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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
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
2   Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York
,
Sophia Kwon
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
,
Erin Caraher
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
,
Kenneth I. Berger
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
,
Joan Reibman
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
,
William N. Rom
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
3   Department of Environmental Medicine, New York University, New York, New York
,
David J. Prezant
2   Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York
4   Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
,
Anna Nolan
1   Division of Pulmonary, Critical Care and Sleep, New York University School of Medicine, New York, New York
2   Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
29 May 2015 (online)

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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

Note

Michael D. Weiden and Sophia Kwon contributed equally to this article.


 

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