A Pandemic's Lifecycle: A Longitudinal Validation of Predictors in 26,249 Severe COVID-19 NYC Admissions [Meeting Abstract]
The Microbiome of Inflammation and Nutrition: World Trade Center [Meeting Abstract]
A Prospective Longitudinal Assessment of Nutrition in the FDNY World [Meeting Abstract]
World Trade Center Particulate Matter-Induced Cardiorespiratory and [Meeting Abstract]
Twenty-Year Reflection on the Impact of World Trade Center Exposure on Pulmonary Outcomes in Fire Department of the City of New YorkÂ (FDNY) Rescue and Recovery Workers
After the terrorist attacks on September 11, 2001 (9/11), many rescue/recovery workers developed respiratory symptoms and pulmonary diseases due to their extensive World Trade Center (WTC) dust cloud exposure. Nearly all Fire Department of the City of New YorkÂ (FDNY) workers were present within 48Â h of 9/11 and for the next several months. Since the FDNY had a well-established occupational health service for its firefighters and Emergency Medical Services workers prior to 9/11, the FDNY was able to immediately start a rigorous monitoring and treatment program for its WTC-exposed workers. As a result, respiratory symptoms and diseases were identified soon after 9/11. This focused review summarizes the WTC-related respiratory diseases that developed in the FDNY cohort after 9/11, including WTC cough syndrome, obstructive airways disease, accelerated lung function decline, airway hyperreactivity, sarcoidosis, and obstructive sleep apnea. Additionally, an extensive array of biomarkers has been identified as associated with WTC-related respiratory disease. Future research efforts will not only focus on further phenotyping/treating WTC-related respiratory disease but also on additional diseases associated with WTC exposure, especially those that take decades to develop, such as cardiovascular disease, cancer, and interstitial lung disease.
Dynamic Metabolic Risk Profiling of World Trade Center-Lung Disease: A Longitudinal Cohort Study
COVID-19 Myocarditis: A Case Report, Overview of Diagnosis and Treatment [Case Report]
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), emerged in Wuhan, China, and rapidly led to a global pandemic that affected 213 countries, more than 5.8 million cases, and 360,000 deaths worldwide as of May 28, 2020. The United States currently has the highest number of COVID-19 cases in the world and contributes to nearly a third of the global death rate. The prevalence of COVID myocarditis is unclear but generally considered rare, with estimates up to 7% of COVID-related deaths. However, these patients suffered catastrophic worsening disease with respiratory compromise requiring intubation and often death. We report the case of a patient with COVID-19-induced myocarditis who was successfully treated with dexamethasone and review the literature.
Author Correction: World Trade Center-Cardiorespiratory and Vascular Dysfunction: Assessing the Phenotype and Metabolome of a Murine Particulate Matter Exposure Model
PEDF, a pleiotropic WTC-LI biomarker: Machine learning biomarker identification and validation
Biomarkers predict World Trade Center-Lung Injury (WTC-LI); however, there remains unaddressed multicollinearity in our serum cytokines, chemokines, and high-throughput platform datasets used to phenotype WTC-disease. To address this concern, we used automated, machine-learning, high-dimensional data pruning, and validated identified biomarkers. The parent cohort consisted of male, never-smoking firefighters with WTC-LI (FEV1, %Pred< lower limit of normal (LLN); n = 100) and controls (n = 127) and had their biomarkers assessed. Cases and controls (n = 15/group) underwent untargeted metabolomics, then feature selection performed on metabolites, cytokines, chemokines, and clinical data. Cytokines, chemokines, and clinical biomarkers were validated in the non-overlapping parent-cohort via binary logistic regression with 5-fold cross validation. Random forests of metabolites (n = 580), clinical biomarkers (n = 5), and previously assayed cytokines, chemokines (n = 106) identified that the top 5% of biomarkers important to class separation included pigment epithelium-derived factor (PEDF), macrophage derived chemokine (MDC), systolic blood pressure, macrophage inflammatory protein-4 (MIP-4), growth-regulated oncogene protein (GRO), monocyte chemoattractant protein-1 (MCP-1), apolipoprotein-AII (Apo-AII), cell membrane metabolites (sphingolipids, phospholipids), and branched-chain amino acids. Validated models via confounder-adjusted (age on 9/11, BMI, exposure, and pre-9/11 FEV1, %Pred) binary logistic regression had AUCROC [0.90(0.84-0.96)]. Decreased PEDF and MIP-4, and increased Apo-AII were associated with increased odds of WTC-LI. Increased GRO, MCP-1, and simultaneously decreased MDC were associated with decreased odds of WTC-LI. In conclusion, automated data pruning identified novel WTC-LI biomarkers; performance was validated in an independent cohort. One biomarker-PEDF, an antiangiogenic agent-is a novel, predictive biomarker of particulate-matter-related lung disease. Other biomarkers-GRO, MCP-1, MDC, MIP-4-reveal immune cell involvement in WTC-LI pathogenesis. Findings of our automated biomarker identification warrant further investigation into these potential pharmacotherapy targets.
Food intake restriction for health outcome support and education (firehouse): A randomized clinical trial [Meeting Abstract]
RATIONALE Particulate matter (PM) exposure and Metabolic Syndrome (MetSyn) are growing, global health concerns. FDNY first responders experienced a high exposure to PM following the collapse of the WTC, due to their detailed phenotyping we were able to observe that MetSyn characteristics were associated with higher risk of developing WTC-lung injury [WTC-LI; forced expiratory volume in 1 second (FEV1) less than the lower limit of normal (LLN)]. Our prior metabolomics studies showed metabolites-polyunsaturated fatty acids and branched chain amino acids-rich in Mediterranean type diets were higher in subjects that didn't develop WTC-LI. Therefore, our objective was to investigate how a calorie-restricted Mediterranean dietary intervention could attenuate the adverse effects of WTC exposure among the affected FDNY population. METHODS Food Intake REstriction for Heath OUtcome Support and Education (FIREHOUSE) RCT is a calorie-restricted Mediterranean 6- month dietary intervention of male firefighters with WTC-LI and BMI>27kg/m2; ClinicalTrials.gov Identifier: NCT03581006, NYU IRB # 17-00127. Power analysis and primary outcome assessment targeted at least a 1 kg/m2 change of BMI (primary outcome) in the intervention group. Secondary outcomes include FEV1, fractional exhaled nitric oxide (FeNO), pulse wave velocity (PWV), lipid profiles, targeted metabolic/clinical biomarkers, and quality of life measures. Change in outcomes from baseline to 6-months post-intervention will be compared between the two randomized groups. Interim analysis with an O'Brien Fleming boundary for a 3-look design was planned at the completion 30, 50, and 70 subjects in each group with an alpha spending rule of 0.001, 0.007, and 0.033, respectively. Subjects were randomized 1:1 to Low Calorie Mediterranean (LoCalMed), integrative technology-supported approach with social cognitive theory-based group counseling or Usual care. RESULTS Our interim analysis showed that LowCalMed resulted in a significant reduction in BMI compared to usual care (n=40/arm) (p<0.001 via independent two sample t-test). While we are continuing to analyze our data, so far we observed a decreased BMI in both groups; however, the intervention has a mean BMI reduction of 1.84 kg/m2 while the controls' mean difference was only 0.61 kg/m2, Figure 1. CONCLUSIONS While this study focuses on a population with a unique exposure, exposure to PM is a grave issue with global implications. Additionally, MetSyn is an increasing problem throughout the world. The findings of this study aim to not only improve the quality of life and lung health of the WTC-exposed population, but also be generalized to benefit a broader global context