title: Early elevation of serum MMP-3 and MMP-12 predicts protection from World Trade Center-lung injury in New York City Firefighters: a nested case-control study.
abstract: OBJECTIVE
  After 9/11/2001, some Fire Department of New York (FDNY) workers had excessive lung function decline. We hypothesized that early serum matrix metalloproteinases (MMP) expression predicts World Trade Center-Lung Injury (WTC-LI) years later.
  
  
  METHODS
  This is a nested case-control analysis of never-smoking male firefighters with normal pre-exposure Forced Expiratory Volume in one second (FEV1) who had serum drawn up to 155 days post 9/11/2001. Serum MMP-1, 2,3,7,8, 9, 12 and 13 were measured. Cases of WTC-LI (N = 70) were defined as having an FEV1 one standard deviation below the mean (FEV1 ≤ 77%) at subspecialty pulmonary evaluation (SPE) which was performed 32 months (IQR 21-53) post-9/11. Controls (N = 123) were randomly selected. We modeled MMP's ability as a predictor of cases status with logistic regression adjusted for time to blood draw, exposure intensity, weight gain and pre-9/11 FEV1.
  
  
  RESULTS
  Each log-increase in MMP-3 and MMP-12 showed reduced odds of developing WTC-LI by 73% and 54% respectively. MMP-3 and MMP-12 consistently clustered together in cases, controls, and the cohort. Increasing time to blood draw significantly and independently increased the risk of WTC-LI.
  
  
  CONCLUSIONS
  Elevated serum levels of MMP-3 and MMP-12 reduce the risk of developing WTC-LI. At any level of MMP-3 or 12, increased time to blood draw is associated with a diminished protective effect.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep, New York University, School of Medicine, New York, New York, United States of America.
authors.forename: Sophia
authors.initials: S
authors.lastname: Kwon
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiden
authors.forename: Ghislaine C
authors.initials: GC
authors.lastname: Echevarria
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Comfort
authors.forename: Bushra
authors.initials: B
authors.lastname: Naveed
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
authors.forename: William N
authors.initials: WN
authors.lastname: Rom
authors.forename: Anna
authors.initials: A
authors.lastname: Nolan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D061388:Firefighters; D005541:Forced Expiratory Volume; D015870:Gene Expression; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000378:metabolism / Q000473:pathology; D055370:Lung Injury / Q000097:blood* / Q000175:diagnosis / Q000201:enzymology / Q000473:pathology; D008297:Male; D053508:Matrix Metalloproteinase 12 / Q000097:blood* / Q000235:genetics; D019278:Matrix Metalloproteinase 3 / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D009519:New York City; D016273:Occupational Exposure; D011379:Prognosis; D047851:September 11 Terrorist Attacks; D013997:Time Factors
chemical_list: D019278:Matrix Metalloproteinase 3; D053508:Matrix Metalloproteinase 12