Biomarkers of World Trade Center Particulate Matter Exposure: Physiology of Distal Airway and Blood Biomarkers that Predict FEV1 Decline

Michael D. Weiden; Sophia Kwon; Erin Caraher; Kenneth I. Berger; Joan Reibman; William N. Rom; David J. Prezant; Anna Nolan

doi:10.1055/s-0035-1547349

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2015; 36(03): 323-333
DOI: 10.1055/s-0035-1547349

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Biomarkers of World Trade Center Particulate Matter Exposure: Physiology of Distal Airway and Blood Biomarkers that Predict FEV₁ Decline

Michael D. Weiden

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

²Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York

,

Sophia Kwon

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

,

Erin Caraher

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

,

Kenneth I. Berger

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

,

Joan Reibman

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

,

William N. Rom

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

³Department of Environmental Medicine, New York University, New York, New York

,

David J. Prezant

²Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York

⁴Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York

,

Anna Nolan

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

²Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York

› Institutsangaben

Abstract

Biomarkers can be important predictors of disease severity and progression. The intense exposure to particulates and other toxins from the destruction of the World Trade Center (WTC) overwhelmed the lung's normal protective barriers. The Fire Department of New York (FDNY) cohort not only had baseline pre-exposure lung function measures but also had serum samples banked soon after their WTC exposure. This well-phenotyped group of highly exposed first responders is an ideal cohort for biomarker discovery and eventual validation. Disease progression was heterogeneous in this group in that some individuals subsequently developed abnormal lung function while others recovered. Airflow obstruction predominated in WTC-exposed patients who were symptomatic. Multiple independent disease pathways may cause this abnormal FEV₁ after irritant exposure. WTC exposure activates one or more of these pathways causing abnormal FEV₁ in an individual. Our hypothesis was that serum biomarkers expressed within 6 months after WTC exposure reflect active disease pathways and predict subsequent development or protection from abnormal FEV₁ below the lower limit of normal known as WTC-Lung Injury (WTC-LI). We utilized a nested case–cohort control design of previously healthy never smokers who sought subspecialty pulmonary evaluation to explore predictive biomarkers of WTC-LI. We have identified biomarkers of inflammation, metabolic derangement, protease/antiprotease balance, and vascular injury expressed in serum within 6 months of WTC exposure that were predictive of their FEV₁ up to 7 years after their WTC exposure. Predicting future risk of airway injury after particulate exposures can focus monitoring and early treatment on a subset of patients in greatest need of these services.

Keywords

World Trade Center - lung injury - predictive biomarkers - obstructive airway disease

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