Faster Aging, Chronic Disease Linked to WTC Responders With PTSD

Study published in Nature Communications led by Stony Brook researchers reveals molecular signatures related to disease and aging processes in a large patient cohort

STONY BROOK, NY, June 25, 2026 - Post-Traumatic Stress Disorder (PTSD) remains a common condition affecting World Trade Center (WTC) responders 25 years after the attack on the Twin Towers. While the condition is considered mainly psychological, a new study sheds light on changes in the biological processes of WTC patients with PTSD that may explain why PTSD is associated with a variety of chronic diseases that ultimately contribute to aging.

Completed by a team of researchers affiliated with the Stony Brook World Trade Center Health and Wellness Program, which monitors the health and provides patient care to some 10,000 WTC responders, and scientists at Duke University, the study is published early online in Nature Communications. (To access the full text, scroll down to the bottom and open the sharable link.)

The work represents more than a decade of research led by Benjamin J. Luft, MD, senior author, the Edmund D. Pellegrino Professor of Medicine in the Renaissance School of Medicine (RSOM) at Stony Brook University, and Director of the WTC Health and Wellness Program; and Pei-Fen Kuan, PhD, first author, and Professor in the Department of Applied Mathematics and Statistics in the College of Engineering and Applied Sciences at Stony Brook University.

Medical researchers have documented that PTSD is associated with an increased risk of chronic disease and accelerated biological aging, yet the underlying mechanisms in patients remain unclear. For this study, the team collected blood samples of WTC responder patients nearly 18 years after 9/11. They performed plasma proteomics and collaborated with Dr. Christopher Newgard and his team at the Duke Molecular Physiology Institute to perform targeted metabolomics in 393 WTC responders - 232 of these individuals had diagnosed PTSD, and 161 were trauma-exposed controls. A total of 114 proteins and seven metabolites were expressed differently in the PTSD patients.

Essentially, these identified proteins and metabolites are molecular signatures that converge on the body's pathways that are related to neuronal structure, immune system activation, metabolic regulation, redox balance (related to the oxidation process key to health), and important extracellular processes. The team determined that these molecular expressions contributed to metabolite dysregulation often seen within chronic disease processes.

Additionally, the authors emphasize that an important finding in the study is that PTSD is associated with accelerated proteomic aging across multiple organ-enriched plasma signatures, which includes key indicators for the pancreas and lung. They point out that accelerated pancreatic aging suggests long-term trauma exposure may be linked to declines in pancreatic function earlier in life.

Such changes together, they write, "indicate that PTSD is accompanied by coordinated, multisystem, molecular dysregulation that extends beyond the central nervous system and provides insight into the long-term biological embedding of traumatic stress."

"What we have observed through detailed metabolic analyses is that trauma affects not only psychological health, but also multiple biological systems over many years," says Dr. Luft.

"These changes to certain fundamental biological processes are an indicator and can explain at least in part why PTSD is associated with greater incidence of cognitive problems, heart disease, lung ailments, and other chronic diseases that will cause patients to age more quickly," Dr. Luft explains. "This is why it is so important, especially going forward many years after the attack of 9/11 to approach the medical monitoring and care of these patients from both their mental and physical health together."

A systems-level view of PTSD

The significance of completing plasma proteomics and metabolic profiling is that proteomics allows for the direct measurement of proteins that control nearly all physiological processes. Metabolic profiling examines small molecules that reflect gene and protein activity. Analyses of both proteomic and metabolic profiling therefore provides a complementary view of the biochemical states of each of the study subjects.

"By integrating proteomic and metabolomic data, we were able to uncover coordinated molecular networks that might be missed if each type of data is analyzed separately," explains Dr. Kuan.

This method enabled the team to estimate organ-specific proteomic aging, including for the heart, kidney, liver and lung. In studies of aging and chronic disease, these organ-level aging estimates correlate with risks for chronic conditions such as cardiovascular and renal disease.

The authors believe their study presents one of the most comprehensive proteomic and metabolic profiles of PTSD to date. In conclusion, their method led to findings that "link PTSD to neuronal, immune, metabolic and aging-related processes, emphasizing its systemic nature and informing future biomarker research."

Several federal funding agencies supported this research that led to these findings, including the Centers for Disease Control and Prevention's (CDC) National Institute for Occupational Safety and Health (NIOSH), the National Institutes of Health's (NIH) National Institute on Aging (NIA), and the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The SUNY Research Foundation also provided support.