Elevated peripheral eosinophils are associated with new-onset and persistent wheeze and airflow obstruction in world trade center-exposed individuals.
Elevated peripheral eosinophils are associated with new-onset and persistent wheeze and airflow obstruction in world trade center-exposed individuals.
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DOI：
10.3109/02770903.2012.743149
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发表时间：
2013-02
期刊：
影响因子：
--
通讯作者：
Reibman J
中科院分区：
文献类型：
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作者：
Kazeros A;Maa MT;Patrawalla P;Liu M;Shao Y;Qian M;Turetz M;Parsia S;Caplan-Shaw C;Berger KI;Goldring R;Rogers L;Reibman J
接触世界贸易中心（WTC）粉尘和烟雾与救援和恢复工作人员以及接触的社区成员出现哮喘样呼吸道症状有关。在哮喘亚群中有肺和外周嗜酸性粒细胞增加的嗜酸性粒细胞炎症。我们假设wtc暴露个体持续的哮喘样症状可能与以外周嗜酸性粒细胞为特征的全身性炎症有关。世贸中心环境健康中心（EHC）是一个针对当地居民、当地工人和有疑似世贸中心相关症状的清洁工人的治疗项目。患者接受标准化的评估，包括问卷调查和全血细胞计数。在2005年9月至2009年3月期间，2461人参加了该计划并可用于分析。排除了2001年9月11日之前已有呼吸道症状或肺部疾病诊断以及目前或大量吸烟的个体。1508人符合纳入标准。这些患者的平均年龄为47岁，大多数是女性（51%），具有不同的种族/民族。WTC粉尘/烟雾暴露后出现并持续存在的呼吸道症状包括用力时呼吸困难（68%）、咳嗽（57%）、胸闷（46%）和喘息（33%）。与没有喘息的患者相比，有喘息的患者外周血嗜酸性粒细胞升高的比例更高（21%对13%，p<0.0001）。外周血嗜酸性粒细胞升高的个体在肺活量测定中更容易出现气流阻塞（16%比7%，p = 0.0003）。在不同的wtc暴露人群中，外周嗜酸性粒细胞与喘息和肺功能降低有关。这些数据提示嗜酸性粒细胞可能参与该人群的肺部炎症，其症状与wtc相关哮喘一致。
Exposure to World Trade Center (WTC) dust and fumes is associated with onset of asthma-like respiratory symptoms in rescue and recovery workers and exposed community members. Eosinophilic inflammation with increased lung and peripheral eosinophils has been described in subpopulations with asthma. We hypothesized that persistent asthma-like symptoms in WTC-exposed individuals would be associated with systemic inflammation characterized by peripheral eosinophils. The WTC Environmental Health Center (EHC) is a treatment program for local residents, local workers, and clean-up workers with presumed WTC-related symptoms. Patients undergo a standardized evaluation including questionnaires and complete blood count. Between 9/2005–3/2009, 2461 individuals enrolled in the program and were available for analysis. Individuals with pre-existing respiratory symptoms or lung disease diagnoses prior to 9/11/2001 and current or significant tobacco use were excluded. 1508 individuals met inclusion criteria. These patients had a mean age of 47 years, were mostly female (51%) and had a diverse race/ethnicity. Respiratory symptoms that developed after WTC dust/fume exposure and remained persistent included dyspnea on exertion (68%), cough (57%), chest tightness (46%), and wheeze (33%). A larger percentage of those with wheeze had elevated peripheral eosinophils compared to those without wheeze (21% vs. 13%, p<0.0001). Individuals with elevated peripheral eosinophils were more likely to have airflow obstruction on spirometry (16% vs. 7%, p = 0.0003). Peripheral eosinophils were associated with wheeze and reduced lung function in a diverse WTC-exposed population. These data suggest that eosinophils may participate in lung inflammation in this population with symptoms consistent with WTC-related asthma.