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. 2013 Aug;33(6):1134-42.
doi: 10.1007/s10875-013-9913-2. Epub 2013 Jun 7.

Chitotriosidase is a biomarker for the resistance to World Trade Center lung injury in New York City firefighters

Soo Jung Cho  1 , Anna Nolan, Ghislaine C Echevarria, Sophia Kwon, Bushra Naveed, Edward Schenck, Jun Tsukiji, David J Prezant, William N Rom, Michael D Weiden
Affiliations

Chitotriosidase is a biomarker for the resistance to World Trade Center lung injury in New York City firefighters

Soo Jung Cho et al. J Clin Immunol. 2013 Aug.

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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Conflict of interest statement

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

Figures

Figure 1
Figure 1
Study design. WTC=World Trade Center; FDNY=Fire Department City of New York; NHANES=National Health and Nutrition Examination Survey; PFT=Pulmonary Function Test
Figure 2
Figure 2
Final logistic model prediction A. Calculated probability of FEV1/FVC<LLN with 95% CI as the concentration of chitotriosidase increased over the observed biomarker range with all other covariates held constant. B. Calculated probability of FEV1/FVC<LLN as IgE increases C. Receiver operating characteristic (ROC) of the final model to predict abnormal FEV1/FVC. Area under the curve (AUC)=0.86.
See this image and copyright information in PMC

References

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