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Galbraith K, Serrano J, Shen G, Tran I, Slocum CC, Ketchum C, Abdullaev Z, Turakulov R, Bale T, Ladanyi M, Sukhadia P, Zaidinski M, Mullaney K, DiNapoli S, Liechty BL, Barbaro M, Allen JC, Gardner SL, Wisoff J, Harter D, Hidalgo ET, Golfinos JG, Orringer DA, Aldape K, Benhamida J, Wrzeszczynski KO, Jour G, Snuderl M. Impact of Rare and Multiple Concurrent Gene Fusions on Diagnostic DNA Methylation Classifier in Brain Tumors. Mol Cancer Res 2024; 22:21-28. [PMID: 37870438 PMCID: PMC10942665 DOI: 10.1158/1541-7786.mcr-23-0627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/01/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Abstract
DNA methylation is an essential molecular assay for central nervous system (CNS) tumor diagnostics. While some fusions define specific brain tumors, others occur across many different diagnoses. We performed a retrospective analysis of 219 primary CNS tumors with whole genome DNA methylation and RNA next-generation sequencing. DNA methylation profiling results were compared with RNAseq detected gene fusions. We detected 105 rare fusions involving 31 driver genes, including 23 fusions previously not implicated in brain tumors. In addition, we identified 6 multi-fusion tumors. Rare fusions and multi-fusion events can impact the diagnostic accuracy of DNA methylation by decreasing confidence in the result, such as BRAF, RAF, or FGFR1 fusions, or result in a complete mismatch, such as NTRK, EWSR1, FGFR, and ALK fusions. IMPLICATIONS DNA methylation signatures need to be interpreted in the context of pathology and discordant results warrant testing for novel and rare gene fusions.
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Affiliation(s)
- Kristyn Galbraith
- Department of Pathology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY, USA
| | - Jonathan Serrano
- Department of Pathology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY, USA
| | - Guomiao Shen
- Department of Pathology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY, USA
| | - Ivy Tran
- Department of Pathology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY, USA
| | - Cheyanne C. Slocum
- Department of Pathology & Laboratory Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, New York, NY, USA
| | - Courtney Ketchum
- Department of Pathology & Laboratory Medicine, National Institute of Health-Bethesda, Maryland, USA
| | - Zied Abdullaev
- Department of Pathology & Laboratory Medicine, National Institute of Health-Bethesda, Maryland, USA
| | - Rust Turakulov
- Department of Pathology & Laboratory Medicine, National Institute of Health-Bethesda, Maryland, USA
| | - Tejus Bale
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marc Ladanyi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Purvil Sukhadia
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael Zaidinski
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kerry Mullaney
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sara DiNapoli
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Benjamin L. Liechty
- Department of Pathology & Laboratory Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, New York, NY, USA
| | - Marissa Barbaro
- Department of Neuro-oncology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Jeffrey C. Allen
- Department of Pediatrics, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Sharon L. Gardner
- Department of Pediatrics, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Jeffrey Wisoff
- Department of Neurosurgery, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
| | - David Harter
- Department of Neurosurgery, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Eveline Teresa Hidalgo
- Department of Neurosurgery, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
| | - John G. Golfinos
- Department of Neurosurgery, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
- Brain and Spine Tumor Center, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA
| | - Daniel A. Orringer
- Department of Neurosurgery, NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
- Brain and Spine Tumor Center, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA
| | - Kenneth Aldape
- Department of Pathology & Laboratory Medicine, National Institute of Health-Bethesda, Maryland, USA
| | - Jamal Benhamida
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - George Jour
- Department of Pathology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY, USA
- Brain and Spine Tumor Center, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health and NYU Grossman School of Medicine, New York, NY, USA
- Brain and Spine Tumor Center, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA
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2
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Tuminello S, Nguyen E, Durmus N, Alptekin R, Yilmaz M, Crisanti MC, Snuderl M, Chen Y, Shao Y, Reibman J, Taioli E, Arslan AA. World Trade Center Exposure, DNA Methylation Changes, and Cancer: A Review of Current Evidence. EPIGENOMES 2023; 7:31. [PMID: 38131903 PMCID: PMC10742700 DOI: 10.3390/epigenomes7040031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction: Known carcinogens in the dust and fumes from the destruction of the World Trade Center (WTC) towers on 9 November 2001 included metals, asbestos, and organic pollutants, which have been shown to modify epigenetic status. Epigenome-wide association analyses (EWAS) using uniform (Illumina) methodology have identified novel epigenetic profiles of WTC exposure. Methods: We reviewed all published data, comparing differentially methylated gene profiles identified in the prior EWAS studies of WTC exposure. This included DNA methylation changes in blood-derived DNA from cases of cancer-free "Survivors" and those with breast cancer, as well as tissue-derived DNA from "Responders" with prostate cancer. Emerging molecular pathways related to the observed DNA methylation changes in WTC-exposed groups were explored and summarized. Results: WTC dust exposure appears to be associated with DNA methylation changes across the genome. Notably, WTC dust exposure appears to be associated with increased global DNA methylation; direct dysregulation of cancer genes and pathways, including inflammation and immune system dysregulation; and endocrine system disruption, as well as disruption of cholesterol homeostasis and lipid metabolism. Conclusion: WTC dust exposure appears to be associated with biologically meaningful DNA methylation changes, with implications for carcinogenesis and development of other chronic diseases.
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Affiliation(s)
- Stephanie Tuminello
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (S.T.)
| | - Emelie Nguyen
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10016, USA
| | - Nedim Durmus
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Ramazan Alptekin
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Muhammed Yilmaz
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
| | | | - Matija Snuderl
- Department of Pathology, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Yu Chen
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (S.T.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (S.T.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
| | - Joan Reibman
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- Division of Environmental Medicine, Department of Medicine, NYU Grossman School of Medicine, New York University, New York, NY 10016, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10016, USA
| | - Alan A. Arslan
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (S.T.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY 10016, USA
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3
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Yang L, Shao Y. Integrated partially linear model for multi-center studies with heterogeneity and batch effect in covariates. STATISTICS-ABINGDON 2023; 57:987-1009. [PMID: 38283617 PMCID: PMC10812905 DOI: 10.1080/02331888.2023.2258429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 09/04/2023] [Indexed: 01/30/2024]
Abstract
The design of multi-center study is increasingly used for borrowing strength from multiple research groups to obtain broadly applicable and reproducible study findings. Regression analysis is widely used for analyzing multi-group studies, however, some of the large number of regression predictors are nonlinear and/or often measured with batch effects in many large scale collaborative studies. Also, the group compositions of the nonlinear predictors are potentially heterogeneous across different centers. The conventional pooled data analysis ignores the interplay between nonlinearity and batch effect, group composition heterogeneity, measurement error and other data incoherence in multi-center setting that can cause biased regression estimates and misleading outcomes. In this paper, we propose an integrated partially linear regression model (IPLM) based analysis to account for the predictor's nonlinearity, general batch effect, group composition heterogeneity, high-dimensional covariates, potential measurement-error in covariates, and combinations of these complexities simultaneously. A local linear regression based approach is employed to estimate the nonlinear component and a regularization procedure is introduced to identify the predictors' effects that can be either homogeneous or heterogeneous across groups. In particular, when the effects of all predictors are homogeneous across the study centers, the proposed IPLM can automatically reduce to one single parsimonious partially linear model for all centers. The proposed method has asymptotic estimation and variable selection consistency including high-dimensional covariates. Moreover, it has a fast computing algorithm and its effectiveness is supported by numerical simulation studies. A multi-center Alzheimer's disease research project is provided to illustrate the proposed IPLM based analysis.
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Affiliation(s)
- Lei Yang
- Department of Population Health New York University
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4
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Galbraith K, Vasudevaraja V, Serrano J, Shen G, Tran I, Abdallat N, Wen M, Patel S, Movahed-Ezazi M, Faustin A, Spino-Keeton M, Roberts LG, Maloku E, Drexler SA, Liechty BL, Pisapia D, Krasnozhen-Ratush O, Rosenblum M, Shroff S, Boué DR, Davidson C, Mao Q, Suchi M, North P, Hopp A, Segura A, Jarzembowski JA, Parsons L, Johnson MD, Mobley B, Samore W, McGuone D, Gopal PP, Canoll PD, Horbinski C, Fullmer JM, Farooqi MS, Gokden M, Wadhwani NR, Richardson TE, Umphlett M, Tsankova NM, DeWitt JC, Sen C, Placantonakis DG, Pacione D, Wisoff JH, Teresa Hidalgo E, Harter D, William CM, Cordova C, Kurz SC, Barbaro M, Orringer DA, Karajannis MA, Sulman EP, Gardner SL, Zagzag D, Tsirigos A, Allen JC, Golfinos JG, Snuderl M. Clinical utility of whole-genome DNA methylation profiling as a primary molecular diagnostic assay for central nervous system tumors-A prospective study and guidelines for clinical testing. Neurooncol Adv 2023; 5:vdad076. [PMID: 37476329 PMCID: PMC10355794 DOI: 10.1093/noajnl/vdad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Background Central nervous system (CNS) cancer is the 10th leading cause of cancer-associated deaths for adults, but the leading cause in pediatric patients and young adults. The variety and complexity of histologic subtypes can lead to diagnostic errors. DNA methylation is an epigenetic modification that provides a tumor type-specific signature that can be used for diagnosis. Methods We performed a prospective study using DNA methylation analysis as a primary diagnostic method for 1921 brain tumors. All tumors received a pathology diagnosis and profiling by whole genome DNA methylation, followed by next-generation DNA and RNA sequencing. Results were stratified by concordance between DNA methylation and histopathology, establishing diagnostic utility. Results Of the 1602 cases with a World Health Organization histologic diagnosis, DNA methylation identified a diagnostic mismatch in 225 cases (14%), 78 cases (5%) did not classify with any class, and in an additional 110 (7%) cases DNA methylation confirmed the diagnosis and provided prognostic information. Of 319 cases carrying 195 different descriptive histologic diagnoses, DNA methylation provided a definitive diagnosis in 273 (86%) cases, separated them into 55 methylation classes, and changed the grading in 58 (18%) cases. Conclusions DNA methylation analysis is a robust method to diagnose primary CNS tumors, improving diagnostic accuracy, decreasing diagnostic errors and inconclusive diagnoses, and providing prognostic subclassification. This study provides a framework for inclusion of DNA methylation profiling as a primary molecular diagnostic test into professional guidelines for CNS tumors. The benefits include increased diagnostic accuracy, improved patient management, and refinements in clinical trial design.
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Affiliation(s)
- Kristyn Galbraith
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Varshini Vasudevaraja
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Jonathan Serrano
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Guomiao Shen
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Ivy Tran
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Nancy Abdallat
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Mandisa Wen
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Seema Patel
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Misha Movahed-Ezazi
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Arline Faustin
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Marissa Spino-Keeton
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Leah Geiser Roberts
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Ekrem Maloku
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Steven A Drexler
- Department of Pathology and Laboratory Medicine, NYU, Mineola, New York, USA
- Current affiliations: Department of Pathology, Mount Sinai South Nassau Hospital, Oceanside, New York, USA
| | - Benjamin L Liechty
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, New York, New York, USA
| | - David Pisapia
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, New York, New York, USA
| | - Olga Krasnozhen-Ratush
- Department of Pathology and Laboratory Medicine, Baystate Health, Springfield, Massachusetts, USA
| | - Marc Rosenblum
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Seema Shroff
- Department of Pathology and Laboratory Medicine, AdventHealth Orlando, Orlando, Florida, USA
| | - Daniel R Boué
- Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, and the Ohio State University, Columbus, Ohio, USA
| | | | - Qinwen Mao
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Paula North
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Annette Segura
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jason A Jarzembowski
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lauren Parsons
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mahlon D Johnson
- Department of Pathology, University of Rochester School of Medicine, New York, USA
| | - Bret Mobley
- Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wesley Samore
- Department of Pathology, Advocate Aurora Health, Chicago, Illinois, USA
| | - Declan McGuone
- Department of Pathology, Yale University School of Medicine, Connecticut, USA
| | - Pallavi P Gopal
- Department of Pathology, Yale University School of Medicine, Connecticut, USA
| | - Peter D Canoll
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, USA
| | - Craig Horbinski
- Departments of Pathology and Neurosurgery, Feinberg School of Medicine, Northwestern University, Illinois, USA
| | - Joseph M Fullmer
- Department of Pathology, Beaumont Hospital, Royal Oak, Michigan, USA
| | - Midhat S Farooqi
- Department of Pathology and Laboratory Medicine, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Murat Gokden
- Department of Pathology, University of Arkansas and Arkansas Children’s Hospital, Little Rock, Arkansas, USA
| | - Nitin R Wadhwani
- Department of Pathology and Laboratory Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Illinois, USA
| | - Timothy E Richardson
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Melissa Umphlett
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nadejda M Tsankova
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John C DeWitt
- Department of Pathology, University of Vermont Medical Center
| | - Chandra Sen
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | | | - Donato Pacione
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | - Jeffrey H Wisoff
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | | | - David Harter
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | - Christopher M William
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Christine Cordova
- Department of Neuro-oncology, NYU Langone, New York, New York, USA
- Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH
| | - Sylvia C Kurz
- Department of Neuro-oncology, NYU Langone, New York, New York, USA
- Department of Interdisciplinary Neuro-Oncology, Comprehensive Cancer Center, University of Tuebingen, Tübingen, Germany
| | - Marissa Barbaro
- Department of Neuro-oncology, NYU Langone, New York, New York, USA
| | | | - Matthias A Karajannis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Erik P Sulman
- Department of Radiation Oncology, NYU Langone, New York, New York, USA
| | | | - David Zagzag
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | | | - Jeffrey C Allen
- Department of Pediatrics, NYU Langone, New York, New York, USA
| | - John G Golfinos
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York, New York, USA
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5
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Grunig G, Durmus N, Zhang Y, Lu Y, Pehlivan S, Wang Y, Doo K, Cotrina-Vidal ML, Goldring R, Berger KI, Liu M, Shao Y, Reibman J. Molecular Clustering Analysis of Blood Biomarkers in World Trade Center Exposed Community Members with Persistent Lower Respiratory Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8102. [PMID: 35805759 PMCID: PMC9266229 DOI: 10.3390/ijerph19138102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Abstract
The destruction of the World Trade Center (WTC) on September 11, 2001 (9/11) released large amounts of toxic dusts and fumes into the air that exposed many community members who lived and/or worked in the local area. Many community members, defined as WTC survivors by the federal government, developed lower respiratory symptoms (LRS). We previously reported the persistence of these symptoms in patients with normal spirometry despite treatment with inhaled corticosteroids and/or long-acting bronchodilators. This report expands upon our study of this group with the goal to identify molecular markers associated with exposure and heterogeneity in WTC survivors with LRS using a selected plasma biomarker approach. Samples from WTC survivors with LRS (n = 73, WTCS) and samples from healthy control participants of the NYU Bellevue Asthma Registry (NYUBAR, n = 55) were compared. WTCS provided information regarding WTC dust exposure intensity. Hierarchical clustering of the linear biomarker data identified two clusters within WTCS and two clusters within NYUBAR controls. Comparison of the WTCS clusters showed that one cluster had significantly increased levels of circulating matrix metalloproteinases (MMP1, 2, 3, 8, 12, 13), soluble inflammatory receptors (receptor for advanced glycation end-products-RAGE, Interleukin-1 receptor antagonist (IL-1RA), suppression of tumorigenicity (ST)2, triggering receptor expressed on myeloid cells (TREM)1, IL-6Ra, tumor necrosis factor (TNF)RI, TNFRII), and chemokines (IL-8, CC chemokine ligand- CCL17). Furthermore, this WTCS cluster was associated with WTC exposure variables, ash at work, and the participant category workers; but not with the exposure variable WTC dust cloud at 9/11. A comparison of WTC exposure categorial variables identified that chemokines (CCL17, CCL11), circulating receptors (RAGE, TREM1), MMPs (MMP3, MMP12), and vascular markers (Angiogenin, vascular cell adhesion molecule-VCAM1) significantly increased in the more exposed groups. Circulating biomarkers of remodeling and inflammation identified clusters within WTCS and were associated with WTC exposure.
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Affiliation(s)
- Gabriele Grunig
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Nedim Durmus
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
| | - Yian Zhang
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Yuting Lu
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Sultan Pehlivan
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Yuyan Wang
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Kathleen Doo
- Pulmonary, Kaiser Permanente East Bay, Oakland, CA 94611, USA;
| | - Maria L. Cotrina-Vidal
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Roberta Goldring
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Kenneth I. Berger
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
| | - Mengling Liu
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Joan Reibman
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY 10010, USA
- Division of Pulmonary Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA; (N.D.); (S.P.); (M.L.C.-V.); (R.G.); (K.I.B.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (Y.Z.); (Y.L.); (Y.W.); (M.L.)
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6
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Yu H, Tuminello S, Alpert N, van Gerwen M, Yoo S, Mulholland DJ, Aaronson SA, Donovan M, Oh WK, Gong Y, Wang L, Zhu J, Taioli E. Global DNA methylation of WTC prostate cancer tissues show signature differences compared to non-exposed cases. Carcinogenesis 2022; 43:528-537. [PMID: 35239955 PMCID: PMC9234756 DOI: 10.1093/carcin/bgac025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 12/31/2022] Open
Abstract
There is increased incidence of prostate cancer (PC) among World Trade Center (WTC)-exposed responders and community members, with preliminary evidence suggestive of more aggressive disease. While previous research is supportive of differences in DNA methylation and gene expression as a consequence of WTC exposure, as measured in blood of healthy individuals, the epigenetics of WTC PC tissues has yet to be explored. Patients were recruited from the World Trade Center Health Program. Non-WTC PC samples were frequency matched on age, race/ethnicity and Gleason score. Bisulfite-treated DNA was extracted from tumor tissue blocks and used to assess global DNA methylation with the MethylationEPIC BeadChip. Differential and pathway enrichment analyses were conducted. RNA from the same tumor blocks was used for gene expression analysis to further support DNA methylation findings. Methylation data were generated for 28 samples (13 WTC and 15 non-WTC). Statistically significant differences in methylation were observed for 3,586 genes; on average WTC samples were statistically significantly more hypermethylated (P = 0.04131). Pathway enrichment analysis revealed hypermethylation in epithelial mesenchymal transition (EMT), hypoxia, mitotic spindle, TNFA signaling via NFKB, WNT signaling, and TGF beta signaling pathways in WTC compared to non-WTC samples. The androgen response, G2M and MYC target pathways were hypomethylated. These results correlated well with RNA gene expression. In conclusion, long-term epigenic changes associated with WTC dust exposure were observed in PC tissues. These occurred in genes of critical pathways, likely increasing prostate tumorigenesis potential. This warrants analysis of larger WTC groups and other cancer types.
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Affiliation(s)
- Haocheng Yu
- Sema4, a Mount Sinai venture, Stamford, CT, USA
| | - Stephanie Tuminello
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health, New York University Langone Health, New York, NY, USA
| | - Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maaike van Gerwen
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - David J Mulholland
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stuart A Aaronson
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Donovan
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William K Oh
- Division of Hematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yixuan Gong
- Division of Hematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Li Wang
- Sema4, a Mount Sinai venture, Stamford, CT, USA
- Icahn Institute for Data Science and Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun Zhu
- Sema4, a Mount Sinai venture, Stamford, CT, USA
- Icahn Institute for Data Science and Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NYUSA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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7
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Manu DM, Mwinyi J, Schiöth HB. Challenges in Analyzing Functional Epigenetic Data in Perspective of Adolescent Psychiatric Health. Int J Mol Sci 2022; 23:ijms23105856. [PMID: 35628666 PMCID: PMC9147258 DOI: 10.3390/ijms23105856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/11/2022] [Accepted: 05/18/2022] [Indexed: 12/10/2022] Open
Abstract
The formative period of adolescence plays a crucial role in the development of skills and abilities for adulthood. Adolescents who are affected by mental health conditions are at risk of suicide and social and academic impairments. Gene–environment complementary contributions to the molecular mechanisms involved in psychiatric disorders have emphasized the need to analyze epigenetic marks such as DNA methylation (DNAm) and non-coding RNAs. However, the large and diverse bioinformatic and statistical methods, referring to the confounders of the statistical models, application of multiple-testing adjustment methods, questions regarding the correlation of DNAm across tissues, and sex-dependent differences in results, have raised challenges regarding the interpretation of the results. Based on the example of generalized anxiety disorder (GAD) and depressive disorder (MDD), we shed light on the current knowledge and usage of methodological tools in analyzing epigenetics. Statistical robustness is an essential prerequisite for a better understanding and interpretation of epigenetic modifications and helps to find novel targets for personalized therapeutics in psychiatric diseases.
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8
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Galbraith K, Snuderl M. DNA methylation as a diagnostic tool. Acta Neuropathol Commun 2022; 10:71. [PMID: 35527288 PMCID: PMC9080136 DOI: 10.1186/s40478-022-01371-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 01/09/2023] Open
Abstract
DNA methylation of cytosines in CpG sites throughout the genome is an epigenetic mark contributing to gene expression regulation. DNA methylation patterns are specific to tissue type, conserved throughout life and reflect changes during tumorigenesis. DNA methylation recently emerged as a diagnostic tool to classify tumors based on a combination of preserved developmental and mutation induced signatures. In addition to the tumor classification, DNA methylation data can also be used to evaluate copy number variation, assess promoter methylation status of specific genes, such as MGMT or MLH1, and deconvolute the tumor microenvironment, assessing the tumor immune infiltrate as a potential biomarker for immunotherapy. Here we review the role for DNA methylation in tumor diagnosis.
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9
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Tuminello S, Zhang Y, Yang L, Durmus N, Snuderl M, Heguy A, Zeleniuch-Jacquotte A, Chen Y, Shao Y, Reibman J, Arslan AA. Global DNA Methylation Profiles in Peripheral Blood of WTC-Exposed Community Members with Breast Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095104. [PMID: 35564499 PMCID: PMC9105091 DOI: 10.3390/ijerph19095104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 12/22/2022]
Abstract
Breast cancer represents the most common cancer diagnosis among World Trade Center (WTC)-exposed community members, residents, and cleanup workers enrolled in the WTC Environmental Health Center (WTC EHC). The primary aims of this study were (1) to compare blood DNA methylation profiles of WTC-exposed community members with breast cancer and WTC-unexposed pre-diagnostic breast cancer blood samples, and (2) to compare the DNA methylation differences among the WTC EHC breast cancer cases and WTC-exposed cancer-free controls. Gene pathway enrichment analyses were further conducted. There were significant differences in DNA methylation between WTC-exposed breast cancer cases and unexposed prediagnostic breast cancer cases. The top differentially methylated genes were Intraflagellar Transport 74 (IFT74), WD repeat-containing protein 90 (WDR90), and Oncomodulin (OCM), which are commonly upregulated in tumors. Probes associated with established tumor suppressor genes (ATM, BRCA1, PALB2, and TP53) were hypermethylated among WTC-exposed breast cancer cases compared to the unexposed group. When comparing WTC EHC breast cancer cases vs. cancer-free controls, there appeared to be global hypomethylation among WTC-exposed breast cancer cases compared to exposed controls. Functional pathway analysis revealed enrichment of several gene pathways in WTC-exposed breast cancer cases including endocytosis, proteoglycans in cancer, regulation of actin cytoskeleton, axon guidance, focal adhesion, calcium signaling, cGMP-PKG signaling, mTOR, Hippo, and oxytocin signaling. The results suggest potential epigenetic links between WTC exposure and breast cancer in local community members enrolled in the WTC EHC program.
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Affiliation(s)
- Stephanie Tuminello
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (Y.Z.); (A.Z.-J.); (Y.C.); (Y.S.)
- Correspondence: (S.T.); (A.A.A.)
| | - Yian Zhang
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (Y.Z.); (A.Z.-J.); (Y.C.); (Y.S.)
| | - Lei Yang
- Foundation Medicine, Cambridge, MA 02141, USA;
| | - Nedim Durmus
- Department of Medicine, New York University Langone Health, New York, NY 10016, USA; (N.D.); (J.R.)
| | - Matija Snuderl
- Department of Pathology, New York University Langone Health, New York, NY 10016, USA; (M.S.); (A.H.)
| | - Adriana Heguy
- Department of Pathology, New York University Langone Health, New York, NY 10016, USA; (M.S.); (A.H.)
- NYU Langone’s Genome Technology Center, New York, NY 10016, USA
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (Y.Z.); (A.Z.-J.); (Y.C.); (Y.S.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
| | - Yu Chen
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (Y.Z.); (A.Z.-J.); (Y.C.); (Y.S.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (Y.Z.); (A.Z.-J.); (Y.C.); (Y.S.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
| | - Joan Reibman
- Department of Medicine, New York University Langone Health, New York, NY 10016, USA; (N.D.); (J.R.)
| | - Alan A. Arslan
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (Y.Z.); (A.Z.-J.); (Y.C.); (Y.S.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Department of Obstetrics and Gynecology, New York University Langone Health, New York, NY 10016, USA
- Correspondence: (S.T.); (A.A.A.)
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10
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Chiao JW. What causes prostate cancer-learning from a tragedy. Carcinogenesis 2021; 42:1221-1222. [PMID: 34431987 DOI: 10.1093/carcin/bgab078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jen Wei Chiao
- Department of Medicine, New York Medical College, Valhalla, NY, USA
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11
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Shao Y, Durmus N, Zhang Y, Pehlivan S, Fernandez-Beros ME, Umana L, Corona R, Addessi A, Abbott SA, Smyth-Giambanco S, Arslan AA, Reibman J. The Development of a WTC Environmental Health Center Pan-Cancer Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041646. [PMID: 33572220 PMCID: PMC7916067 DOI: 10.3390/ijerph18041646] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022]
Abstract
(1) Background: Recent studies have reported elevated risks of multiple cancers in the World Trade Center (WTC) affected community members (also called WTC “Survivors”). The large variety of WTC-cancers created a need to develop a comprehensive cancer database. This paper describes the development of a pan-cancer database at the WTC Environmental Health Center (EHC) Data Center. (2) Methods: A new REDCap-based pan-cancer database was created using the pathology reports and available biomarker data of confirmed cancer cases after review by a cancer epidemiologist, a pathologist, physicians and biostatisticians. (3) Results: The WTC EHC pan-cancer database contains cancer characteristics and emerging biomarker information for cancers of individuals enrolled in the WTC EHC and diagnosed after 11 September 2001 and up to 31 December 2019 obtained from WTC EHC clinical records, pathological reports and state cancer registries. As of 31 December 2019, the database included 3440 cancer cases with cancer characteristics and biomarker information. (4) Conclusions: This evolving database represents an important resource for the scientific community facilitating future research about the etiology, heterogeneity, characteristics and outcomes of cancers and comorbid mental health conditions, cancer economics and gene–environment interaction in the unique population of WTC survivors.
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Affiliation(s)
- Yongzhao Shao
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine (NYUGSOM), New York University, New York, NY 10016, USA; (Y.Z.); (A.A.A.)
- Department of Environmental Medicine, NYUG-SOM, New York University, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Correspondence: (Y.S.); (J.R.)
| | - Nedim Durmus
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Yian Zhang
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine (NYUGSOM), New York University, New York, NY 10016, USA; (Y.Z.); (A.A.A.)
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Sultan Pehlivan
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Maria-Elena Fernandez-Beros
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Lisette Umana
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Rachel Corona
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Adrienne Addessi
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Sharon A. Abbott
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Sheila Smyth-Giambanco
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
| | - Alan A. Arslan
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine (NYUGSOM), New York University, New York, NY 10016, USA; (Y.Z.); (A.A.A.)
- Department of Environmental Medicine, NYUG-SOM, New York University, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- NYU Perlmutter Comprehensive Cancer Center, New York, NY 10016, USA
- Department of Obstetrics and Gynecology, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
| | - Joan Reibman
- Department of Environmental Medicine, NYUG-SOM, New York University, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC Health + Hospitals, New York, NY 10016, USA; (N.D.); (S.P.); (M.-E.F.-B.); (L.U.); (R.C.); (A.A.); (S.A.A.); (S.S.-G.)
- Division of Pulmonary Medicine, School of Medicine (SOM), NYUG-SOM, New York University, New York, NY 10016, USA
- Correspondence: (Y.S.); (J.R.)
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12
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Reibman J, Caplan-Shaw C, Wu Y, Liu M, Amin MR, Berger KI, Cotrina-Vidal ML, Kazeros A, Durmus N, Fernandez-Beros ME, Goldring RM, Rosen R, Shao Y. Characterization of Persistent Uncontrolled Asthma Symptoms in Community Members Exposed to World Trade Center Dust and Fumes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186645. [PMID: 32933057 PMCID: PMC7558705 DOI: 10.3390/ijerph17186645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 12/22/2022]
Abstract
The destruction of the World Trade Center (WTC) towers on the 11th of September, 2001 released a vast amount of aerosolized dust and smoke resulting in acute and chronic exposures to community members as well as responders. The WTC Environmental Health Center (WTC EHC) is a surveillance and treatment program for a diverse population of community members, including local residents and local workers with WTC dust exposure. Many of these patients have reported persistent lower respiratory symptoms (LRS) despite treatment for presumed asthma. Our goal was to identify conditions associated with persistent uncontrolled LRS despite standard asthma management. We recruited 60 patients who were uncontrolled at enrollment and, after a three-month run-in period on high-dose inhaled corticosteroid and long acting bronchodilator, reassessed their status as Uncontrolled or Controlled based on a score from the Asthma Control Test (ACT). Despite this treatment, only 11 participants (18%) gained Controlled status as defined by the ACT. We compared conditions associated with Uncontrolled and Controlled status. Those with Uncontrolled symptoms had higher rates of upper airway symptoms. Many patients had persistent bronchial hyper-reactivity (BHR) and upper airway hyper-reactivity as measured by paradoxical vocal fold movement (PVFM). We found a significant increasing trend in the percentage of Controlled with respect to the presence of BHR and PVFM. We were unable to identify significant differences in lung function or inflammatory markers in this small group. Our findings suggest persistent upper and lower airway hyper-reactivity that may respond to standard asthma treatment, whereas others with persistent LRS necessitate additional diagnostic evaluation, including a focus on the upper airway.
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Affiliation(s)
- Joan Reibman
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
- Correspondence: ; Tel.: +1-212-263-6479
| | - Caralee Caplan-Shaw
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Yinxiang Wu
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
| | - Mengling Liu
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Milan R. Amin
- Department of Otolaryngology-Head and Neck Surgery, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Kenneth I. Berger
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Maria L. Cotrina-Vidal
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Angeliki Kazeros
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Nedim Durmus
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
| | - Maria-Elena Fernandez-Beros
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Roberta M. Goldring
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA; (C.C.-S.); (K.I.B.); (A.K.); (N.D.); (M.-E.F.-B.); (R.M.G.)
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
| | - Rebecca Rosen
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Yongzhao Shao
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA; (Y.W.); (M.L.); (Y.S.)
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York, NY 10016, USA
- World Trade Center Environmental Health Center, NYC H+HC, New York, NY 10016, USA; (M.L.C.-V.); (R.R.)
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