soo Jung Cho, Anna Nolan, Sophia Kwon, Bushra Naveed, Edward Schenck, Jun Tsukiji, William N. Rom & Michael D. Weiden

  2. School of Medicine, Department of Environmental Medicine, New York University, Tuxedo Park, NY, USA

    Anna Nolan, William N. Rom & Michael D. Weiden

  3. Fire Department of New York, Bureau of Health Services and Office of Medical Affairs, Brooklyn, NY, USA

    Anna Nolan, David J. Prezant & Michael D. Weiden

  4. División de Anestesiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile

    Ghislaine C. Echevarria

  5. Department of Medicine, New York University, New York, NY, USA

    Ghislaine C. Echevarria

  6. Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA

    David J. Prezant

  7. Albert Einstein College of Medicine, Bronx, NY, USA

    David J. Prezant

  8. Medicine and Environmental Medicine, New York University School of Medicine, 550 1st Ave, New York, NY, 10016, USA

    Michael D. Weiden

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  1. Soo Jung Cho
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Correspondence to Michael D. Weiden.

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Cho, S.J., Nolan, A., Echevarria, G.C. et al. Chitotriosidase is a Biomarker for the Resistance to World Trade Center Lung Injury in New York City Firefighters. J Clin Immunol 33, 1134–1142 (2013). https://doi.org/10.1007/s10875-013-9913-2

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