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Enzyme Tied to World Trade Center Illnesses

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http://www.nydailynews.com/front/story/465120p-391263c.html .

Enzyme tied to WTC ills

May explain cough, study sez

BY PAUL H.B. SHIN

DAILY NEWS STAFF WRITER

Doctors unveiled a tantalizing glimpse yesterday into why some firefighters

may suffer from the " World Trade Center cough " while others who endured the

toxic dust and fumes at Ground Zero are relatively healthy.

Firefighters whose lung capacity deteriorated faster in the wake of 9/11

were more likely to be deficient in a key natural enzyme that protects

against lung damage, according to a study of 90 of the 12,000 Bravest who

responded to the attacks at Ground Zero.

But Dr. Prezant, the study's lead researcher and the FDNY's co-chief

medical officer, cautioned against drawing too broad a conclusion from the

report.

" This is very, very preliminary information that cannot in any shape or form

be translated into a diagnosis or treatment initiative, " Prezant told the

Daily News from Salt Lake City, where he presented his findings at a

gathering of the American College of Chest Physicians.

" It is only one small piece of a puzzle, " he said. " We are trying to

understand the science behind why some patients come down with World Trade

Center respiratory diseases and others do not. "

However, the research could eventually help solve the puzzle years down the

road, said Prezant, a lung specialist at Montefiore Medical Center.

Using a blood test normally used to screen people at risk of early-onset

emphysema, Prezant found that 11 of the 90 firefighters had low levels of an

enzyme called alpha-1 antitrypsin, or A1AT.

Of the 11, four had a significant deficiency of A1AT while seven had a

moderate deficiency, the blood tests showed.

But none had the most severe kind of genetic deficiency. All have the WTC

cough.

" What this enzyme does is it protects the lungs from damage, " said Dr. Mark

Rosen, a pulmonologist at North Shore-Long Island Jewish Medical Center and

president of American College of Chest Physicians.

" It prevents the destruction of lung tissue by a variety of mechanisms, " he

said.

About 150,000 Americans have a severe shortage of A1AT, but many are

undiagnosed.

" Many more have a partial deficiency, and most of those people are not

diagnosed for their whole lives because most of those people don't get sick "

unless they are exposed to toxins such as cigarette smoke, Rosen said.

Prezant stressed that trying to determine whether a particular disease -

whether it's WTC cough or breast cancer - is due to genetic or environmental

factors is a science that's still in its infancy.

" It's not going to be one genetic trait " that is responsible for WTC cough,

Prezant said.

That's why simply testing responders for the enzyme won't be useful, he

said.

But the ongoing research at the FDNY is " on the cutting edge for trying to

find future cures. "

A study published in August by one of Prezant's colleagues at Montefiore

painted a grim picture of the lung ailments among the 12,000 firefighters

who inhaled dust and smoke on 9/11 and in the following months.

Those firefighters suffered a dramatic loss of lung capacity - 12 times the

normal rate that occurs each year as people age, the study found.

Originally published on October 25, 2006

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