title: Chitotriosidase is a biomarker for the resistance to World Trade Center lung injury in New York City firefighters.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, NY 10016, USA.
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Cho
authors.forename: Anna
authors.initials: A
authors.lastname: Nolan
authors.forename: Ghislaine C
authors.initials: GC
authors.lastname: Echevarria
authors.forename: Sophia
authors.initials: S
authors.lastname: Kwon
authors.forename: Bushra
authors.initials: B
authors.lastname: Naveed
authors.forename: Edward
authors.initials: E
authors.lastname: Schenck
authors.forename: Jun
authors.initials: J
authors.lastname: Tsukiji
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
authors.forename: William N
authors.initials: WN
authors.lastname: Rom
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiden
mesh_terms: D054392:Adipokines / Q000097:blood; D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1; D006596:Hexosaminidases / Q000096:biosynthesis* / Q000097:blood / Q000235:genetics; D006801:Humans; D007113:Immunity, Innate; D007073:Immunoglobulin E / Q000097:blood; D037102:Lectins / Q000097:blood; D055370:Lung Injury / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011379:Prognosis; D012129:Respiratory Function Tests; D012306:Risk; D047851:September 11 Terrorist Attacks
chemical_list: D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D037102:Lectins; D007073:Immunoglobulin E; D006596:Hexosaminidases; C086400:chitotriosidase