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Papers by Anna Nolan
American Journal of Respiratory and Critical Care Medicine
D31. NEW INSIGHTS INTO INFLAMMATION AND ACUTE LUNG INJURY, 2009
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
Seminars in Respiratory and Critical Care Medicine, 2015
Biomarkers can be important predictors of disease severity and progression. The intense exposure ... more Biomarkers can be important predictors of disease severity and progression. The intense exposure to particulates and other toxins from the destruction of the World Trade Center (WTC) overwhelmed the lung's normal protective barriers. The Fire Department of New York (FDNY) cohort not only had baseline pre-exposure lung function measures but also had serum samples banked soon after their WTC exposure. This well-phenotyped group of highly exposed first responders is an ideal cohort for biomarker discovery and eventual validation. Disease progression was heterogeneous in this group in that some individuals subsequently developed abnormal lung function while others recovered. Airflow obstruction predominated in WTC-exposed patients who were symptomatic. Multiple independent disease pathways may cause this abnormal FEV1 after irritant exposure. WTC exposure activates one or more of these pathways causing abnormal FEV1 in an individual. Our hypothesis was that serum biomarkers expressed within 6 months after WTC exposure reflect active disease pathways and predict subsequent development or protection from abnormal FEV1 below the lower limit of normal known as WTC-Lung Injury (WTC-LI). We utilized a nested case-cohort control design of previously healthy never smokers who sought subspecialty pulmonary evaluation to explore predictive biomarkers of WTC-LI. We have identified biomarkers of inflammation, metabolic derangement, protease/antiprotease balance, and vascular injury expressed in serum within 6 months of WTC exposure that were predictive of their FEV1 up to 7 years after their WTC exposure. Predicting future risk of airway injury after particulate exposures can focus monitoring and early treatment on a subset of patients in greatest need of these services.
PLoS currents, 2015
Adverse respiratory effects of World Trade Center (WTC) exposure have been widely documented, but... more Adverse respiratory effects of World Trade Center (WTC) exposure have been widely documented, but the length of time that exposure remains associated with disease is uncertain. We estimate the incidence of new cases of physician-diagnosed obstructive airway disease (OAD) as a function of time since 9/11/2001 in WTC-exposed firefighters. Exposure was categorized by first WTC arrival time: high (9/11/2001 AM); moderate (9/11/2001 PM or 9/12/2001); or low (9/13-24/2001). We modeled relative rates (RR) and 95% confidence intervals (CI) of OAD incidence by exposure over the first 10 years post-9/11/2001, estimating the time(s) of change in the RR with change point models. We further examined the relationship between self-reported lower respiratory symptoms and physician diagnoses. Change points were observed at 15 and 84 months post-9/11/2001, with relative incidence rates for the high versus low exposure group of 4.02 (95% CI 2.62-6.16) prior to 15 months, 1.90 (95% CI 1.49-2.44) from m...
D40. UNDERSTANDING INHALATIONAL DISASTERS, 2009
B45. ANIMAL AND CELL MODELS FOR THE CARDIOVASCULAR EFFECTS OF AIR POLLUTION, 2009
C52. OCCUPATIONAL LUNG DISEASE, 2011
A29. NOVEL INSIGHTS INTO LUNG MECHANICS IN HEALTH AND DISEASE, 2010
BMJ open, 2014
We hypothesise that there is an association between an elevated pulmonary artery/aorta (PA/A) and... more We hypothesise that there is an association between an elevated pulmonary artery/aorta (PA/A) and World Trade Center-Lung Injury (WTC-LI). We assessed if serum vascular disease biomarkers were predictive of an elevated PA/A. Retrospective case-cohort analysis of thoracic CT scans of WTC-exposed firefighters who were symptomatic between 9/12/2001 and 3/10/2008. Quantification of vascular-associated biomarkers from serum collected within 200 days of exposure. Urban tertiary care centre and occupational healthcare centre. Male never-smoking firefighters with accurate pre-9/11 forced expiratory volume in 1 s (FEV1)≥75%, serum sampled ≤200 days of exposure was the baseline cohort (n=801). A subcohort (n=97) with available CT scans and serum biomarkers was identified. WTC-LI was defined as FEV1≤77% at the subspecialty pulmonary evaluation (n=34) and compared with controls (n=63) to determine the associated PA/A ratio. The subcohort was restratified based on PA/A≥0.92 (n=38) and PA/A<0....
American Journal of Respiratory and Critical Care Medicine
D31. NEW INSIGHTS INTO INFLAMMATION AND ACUTE LUNG INJURY, 2009
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
American Journal of Respiratory and Critical Care Medicine
Seminars in Respiratory and Critical Care Medicine, 2015
Biomarkers can be important predictors of disease severity and progression. The intense exposure ... more Biomarkers can be important predictors of disease severity and progression. The intense exposure to particulates and other toxins from the destruction of the World Trade Center (WTC) overwhelmed the lung&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s normal protective barriers. The Fire Department of New York (FDNY) cohort not only had baseline pre-exposure lung function measures but also had serum samples banked soon after their WTC exposure. This well-phenotyped group of highly exposed first responders is an ideal cohort for biomarker discovery and eventual validation. Disease progression was heterogeneous in this group in that some individuals subsequently developed abnormal lung function while others recovered. Airflow obstruction predominated in WTC-exposed patients who were symptomatic. Multiple independent disease pathways may cause this abnormal FEV1 after irritant exposure. WTC exposure activates one or more of these pathways causing abnormal FEV1 in an individual. Our hypothesis was that serum biomarkers expressed within 6 months after WTC exposure reflect active disease pathways and predict subsequent development or protection from abnormal FEV1 below the lower limit of normal known as WTC-Lung Injury (WTC-LI). We utilized a nested case-cohort control design of previously healthy never smokers who sought subspecialty pulmonary evaluation to explore predictive biomarkers of WTC-LI. We have identified biomarkers of inflammation, metabolic derangement, protease/antiprotease balance, and vascular injury expressed in serum within 6 months of WTC exposure that were predictive of their FEV1 up to 7 years after their WTC exposure. Predicting future risk of airway injury after particulate exposures can focus monitoring and early treatment on a subset of patients in greatest need of these services.
PLoS currents, 2015
Adverse respiratory effects of World Trade Center (WTC) exposure have been widely documented, but... more Adverse respiratory effects of World Trade Center (WTC) exposure have been widely documented, but the length of time that exposure remains associated with disease is uncertain. We estimate the incidence of new cases of physician-diagnosed obstructive airway disease (OAD) as a function of time since 9/11/2001 in WTC-exposed firefighters. Exposure was categorized by first WTC arrival time: high (9/11/2001 AM); moderate (9/11/2001 PM or 9/12/2001); or low (9/13-24/2001). We modeled relative rates (RR) and 95% confidence intervals (CI) of OAD incidence by exposure over the first 10 years post-9/11/2001, estimating the time(s) of change in the RR with change point models. We further examined the relationship between self-reported lower respiratory symptoms and physician diagnoses. Change points were observed at 15 and 84 months post-9/11/2001, with relative incidence rates for the high versus low exposure group of 4.02 (95% CI 2.62-6.16) prior to 15 months, 1.90 (95% CI 1.49-2.44) from m...
D40. UNDERSTANDING INHALATIONAL DISASTERS, 2009
B45. ANIMAL AND CELL MODELS FOR THE CARDIOVASCULAR EFFECTS OF AIR POLLUTION, 2009
C52. OCCUPATIONAL LUNG DISEASE, 2011
A29. NOVEL INSIGHTS INTO LUNG MECHANICS IN HEALTH AND DISEASE, 2010
BMJ open, 2014
We hypothesise that there is an association between an elevated pulmonary artery/aorta (PA/A) and... more We hypothesise that there is an association between an elevated pulmonary artery/aorta (PA/A) and World Trade Center-Lung Injury (WTC-LI). We assessed if serum vascular disease biomarkers were predictive of an elevated PA/A. Retrospective case-cohort analysis of thoracic CT scans of WTC-exposed firefighters who were symptomatic between 9/12/2001 and 3/10/2008. Quantification of vascular-associated biomarkers from serum collected within 200 days of exposure. Urban tertiary care centre and occupational healthcare centre. Male never-smoking firefighters with accurate pre-9/11 forced expiratory volume in 1 s (FEV1)≥75%, serum sampled ≤200 days of exposure was the baseline cohort (n=801). A subcohort (n=97) with available CT scans and serum biomarkers was identified. WTC-LI was defined as FEV1≤77% at the subspecialty pulmonary evaluation (n=34) and compared with controls (n=63) to determine the associated PA/A ratio. The subcohort was restratified based on PA/A≥0.92 (n=38) and PA/A<0....