One airway: biomarkers of protection from upper and lower airway injury after World Trade Center exposure.
Cho-SJ; Echevarria-GC; Kwon-S; Naveed-B; Schenck-EJ; Tsukiji-J; Rom-WN; Prezant-DJ; Nolan-A; Weiden-MD
Respir Med 2014 Jan; 108(1):162-170
BACKGROUND: Firefighters exposed to World Trade Center (WTC) dust have developed chronic rhinosinusitis (CRS) and abnormal forced expiratory volume in 1 s (FEV1). Overlapping but distinct immune responses may be responsible for the clinical manifestations of upper and lower airway injury. We investigated whether a panel of inflammatory cytokines, either associated or not associated with WTC-LI, can predict future chronic rhinosinusitis disease and its severity. METHODS: Serum obtained within six months of 9/11/2001 from 179 WTC exposed firefighters presenting for subspecialty evaluation prior to 3/2008 was assayed for 39 cytokines. The main outcomes were medically managed CRS (N = 62) and more severe CRS cases requiring sinus surgery (N = 14). We tested biomarker-CRS severity association using ordinal logistic regression analysis. RESULTS: Increasing serum IL-6, IL-8, GRO and neutrophil concentration reduced the risk of CRS progression. Conversely, increasing TNF-alpha increased the risk of progression. In a multivariable model adjusted for exposure intensity, increasing IL-6, TNF-a and neutrophil concentration remained significant predictors of progression. Elevated IL-6 levels and neutrophil counts also reduced the risk of abnormal FEV1 but in contrast to CRS, increased TNF-alpha did not increase the risk of abnormal FEV1. CONCLUSIONS: Our study demonstrates both independent and overlapping biomarker associations with upper and lower respiratory injury, and suggests that the innate immune response may play a protective role against CRS and abnormal lung function in those with WTC exposure.
Fire-fighters; Emergency-responders; Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Airway-obstruction; Dust-exposure; Employee-exposure; Particulate-dust; Immune-reaction; Cytotoxicity; Nasal-disorders; Chronic-inflammation;
Author Keywords: One airway; Chronic rhinosinusitis; World Trade Center; Innate immunity
Michael D. Weiden, New York University School of Medicine, 550 1st Ave, New York, NY 10016, USA
Cooperative-Agreement-Number-U10-OH-008243; Cooperative-Agreement-Number-U10-OH-008242; M062014
New York City Fire Department