PDF(Pubmed)
Abstract：
BACKGROUND: Particulate matter exposure (PM) is a cause of aerodigestive disease globally. The destruction of the World Trade Center (WTC) exposed fifirst responders and inhabitants of New York City to WTC-PM and caused obstructive airways disease (OAD), gastroesophageal Refux disease (GERD) and Barrett\'s Esophagus (BE). GERD not only diminishes health-related quality of life but also gives rise to complications that extend beyond the scope of BE. GERD can incite or exacerbate allergies, sinusitis, bronchitis, and asthma. Disease features of the aerodigestive axis can overlap, often necessitating more invasive diagnostic testing and treatment modalities. This presents a need to develop novel non-invasive biomarkers of GERD, BE, airway hyperreactivity (AHR), treatment efficacy, and severity of symptoms.
METHODS: Our observational case-cohort study will leverage the longitudinally phenotyped Fire Department of New York (FDNY)-WTC exposed cohort to identify Biomarkers of Airway Disease, Barrett\'s and Underdiagnosed Refux Noninvasively (BAD-BURN). Our study population consists of n = 4,192 individuals from which we have randomly selected a sub-cohort control group (n = 837). We will then recruit subgroups of i. AHR only ii. GERD only iii. BE iv. GERD/BE and AHR overlap or v. No GERD or AHR, from the sub-cohort control group. We will then phenotype and examine non-invasive biomarkers of these subgroups to identify under-diagnosis and/or treatment efficacy. The findings may further contribute to the development of future biologically plausible therapies, ultimately enhance patient care and quality of life.
CONCLUSIONS: Although many studies have suggested interdependence between airway and digestive diseases, the causative factors and specific mechanisms remain unclear. The detection of the disease is further complicated by the invasiveness of conventional GERD diagnosis procedures and the limited availability of disease-specific biomarkers. The management of Refux is important, as it directly increases risk of cancer and negatively impacts quality of life. Therefore, it is vital to develop novel noninvasive disease markers that can effectively phenotype, facilitate early diagnosis of premalignant disease and identify potential therapeutic targets to improve patient care.
BACKGROUND: ClinicalTrials.gov Identifier: NCT05216133; January 18, 2022.
METHODS: Our observational case-cohort study will leverage the longitudinally phenotyped Fire Department of New York (FDNY)-WTC exposed cohort to identify Biomarkers of Airway Disease, Barrett\'s and Underdiagnosed Refux Noninvasively (BAD-BURN). Our study population consists of n = 4,192 individuals from which we have randomly selected a sub-cohort control group (n = 837). We will then recruit subgroups of i. AHR only ii. GERD only iii. BE iv. GERD/BE and AHR overlap or v. No GERD or AHR, from the sub-cohort control group. We will then phenotype and examine non-invasive biomarkers of these subgroups to identify under-diagnosis and/or treatment efficacy. The findings may further contribute to the development of future biologically plausible therapies, ultimately enhance patient care and quality of life.
CONCLUSIONS: Although many studies have suggested interdependence between airway and digestive diseases, the causative factors and specific mechanisms remain unclear. The detection of the disease is further complicated by the invasiveness of conventional GERD diagnosis procedures and the limited availability of disease-specific biomarkers. The management of Refux is important, as it directly increases risk of cancer and negatively impacts quality of life. Therefore, it is vital to develop novel noninvasive disease markers that can effectively phenotype, facilitate early diagnosis of premalignant disease and identify potential therapeutic targets to improve patient care.
BACKGROUND: ClinicalTrials.gov Identifier: NCT05216133; January 18, 2022.
摘要：
背景：颗粒物暴露（PM）是全球呼吸消化疾病的原因。世界贸易中心（WTC）的破坏使纽约市的第一响应者和居民暴露于WTC-PM，并导致阻塞性气道疾病（OAD）。胃食管反流病（GERD）和Barrett食管（BE）。GERD不仅会降低与健康相关的生活质量，还会引起超出BE范围的并发症。GERD会引起或加剧过敏，鼻窦炎,支气管炎,和哮喘。呼吸消化轴的疾病特征可以重叠，通常需要更具侵入性的诊断测试和治疗方式。这表明需要开发新的GERD的非侵入性生物标志物，BE,气道高反应性（AHR），治疗功效,和症状的严重程度。
方法：我们的观察性病例队列研究将利用纽约消防局（FDNY）-WTC暴露的纵向表型队列来识别AirwayDisease的Biomarker，B-arrett和U-侵入性诊断为R-EfluxN(BAD-BURN)。我们的研究人群由n=4,192个人组成，我们从中随机选择了一个子队列对照组（n=837）。然后，我们将招募i。AHR仅II的子组。只有GERDiii.BEiv.GERD/BE和AHR重叠或v.无GERD或AHR，来自亚队列对照组。然后我们将表型并检查这些亚组的非侵入性生物标志物，以鉴定诊断不足和/或治疗功效。这些发现可能进一步有助于未来生物合理疗法的发展，最终提高患者的护理和生活质量。
结论：尽管许多研究表明气道和消化系统疾病之间存在相互依存关系，致病因素和具体机制尚不清楚.常规GERD诊断程序的侵入性和疾病特异性生物标志物的有限可用性使疾病的检测进一步复杂化。反流的管理很重要，因为它直接增加患癌症的风险，并对生活质量产生负面影响。因此,至关重要的是开发新的非侵入性疾病标记，可以有效的表型，促进癌前疾病的早期诊断，并确定潜在的治疗目标，以改善患者护理。
背景：ClinicalTrials.gov标识符：NCT05216133；2022年1月18日。
方法：我们的观察性病例队列研究将利用纽约消防局（FDNY）-WTC暴露的纵向表型队列来识别AirwayDisease的Biomarker，B-arrett和U-侵入性诊断为R-EfluxN(BAD-BURN)。我们的研究人群由n=4,192个人组成，我们从中随机选择了一个子队列对照组（n=837）。然后，我们将招募i。AHR仅II的子组。只有GERDiii.BEiv.GERD/BE和AHR重叠或v.无GERD或AHR，来自亚队列对照组。然后我们将表型并检查这些亚组的非侵入性生物标志物，以鉴定诊断不足和/或治疗功效。这些发现可能进一步有助于未来生物合理疗法的发展，最终提高患者的护理和生活质量。
结论：尽管许多研究表明气道和消化系统疾病之间存在相互依存关系，致病因素和具体机制尚不清楚.常规GERD诊断程序的侵入性和疾病特异性生物标志物的有限可用性使疾病的检测进一步复杂化。反流的管理很重要，因为它直接增加患癌症的风险，并对生活质量产生负面影响。因此,至关重要的是开发新的非侵入性疾病标记，可以有效的表型，促进癌前疾病的早期诊断，并确定潜在的治疗目标，以改善患者护理。
背景：ClinicalTrials.gov标识符：NCT05216133；2022年1月18日。
