Chitotriosidase is a Biomarker for the Resistance to World Trade Center Lung Injury in New York City Firefighters
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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.
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.
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.
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.
KeywordsChitotriosidase immunoglobulin E WTC particulate matter pulmonary function testing
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..
The authors of this manuscript have no actual or potential conflicts of interest to disclose.
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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