Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, NY 10016, USA.
J Clin Immunol. 2013 Aug;33(6):1134-42. doi: 10.1007/s10875-013-9913-2. Epub 2013 Jun 7.
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.
世贸中心（WTC）暴露会导致暴露多年后出现气流阻塞。几丁质酶和 IgE 是阻塞性气道疾病的先天和体液介质。我们研究了 WTC 暴露后早期血清几丁质酶和 IgE 的表达是否预测随后的阻塞。
采用嵌套病例对照设计，251 名 FDNY 人员在 2001 年 9 月 11 日之后的几个月内抽取血清，测量几丁三糖酶、YKL-40 和 IgE。主要结局是随后的一秒用力呼气量/用力肺活量（FEV1/FVC）低于正常下限（LLN）。病例（N=125）的 FEV1/FVC 异常，而对照组的 FEV1/FVC 正常（N=126）。在二次分析中，抗性病例（N=66）的 FEV1（≥107%）比平均值高一个标准差。Logistic 回归调整了年龄、BMI、暴露强度和暴露后 FEV1/FVC，对早期生物标志物与后期肺功能之间的关联进行建模。
病例和对照组最初失去了肺功能。对照组恢复到 9/11 前的 FEV1 和 FVC，而病例继续下降。病例组血清几丁质酶表达较低，IgE 水平较高。IgE 的增加增加了气流阻塞的几率，降低了 FEV1 高于平均水平的几率。相反，几丁质酶的增加降低了异常 FEV1/FVC 的几率，并增加了 FEV1≥107%的几率。在该队列中，血清 YKL-40 与 FEV1/FVC 或 FEV1 无关。
WTC 颗粒物暴露后血清几丁质酶增加可降低发生阻塞的几率，并与肺功能恢复有关。相反，升高的 IgE 是气流阻塞和肺功能进行性下降的危险因素。
