Tobacco and pregnancy: Overview of exposures and effects

Assessment of genotoxicity of waterpipe and cigarette smoking in lymphocytes using the sister-chromatid exchange assay: a comparative study

Tobacco smoking is a major world health problem. Recently, waterpipe smoking has become more popular in many countries. Although the genotoxicity associated with cigarette smoking has been extensively investigated, studies evaluating such toxicity in waterpipe users are still lacking. In this study, we examined the genotoxicity of waterpipe smoking in lymphocytes compared with the genotoxicity of cigarette smoking. Genotoxicity was evaluated using the sister chromatid exchanges (SCEs) assay. Fifty waterpipe smokers and 18 healthy nonsmokers participated in this study. Additionally, 18 heavy cigarette smokers (CS) were recruited for comparison. The results show that waterpipe smoking and cigarette smoking significantly increase the frequencies of SCEs (P < 0.01) compared with those of nonsmokers, indicating the genotoxic effect of tobacco smoking. In addition, frequencies of SCEs were significantly higher among waterpipe smokers compared with CS (P < 0.01), indicating that waterpipe smoking is more genotoxic than cigarette smoking. Moreover, the frequency of SCEs increased with the extent of waterpipe use. In conclusion, waterpipe smoking is genotoxic to lymphocytes and the magnitude of its genotoxicity is higher than that induced by regular cigarette smoking.

Zebrafish for the study of the biological effects of nicotine

INTRODUCTION

Zebrafish are emerging as a powerful animal model for studying the molecular and physiological effects of nicotine exposure. The zebrafish have many advantageous physical characteristics, including small size, high fecundity rates, and externally developing transparent embryos. When combined with a battery of molecular-genetic tools and behavioral assays, these attributes enable studies to be conducted that are not practical using traditional animal models.

METHODS

We reviewed the literature on the application of the zebrafish model as a preclinical model to study the biological effects of nicotine exposure.

RESULTS

The identified studies used zebrafish to examine the effects of nicotine exposure on early development, addiction, anxiety, and learning. The methods used included green fluorescent protein-labeled proteins to track in vivo nicotine-altered neuron development, nicotine-conditioned place preference, and locomotive sensitization linked with high-throughput molecular and genetic screens and behavioral models of learning and stress response to nicotine. Data are presented on the complete homology of all known human neural nicotinic acetylcholine receptors in zebrafish and on the biological similarity of human and zebrafish dopaminergic signaling.

CONCLUSIONS

Tobacco dependence remains a major health problem worldwide. Further understanding of the molecular effects of nicotine exposure and genetic contributions to dependence may lead to improvement in patient treatment strategies. While there are limitations to the use of zebrafish as a preclinical model, it should provide a valuable tool to complement existing model systems. The reviewed studies demonstrate the enormous opportunity zebrafish have to advance the science of nicotine and tobacco research.

Reproducibility of reported in utero exposure to tobacco smoke

PURPOSE

In studies of the fetal origins of disease and life course epidemiology, measures of fetal exposure may be based on information reported by the adults who were exposed in utero. In particular, the full spectrum of consequences of in utero exposure to maternal tobacco smoking is now an area of active investigation, and the ability to report such exposure reproducibly is of interest. We evaluated the reproducibility of in utero exposure to tobacco smoke, reported by the adult daughter during consecutive pregnancies.

METHODS

This study was based on 11,257 women who enrolled for more than one pregnancy in the Norwegian Mother and Child Cohort Study (MoBa). Participants completed a questionnaire around 17 weeks of gestation, which asked about their in utero exposure to tobacco smoke. Kappa statistics were calculated. Determinants of agreement were evaluated using logistic regression.

RESULTS

Weighted Kappa for in utero exposure for the first and second reports was 0.80. Determinants of agreement were higher education (better) and longer time between reports (worse).

CONCLUSIONS

Information on in utero exposure to maternal tobacco smoking provided by adult women was highly reproducible in this population.

Modulation of cell adhesion systems by prenatal nicotine exposure in limbic brain regions of adolescent female rats

Maternal smoking during pregnancy (MS) has long-lasting neurobehavioural effects on the offspring. Many MS-associated psychiatric disorders begin or change symptomatology during adolescence, a period of continuous development of the central nervous system. However, the underlying molecular mechanisms are largely unknown. Given that cell adhesion molecules (CAMs) modulate various neurotransmitter systems and are associated with many psychiatric disorders, we hypothesize that CAMs are altered by prenatal treatment of nicotine, the major psychoactive component in tobacco, in adolescent brains. Pregnant Sprague-Dawley rats were treated with nicotine (3 mg/kg.d) or saline via osmotic mini-pumps from gestational days 4 to 18. Female offspring at postnatal day 35 were sacrificed, and several limbic brain regions (the caudate putamen, nucleus accumbens, prefrontal cortex, and amygdala) were dissected for evaluation of gene expression using microarray and quantitative RT-PCR techniques. Various CAMs including neurexin, immunoglobulin, cadherin, and adhesion-GPCR superfamilies, and their intracellular signalling pathways were modified by gestational nicotine treatment (GN). Among the CAM-related pathways, GN has stronger effects on cytoskeleton reorganization pathways than on gene transcription pathways. These effects were highly region dependent, with the caudate putamen showing the greatest vulnerability. Given the important roles of CAMs in neuronal development and synaptic plasticity, our findings suggest that alteration of CAMs contributes to the neurobehavioural deficits associated with MS. Further, our study underscores that low doses of nicotine produce substantial and long-lasting changes in the brain, implying that nicotine replacement therapy during pregnancy may carry many of the same risks to the offspring as MS.

Neonatal complications and risk factors among women with gestational diabetes mellitus

OBJECTIVE

This study aimed to identify risk factors for gestational diabetes mellitus (GDM) and assess the effects of GDM on the risk of adverse pregnancy outcomes.

MATERIAL AND METHODS

This was a cross-sectional study using data from the German Perinatal Quality Registry, which is a complete national registry containing information on all hospital births across Germany. The Registry for 2006 contains data on a complete birth cohort of 668,085 newborn infants and 647,392 mothers from all 896 German hospitals. All data were taken from maternity log records and analyzed by multivariate logistic regression. Each recorded case of GDM was identified by a gynecologist or in hospital.

RESULTS

The prevalence of GDM was 2.3% (14,990 of 647,385). High-risk groups were migrants, women of lower socioeconomic status (adjusted odds ratio 1.16, 95% confidence interval 1.05-1.28) and obese women (adjusted odds ratio 4.96, 95% confidence interval 4.70-5.24). A higher risk of fetal malformations was found for those diagnosed with GDM (adjusted odds ratio 1.32, 95% confidence interval 1.15-1.53).

CONCLUSION

The higher risk of fetal malformations with GDM suggests that many of these women may have high glucose levels even during the first trimester. Policies and interventions regarding prenatal care should therefore focus not only on how better diagnostic and treatment procedures can be implemented, but also on how they can reach older and migrant women as well as women of lower socioeconomic status.

Summary of the epidemiological evidence relating snus to health

Interest in snus (Swedish-type moist snuff) as a smoking alternative has increased. This wide-ranging review summarizes evidence relating snus to health and to initiation and cessation of smoking. Meta-analyses are included. After smoking adjustment, snus is unassociated with cancer of the oropharynx (meta-analysis RR 0.97, 95% CI 0.68-1.37), oesophagus (1.10, 0.92-1.33), stomach (0.98, 0.82-1.17), pancreas (1.20, 0.66-2.20), lung (0.71, 0.66-0.76) or other sites, or with heart disease (1.01, 0.91-1.12) or stroke (1.05, 0.95-1.15). No clear associations are evident in never smokers, any possible risk from snus being much less than from smoking. "Snuff-dipper's lesion" does not predict oral cancer. Snus users have increased weight, but diabetes and chronic hypertension seem unaffected. Notwithstanding unconfirmed reports of associations with reduced birthweight, and some other conditions, the evidence provides scant support for any major adverse health effect of snus. Although some claims that snus reduces initiation or encourages quitting are unsoundly based, snus seems not to increase initiation, as indicated by few smokers using snus before starting and current snus use being unassociated with smoking in adults (the association in children probably being due to uncontrolled confounding), and there are no reports that snus discourages quitting.

Smoking and alcohol use during pregnancy and age of menarche in daughters

BACKGROUND

We assessed whether exposure to prenatal smoking or alcohol accelerates age of menarche (AOM) in offspring.

METHODS

We studied a Danish cohort of 3169 singleton females born in April 1984-April 1987. Linear regressions were conducted to examine associations between prenatal smoking or alcohol exposure and offspring's AOM on: (i) the daughters who provided data on both month and the year of menarche (n= 1634) and (ii) the entire sample that provided at least the year of menarche (n= 3169). We also examined associations between only pre-pregnancy smoking or childhood exposure to smoking and AOM. The full model was adjusted for maternal pre-pregnancy body mass index, maternal age at childbirth, parental socio-economic status, parity, consumption of milk products during pregnancy and marital status.

RESULTS

Among those who provided both year and month, AOM was accelerated by 2.8 months (95% CI in months: -5.3, -0.4) among those exposed to 10+ cigarettes/day throughout pregnancy and by 4.1 months (95% CI in months: -7.7, -0.5) among those with mothers who quit smoking sometime during pregnancy, compared with the unexposed group after adjustment for covariates. Similar, but much weaker, associations were observed among girls whose mothers smoked 1-9 cigarettes/day throughout pregnancy or whose fathers smoked compared with their unexposed counterparts after adjustment for covariates [-0.8 months (95% CI: -2.6, 1.0)]. No associations were observed between AOM and only pre-pregnancy smoking or only childhood exposure or prenatal alcohol exposure.

CONCLUSIONS

Our study indicates that heavy smoking throughout the pregnancy may be important in prenatal programming of AOM.

Comparison of the toxicity of smoke from conventional and harm reduction cigarettes using human embryonic stem cells

This study evaluated the hypothesis that smoke from harm reduction cigarettes impedes attachment and proliferation of H9 human embryonic stem cells (hESCs). Smoke from three harm reduction brands was compared with smoke from a conventional brand. Doses of smoke were measured in puff equivalents (PE) (1 PE = the amount of smoke in one puff that dissolves in 1 ml of medium). Cytotoxic doses were determined using morphological criteria and trypan blue staining, and apoptosis was confirmed using Magic Red staining. Attachment and proliferation of hESC were followed at a noncytotoxic dose in time-lapse videos collected using BioStation technology. Data were mined from videos either manually or using video bioinformatics subroutines developed with CL-Quant software. Mainstream (MS) and sidestream (SS) smoke from conventional and harm reduction cigarettes induced apoptosis in hESC colonies at 1 PE. At 0.1 PE (noncytotoxic), SS smoke from all brands inhibited attachment of hESC colonies to Matrigel with the strongest inhibition occurring in harm reduction brands. At 0.1 PE, SS smoke, but not MS smoke, from all brands inhibited hESC growth, and two harm reduction brands were more potent than the conventional brand. In general, hESC appeared more sensitive to smoke than their mouse ESC counterparts. Although harm reduction cigarettes are often marketed as safer than conventional brands, our assays show that SS smoke from harm reduction cigarettes was at least as potent or in some cases more potent than smoke from a conventional brand and that SS smoke was more inhibitory than MS smoke in all assays.

In utero exposure to tobacco smoke and subsequent reduced fertility in females

BACKGROUND

Animal studies have shown that in utero exposure to chemicals in tobacco smoke reduces female fertility, but epidemiological findings have been inconsistent.

METHODS

We examined the association between in utero exposure to tobacco smoke and female fertility among women in the Norwegian Mother and Child Cohort Study, enrolled from 1999 to 2007. Around the 17th week of pregnancy, participants reported how long they took to conceive (time to pregnancy), and whether their mother smoked while pregnant with the participant. This analysis included 48 319 planned pregnancies among women aged 15-44 years. We estimated fecundability odds ratios (FORs) using a discrete-time survival analysis, adjusting for age, education and adult tobacco smoking.

RESULTS

The adjusted FOR for in utero exposure to tobacco smoke among all subjects was 0.96 [95% confidence interval (CI): 0.93, 0.98], among subjects reporting no adult tobacco smoking or passive exposure it was 0.96 (95% CI: 0.93, 0.99) and among subjects reporting adult tobacco smoking or passive exposure it was 0.95 (95% CI: 0.91, 0.99). We performed a probabilistic sensitivity analysis to estimate the effect of exposure and outcome misclassification on the results, and, as expected, the association became more pronounced after taking misclassification into account.

CONCLUSIONS

This large cohort study supports a small-to-modest association between in utero exposure to tobacco smoke and reduced fertility.

Paternal smoking and childhood overweight: evidence from the Hong Kong "Children of 1997"

OBJECTIVE

This study examined, in a non-Western sociohistorical context, whether prenatal or postnatal secondhand smoke (SHS) exposure for children of nonsmoking mothers was associated with higher childhood BMI, and it clarified whether the observed associations were biologically mediated or socioeconomically confounded.

METHODS

A total of 6710 and 6519 children of nonsmoking mothers (N = 7924) with BMI data at approximately 7 and approximately 11 years, respectively, from a population-representative (N = 8327), Hong Kong Chinese birth cohort ("Children of 1997"), born in April or May 1997, were included in the analysis.

RESULTS

Compared with no SHS exposure, daily paternal smoking increased mean BMI z scores, but not height, at 7 years (difference: 0.10 [95% confidence interval: 0.02-0.19]) and at 11 years (difference: 0.16 [95% confidence interval: 0.07-0.26]), with adjustment for gender, birth order, socioeconomic position, mother's place of birth, breastfeeding, serious morbidity, and pubertal status.

CONCLUSIONS

Our findings, although preliminary, suggest that the association of paternal smoking with child overweight might be biologically mediated. Given the known harms of smoking, reducing SHS exposure from conception as a precautionary action for childhood overweight might be warranted.

Effects of exogenous agents on brain development: stress, abuse and therapeutic compounds

The range of exogenous agents likely to affect, generally detrimentally, the normal development of the brain and central nervous system defies estimation although the amount of accumulated evidence is enormous. The present review is limited to certain types of chemotherapeutic and "use-and-abuse" compounds and environmental agents, exemplified by anesthetic, antiepileptic, sleep-inducing and anxiolytic compounds, nicotine and alcohol, and stress as well as agents of infection; each of these agents have been investigated quite extensively and have been shown to contribute to the etiopathogenesis of serious neuropsychiatric disorders. To greater or lesser extent, all of the exogenous agents discussed in the present treatise have been investigated for their influence upon neurodevelopmental processes during the period of the brain growth spurt and during other phases uptill adulthood, thereby maintaining the notion of critical phases for the outcome of treatment whether prenatal, postnatal, or adolescent. Several of these agents have contributed to the developmental disruptions underlying structural and functional brain abnormalities that are observed in the symptom and biomarker profiles of the schizophrenia spectrum disorders and the fetal alcohol spectrum disorders. In each case, the effects of the exogenous agents upon the status of the affected brain, within defined parameters and conditions, is generally permanent and irreversible.

Clustering of socioeconomic, behavioural, and neonatal risk factors for infant health in pregnant smokers

Background

Tobacco smoking is a major cause of morbidity and mortality, including during pregnancy. Although effective ways of promoting smoking cessation during pregnancy exist, the impact of these interventions has not been studied at a national level. We estimated the prevalence of smoking throughout pregnancy in the Netherlands and quantified associations of maternal smoking throughout pregnancy with socioeconomic, behavioural, and neonatal risk factors for infant health and development.

Methodology/Principal Findings

Data of five national surveys, containing records of 14,553 Dutch mothers and their offspring were analyzed. From 2001 to 2007, the overall rate of smoking throughout pregnancy fell by 42% (from 13.2% to 7.6%) mainly as a result of a decrease among highly educated women. In the lowest-educated group, the overall rate of smoking throughout pregnancy was six times as high as in the highest-educated group (18.7% versus 3.2%). Prenatal tobacco smoke exposure was associated with increased risk of extremely preterm (≤28 completed weeks) (OR 7.25; 95% CI 3.40 to 15.38) and small-for-gestational age (SGA) infants (OR 3.08; 95% CI 2.66 to 3.57). Smoking-attributable risk percents in the population (based on adjusted risk ratios) were estimated at 29% for extremely preterm births and at 17% for SGA outcomes. Infants of smokers were more likely to experience significant alcohol exposure in utero (OR 2.08; 95%CI 1.25 to 3.45) and formula feeding in early life (OR 1.91; 95% CI 1.69 to 2.16).

Conclusions

The rates of maternal smoking throughout pregnancy decreased significantly in the Netherlands from 2001 to 2007. If pregnant women were to cease tobacco use completely, an estimated 29% of extremely preterm births and 17% of SGA infants may be avoided annually.

Effects of cigarette smoke on fertilization and embryo development in vivo

OBJECTIVE

To determine the effects of smoking on eggs and subsequent embryo development by maternal exposure to cigarette smoke.

DESIGN

Mice were exposed to cigarette smoke or cigarette smoke condensate (CSC) for 4 weeks and then examined for development and telomere function of embryos in vitro after fertilization. In addition, the effects of continuous smoke on embryo development and telomere length were determined by treating mice for 4 weeks, followed by continuous exposure to cigarette smoke or CSC after fertilization.

SETTING

Laboratory study.

ANIMAL(S)

CD1 mice.

INTERVENTION(S)

Mice were exposed to cigarette smoke or CSC.

MAIN OUTCOME MEASURE(S)

The percentage (rate) of blastocyst development, quality of embryos assessed by total cell number, apoptosis, Oct4 expression (a molecular marker of embryonic stem cells), telomere length and loss, and chromosomal instability were compared between smoke- and CSC- treated mice and sham-treated mice.

RESULT(S)

Mice exposed to cigarette smoke or CSC for 4 weeks exhibited increased egg fragmentation or delayed fertilization, thus reducing development to blastocysts in vitro. Fragmented eggs showed increased reactive oxygen species. Mice exposed to smoke or CSC showed increased apoptosis and altered expression of Oct4 in developed embryos. The effects of smoke or CSC on embryo development showed a dose-dependent relationship to exposure time. Exposure to smoke or CSC beginning 4 weeks before fertilization altered expression of Oct4 and increased apoptosis in blastocysts. Notably, the rate of abnormal embryos significantly increased in the smoke and CSC groups. Smoke and CSC shortened telomeres in embryos, but their telomere shortening was not enough to induce major chromosome abnormalities in mice, which have unusually long telomeres.

CONCLUSION(S)

Together, the whole animal exposure model shows that cigarette smoke induces oxidative stress, telomere shortening, and apoptosis, and compromises embryo development in vivo.

Relationships between prenatal smoking cessation, gestational weight gain and maternal lifestyle characteristics

OBJECTIVES

To describe maternal characteristics and lifestyle factors associated with prenatal smoking habits and to appraise the effect of quitting smoking in early gestation on maternal weight gain during pregnancy.

METHODS

This is a follow-up study of 1753 women who gave birth in 1984/1985 in Stockholm, Sweden. Multivariate logistic models were used to evaluate the association between smoking cessation and weight gain above the American Institute of Medicine (IOM) recommendations, based on pre-pregnancy BMI.

RESULTS

About 22% of all participants identified themselves as current smokers and 11.6% reported smoking cessation during pregnancy. Smokers were more likely to be single mothers and reported low quality of breakfast (e.g. eating only 1 food group at breakfast). Non-smokers were older, more likely to be married and have a healthier lifestyle. Quitters also adopted healthier eating habits (e.g. improvement in their breakfast quality). Women who quit smoking gained, on average, 15.3 kg (SD 4.4) during pregnancy, non-smokers gained 14.1 kg (SD 4.0) and smokers gained 13.8 kg (SD 4.3). Quitters gained significantly more weight than both non-smokers and smokers (p<0.001). Smoking cessation was significantly associated with gaining weight above IOM recommendations, even after controlling for potential confounders (OR: 2.0; 95%CI: 1.4-3.0; p<or=0.0001).

CONCLUSIONS

In this population, smoking cessation in early pregnancy doubled the likelihood of gaining excess weight. This finding highlights the need for supportive measures to help control weight gain among women who quit smoking during pregnancy.

Biomarkers of exposure to tobacco smoke and environmental pollutants in mothers and their transplacental transfer to the foetus. Part II. Oxidative damage

Oxidative damage to macromolecules may have numerous negative health consequences. We measured oxidative damage to DNA, proteins and lipids in 80 newborns and 79 mothers, analyzed the effect of mother's tobacco smoke exposure on oxidative stress, and assessed correlations between oxidative stress markers and bulky and PAH (polycyclic aromatic hydrocarbons)-specific DNA adducts. Mean levels (+/-S.D.) of 8-oxodeoxyguanosine (8-oxodG) per 10(5) dG in the placenta were 2.85+/-0.78; we did not see a difference between 8-oxodG levels in newborns born to mothers exposed and unexposed to tobacco smoke. Protein carbonyl levels, a marker of protein oxidation, were comparable in the umbilical cord and in maternal venous blood plasma (17.4+/-3.2 and 17.6+/-4.2nmol/ml plasma in newborns and mothers, respectively, p=0.66). Lipid peroxidation measured as levels of 15-F(2t)-isoprostane (15-F(2t)-IsoP) in plasma was significantly higher in newborns than in mothers (362+/-129 and 252+/-130pg/ml in newborns and mothers, respectively, p<0.001). We did not find any effect of tobacco smoke exposure on either biomarker in any group. Levels of both protein carbonyls and 15-F(2t)-IsoP in cord blood significantly correlated with those in maternal plasma (p<0.001). 8-oxodG levels positively correlated with plasma carbonyls in cord plasma, as well as with cotinine levels (marker of tobacco smoke exposure) in maternal plasma. 8-oxodG levels also correlated with bulky DNA adducts in lymphocyte DNA of newborns and mothers and with PAH-DNA adducts in the placenta. Our results showed higher lipid peroxidation in newborns than in mothers, close correlation of analyzed oxidative stress markers between newborns and mothers, and a relationship between oxidative stress and induction of DNA adducts.

Evaluation of the accuracy of self-reported smoking in pregnancy when the biomarker level in an active smoker is uncertain

INTRODUCTION

Our main objective was to estimate smoking prevalence as well as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of self-reported smoking among pregnant women in Edmonton, Canada, at 15-16 weeks of gestation.

METHODS

We used serum samples to assemble a cohort of pregnant women who underwent an optional second-trimester screening for chromosomal and developmental anomalies. We determined cotinine concentrations for 92 self-reported smokers (11% of the cohort) and for 285 self-reported nonsmoking mothers, using adapted urinary cotinine assay. Self-reports were collected at the time of delivery. In a validation study, serum cotinine was determined for known smokers and nonsmokers and used, within a Bayesian statistical framework, to define the distribution of cutoffs that differentiate true smokers from nonsmokers. This distribution of cutoffs was used to construct multiple two-by-two tables to obtain the distribution of sensitivity, specificity, PPV, NPV, and prevalence.

RESULTS

Sensitivity was poor (M = 47.4%, SD = 17.3%), but specificity was nearly perfect (M = 94.9%, SD = 1.1%). PPV (M = 66.6%, SD = 11.7%) was smaller than NPV (M = 84.7%, SD = 14.3%). In our sample, the prevalence of true smoking at 15-16 weeks of gestation was described by a skewed distribution with a mean of 21.6% (SD = 13.8%) and a median of 16.6%.

DISCUSSION

The strength of the present study includes blinding of subjects to the intention to test their sera for a biomarker of smoking. A limitation was the use of a nonrandom sample restricted to pregnancies that resulted in live births. We discuss data collection methods that would elicit more accurate smoking histories from pregnant women.

Prenatal exposure to drugs: effects on brain development and implications for policy and education

The effects of prenatal exposure to drugs on brain development are complex and are modulated by the timing, dose and route of drug exposure. It is difficult to assess these effects in clinical cohorts as these are beset with problems such as multiple exposures and difficulties in documenting use patterns. This can lead to misinterpretation of research findings by the general public, the media and policy makers, who may mistakenly assume that the legal status of a drug correlates with its biological impact on fetal brain development and long-term clinical outcomes. It is important to close the gap between what science tells us about the impact of prenatal drug exposure on the fetus and the mother and what we do programmatically with regard to at-risk populations.

The dynamic effects of nicotine on the developing brain

Nicotinic acetylcholine receptors (nAChRs) regulate critical aspects of brain maturation during the prenatal, early postnatal, and adolescent periods. During these developmental windows, nAChRs are often transiently upregulated or change subunit composition in those neural structures that are undergoing major phases of differentiation and synaptogenesis, and are sensitive to environmental stimuli. Nicotine exposure, most often via tobacco smoke, but increasingly via nicotine replacement therapy, has been shown to have unique effects on the developing human brain. Consistent with a dynamic developmental role for acetylcholine, exogenous nicotine produces effects that are unique to the period of exposure and that impact the developing structures regulated by acetylcholine at that time. Here we present a review of the evidence, available from both the clinical literature and preclinical animal models, which suggests that the diverse effects of nicotine exposure are best evaluated in the context of regional and temporal expression patterns of nAChRs during sensitive maturational periods, and disruption of the normal developmental influences of acetylcholine. We present evidence that nicotine interferes with catecholamine and brainstem autonomic nuclei development during the prenatal period of the rodent (equivalent to first and second trimester of the human), alters the neocortex, hippocampus, and cerebellum during the early postnatal period (third trimester of the human), and influences limbic system and late monoamine maturation during adolescence.

Comparison of toxicity of smoke from traditional and harm-reduction cigarettes using mouse embryonic stem cells as a novel model for preimplantation development

BACKGROUND

Embryonic stem cells (ESC), which originate from the inner cell mass of blastocysts, are valuable models for testing the effects of toxicants on preimplantation development. In this study, mouse ESC (mESC) were used to compare the toxicity of mainstream (MS) and sidestream (SS) cigarette smoke on cell attachment, survival and proliferation. In addition, smoke from a traditional commercial cigarette was compared with smoke from three harm-reduction brands.

METHODS

MS and SS smoke solutions were made using an analytical smoking machine and tested at three doses using D3 mESC plated on 0.2% gelatin. At 6 and 24 h, images were taken and the number of attached cells was evaluated.

RESULTS

Both MS and SS smoke from traditional and harm-reduction cigarettes inhibited cell attachment, survival and proliferation dose dependently. For all brands, SS smoke was more potent than MS smoke. However, removal of the cigarette filter increased the toxicity of MS smoke to that of SS smoke. Both MS and SS smoke from harm-reduction cigarettes were as inhibitory, or more inhibitory, than their counterparts from the traditional brand. When preimplantation mouse embryos were cultured for 1 h in MS or SS smoke solutions from a harm-reduction brand, blastomeres became apoptotic, in agreement with the data obtained using mESC.

CONCLUSIONS

mESC provide a valuable model for toxicological studies on the preimplantation stage of development and were used to show that MS and SS smoke from traditional and harm-reduction cigarettes are detrimental to embryonic cells prior to implantation.

Exposure to environmental tobacco smoke during pregnancy in rats yields less effect on indices of brain cell number and size than does postnatal exposure

While there is evidence that human perinatal exposure to environmental tobacco smoke (ETS) can result in an increased risk of respiratory disorders and sudden infant death syndrome, evidence linking ETS exposure to neurodevelopmental handicaps is suggestive but less compelling. We previously noted that postnatal ETS exposure, rather than prenatal exposure, resulted in reduced concentration of hindbrain DNA and increased protein/DNA ratio when rat brain tissue was studied at 9 weeks postnatal age. We have now evaluated the effects of ETS exposure during pregnancy on brain development by assaying brain tissue at term. ETS exposure had no detectable effects on regional brain concentrations of DNA, protein and cholesterol or on protein/DNA and cholesterol/DNA ratios. While ETS exposure during pregnancy also had no detectable effects on the weights of the individual fetuses or on the weights of various organs, certain regions of the fetal skeleton demonstrated accelerated ossification. The findings of this study are contrasted to the developmental effects of both nicotine and ETS in Rhesus macaques. Additional studies designed specifically to assess the risk of prenatal ETS exposure on brain development in non-human primates and other precocial species are warranted.