Bronchodilator Response Predicts Longitudinal Improvement in Small Airway Function in World Trade Center Dust Exposed Community Members

Deepak Pradhan, Ning Xu, Joan Reibman, Roberta M. Goldring, Yongzhao Shao, Mengling Liu and Kenneth I. Berger
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Deepak Pradhan: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY 10016, USA
Ning Xu: Department of Population Health, New York University School of Medicine, New York, NY 10016, USA
Joan Reibman: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY 10016, USA
Roberta M. Goldring: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY 10016, USA
Yongzhao Shao: Department of Population Health, New York University School of Medicine, New York, NY 10016, USA
Mengling Liu: Department of Population Health, New York University School of Medicine, New York, NY 10016, USA
Kenneth I. Berger: Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY 10016, USA

IJERPH, 2019, vol. 16, issue 8, 1-11

Abstract: The evolution of lung function, including assessment of small airways, was assessed in individuals enrolled in the World Trade Center Environmental Health Center (WTC-EHC). We hypothesized that a bronchodilator response at initial evaluation shown by spirometry or in small airways, as measured by forced oscillation technique (FOT), would be associated with improvement in large and small airway function over time. Standardized longitudinal assessment included pre and post bronchodilator (BD) spirometry (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV 1 ) and FOT (resistance at 5 Hz, R 5 ; resistance at 5 minus 20 Hz, R 5–20 ). Longitudinal changes were assessed using linear mixed-effects modelling with adjustment for potential confounders (median follow-up 2.86 years; 95% measurements within 4.9 years). Data demonstrated: (1) parallel improvement in airflow and volume measured by spirometry and small airway function (R 5 and R 5–20 ) measured by FOT; (2) the magnitude of longitudinal improvement was tightly linked to the initial BD response; and (3) longitudinal values for small airway function on FOT were similar to residual abnormality observed post BD at initial visit. These findings suggest presence of reversible and irreversible components of small airway injury that are identifiable at initial presentation. These results have implications for treatment of isolated small airway abnormalities that can be identified by non-invasive effort independent FOT particularly in symptomatic individuals with normal spirometry indices. This study underscores the need to study small airway function to understand physiologic changes over time following environmental and occupational lung injury.

Keywords: airway physiology; dust; environmental health; forced oscillation; respiratory function; small airway disease (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 (3)

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