Sarcoid-Like Granulomatous Disease: Pathologic Case Series in World Trade Center Dust Exposed Rescue and Recovery Workers

Vasanthi R. Sunil, Jared Radbel, Sabiha Hussain, Kinal N. Vayas, Jessica Cervelli, Malik Deen, Howard Kipen, Iris Udasin, Robert Laumbach, Jag Sunderram, Jeffrey D. Laskin and Debra L. Laskin
Additional contact information
Vasanthi R. Sunil: Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA
Jared Radbel: Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
Sabiha Hussain: Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
Kinal N. Vayas: Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA
Jessica Cervelli: Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA
Malik Deen: Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
Howard Kipen: School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
Iris Udasin: School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
Robert Laumbach: School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
Jag Sunderram: Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ 08901, USA
Jeffrey D. Laskin: School of Public Health, Rutgers University, Piscataway, NJ 08854, USA
Debra L. Laskin: Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ 08854, USA

IJERPH, 2019, vol. 16, issue 5, 1-18

Abstract: Sarcoid-like granulomatous diseases (SGD) have been previously identified in cohorts of World Trade Center (WTC) dust-exposed individuals. In the present studies, we analyzed lung and/or lymph node biopsies from patients referred to our clinic with suspected WTC dust-induced lung disease to evaluate potential pathophysiologic mechanisms. Histologic sections of lung and/or lymph node samples were analyzed for markers of injury, oxidative stress, inflammation, fibrosis, and epigenetic modifications. Out of seven patients examined, we diagnosed four with SGD and two with pulmonary fibrosis; one was diagnosed later with SGD at another medical facility. Patients with SGD were predominantly white, obese men, who were less than 50 years old and never smoked. Cytochrome b5, cytokeratin 17, heme oxygenase-1, lipocalin-2, inducible nitric oxide synthase, cyclooxygenase 2, tumor necrosis factor α, ADP-ribosylation factor-like GTPase 11, mannose receptor-1, galectin-3, transforming growth factor β, histone-3 and methylated histone-3 were identified in lung and lymph nodes at varying levels in all samples examined. Three of the biopsy samples with granulomas displayed peri-granulomatous fibrosis. These findings are important and suggest the potential of WTC dust-induced fibrotic sarcoid. It is likely that patient demographics and/or genetic factors influence the response to WTC dust injury and that these contribute to different pathological outcomes.

Keywords: WTC; fibrotic sarcoid; injury; inflammation; fibrosis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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