Menthol and related cooling compounds

Urine menthol as a biomarker of mentholated cigarette smoking

OBJECTIVES

Menthol cigarettes are smoked by 27% of U.S. smokers, and there are concerns that menthol might enhance toxicity of cigarette smoking by increasing systemic absorption of smoke toxins. We measured urine menthol concentrations in relation to biomarkers of exposure to nicotine and tobacco carcinogens.

METHODS

Concentrations of menthol glucuronide (using a novel analytical method), nicotine plus metabolites (nicotine equivalents, NE), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and polycyclic aromatic hydrocarbon (PAH) metabolites were measured in the urine of 60 menthol and 67 regular cigarette smokers.

RESULTS

Urine menthol was measurable in 82% of menthol and 54% in regular cigarette smokers. Among menthol smokers, urine menthol was highly correlated with NE, NNAL, and PAHs. In a multiple regression model NE but not menthol was significantly associated with NNAL and PAHs.

CONCLUSIONS

Urine menthol concentration is a novel biomarker of exposure in menthol cigarette smokers, and is highly correlated with exposure to nicotine and carcinogens. Menthol is not independently associated with carcinogen exposure when nicotine intake is considered.

Raman Optical Activity: A Powerful Technique to Investigate Essential Oil Components

The theory and some applications of Raman Optical Activity (ROA) towards terpene analysis are presented. With this technique, vibrational optical activity from chiral molecules can be measured providing their absolute configuration. This short review provides data obtained for pinene, verbenone, menthol, camphor, carenes and related molecules. The ROA technique seems to be a powerful tool which permits correlation between the properties of biocompounds and their structure.

Efficacy and safety profile of a topical methyl salicylate and menthol patch in adult patients with mild to moderate muscle strain: a randomized, double-blind, parallel-group, placebo-controlled, multicenter study

BACKGROUND

An occlusive patch formulation containing 10% methyl salicylate and 3% l-menthol was recently approved by the US Food and Drug Administration for the treatment of mild to moderate pain. Despite widespread use of counterirritants, including methyl salicylate and menthol, for topical pain relief, published efficacy and safety data regarding the use of the agents alone or in combination are limited.

OBJECTIVE

The goal of this study was to determine the efficacy and safety profile of a patch containing 10% methyl salicylate and 3% l-menthol compared with a placebo patch in adult patients with mild to moderate muscle strain.

METHODS

Eligible patients were men or women aged >or=18 years with a clinical diagnosis of mild to moderate muscle strain. Patients were randomly assigned to receive either 1 active patch or 1 placebo patch applied to the skin at the affected area (ie, shoulder, upper back, upper arm, neck, calf, thigh, forearm, abdomen). Pain intensity was assessed on a 100-mm visual analog scale while at rest and with movement for 12 hours after patch application. The primary efficacy end point was the summed pain intensity difference score through 8 hours (SPID8) with movement. Analyses included use of descriptive statistics and an ANOVA model. Safety data, including adverse events, and secondary efficacy end points were also evaluated.

RESULTS

A total of 208 patients (104 men, 104 women; age range, 18-78 years) were randomized to 1 of 2 study groups (105 in the active-patch group [mean age, 37.3 years], 103 in the placebo-patch group [mean age, 38.1 years]). The primary efficacy analysis (SPID8 with movement) indicated that patients receiving the active patch experienced significantly greater pain relief (approximately 40%) than those patients receiving a placebo patch (mean [SD], 182.6 [131.2] vs 130.1 [144.1]; P = 0.005). Analysis of the per-protocol population also found significantly more relief (P = 0.024) in the active-patch group (176.2 [131.4]; n = 92) versus the placebo-patch group (130.2 [144.0]; n = 96). Statistical analysis of secondary efficacy measures supported the primary end-point results. The number of patients experiencing any type of adverse event was comparable between study groups (active patch, 6.7% [7 events]; placebo patch, 5.8% [6 events]). No serious adverse events were reported during the study.

CONCLUSION

A single, 8-hour application of a patch containing methyl salicylate and l-menthol provided significant relief of pain associated with mild to moderate muscle strain in these adult patients compared with patients receiving a placebo patch.

Topical application of L-menthol induces heat analgesia, mechanical allodynia, and a biphasic effect on cold sensitivity in rats

Menthol is used in analgesic balms and also in foods and oral hygiene products for its fresh cooling sensation. Menthol enhances cooling by interacting with the cold-sensitive thermoTRP channel TRPM8, but its effect on pain is less well understood. We presently used behavioral methods to investigate effects of topical menthol on thermal (hot and cold) pain and innocuous cold and mechanical sensitivity in rats. Menthol dose-dependently increased the latency for noxious heat-evoked withdrawal of the treated hindpaw with a weak mirror-image effect, indicating antinociception. Menthol at the highest concentration (40%) reduced mechanical withdrawal thresholds, with no effect at lower concentrations. Menthol had a biphasic effect on cold avoidance. At high concentrations (10% and 40%) menthol reduced avoidance of colder temperatures (15 degrees C and 20 degrees C) compared to 30 degrees C, while at lower concentrations (0.01-1%) menthol enhanced cold avoidance. In a -5 degrees C cold plate test, 40% menthol significantly increased the nocifensive response latency (cold hypoalgesia) while lower concentrations were not different from vehicle controls. These results are generally consistent with neurophysiological and human psychophysical data and support TRPM8 as a potential peripheral target of pain modulation.

Heterologous regulation of anion transporters by menthol in human airway epithelial cells

The present study concerns previously unreported effects of menthol, a cyclic terpene alcohol produced by the peppermint herb, on anion transporters in polarized human airway Calu-3 epithelia. Application of menthol (0.01-1mM) attenuated transepithelial anion transport, estimated as short-circuit currents (I(SC)), after stimulation by forskolin (10microM) but not before. In contrast, menthol potentiated forskolin-stimulated and -unstimulated apical Cl(-) conductance, which reflected the cystic fibrosis transmembrane conductance regulator (CFTR: the cAMP-regulated Cl(-) channel)-mediated conductance, without correlation to changes in cytosolic cAMP levels. These results indicate that menthol-induced attenuation of forskolin-induced I(SC) despite CFTR up-regulation was due to cAMP-independent inhibition of basolateral anion uptake, which is the rate-limiting step for transepithelial anion transport. Analyses of the responsible basolateral anion transporters revealed that forskolin increased both bumetanide (an inhibitor of the basolateral Na(+)-K(+)-2Cl(-) cotransporter [NKCC1])- and DNDS (an inhibitor of basolateral HCO(3)(-)-dependent anion transporters [NBC1/AE2])-sensitive I(SC) in the control whereas only the former was prevented by the application of menthol. Neither the bumetanide- nor DNDS-sensitive component was, however, reduced by menthol without forskolin. These heterologous effects of menthol were reproduced by latrunculin B, an inhibitor of actin polymerization. F-actin staining showed that menthol prevented forskolin-stimulated rearrangements of actin microfilaments without affecting the distribution of forskolin-unstimulated microfilaments. Collectively, menthol functions as an activator of CFTR and prevents activation of NKCC1 without affecting NBC1/AE although all of these transporters are commonly cAMP-dependent. The heterologous effects may be mediated by the actin cytoskeleton, which interacts with CFTR and NKCC1.

A Randomized, Controlled, Crossover Trial to Investigate Times to Onset of the Perception of Soothing and Cooling by Over-The-Counter Heartburn Treatments

This was a randomized, controlled, four-way crossover study in 45 subjects with a tendency to suffer from moderate heartburn following some meals. The study was designed to assess the time to onset of the perceived soothing and cooling effects of the alginate raft-forming products, Gaviscon Liquid (peppermint), Gaviscon Double Action Liquid (peppermint) and Gaviscon Powder Formulation (fresh tropical), compared with a non-active sublingual control. All three Gaviscon products provided significantly faster soothing and cooling effects compared with the control. Based on the upper 95% confidence limits for the median, time to onset of soothing was perceived within 3.15 min, 3.08 min and 4.05 min for Gaviscon Liquid, Double Action Liquid and Powder Formulation, respectively. Similarly, time to onset of cooling was perceived within 1.95 min, 1.23 min and 11.22 min for Gaviscon Liquid, Double Action Liquid and Powder Formulation, respectively. The results show that Gaviscon Liquid and Gaviscon Double Action soothe within 3.15 min and cool within 1.95 min.

A review and assessment of menthol employed as a cigarette flavoring ingredient

Cigarette smoking is established as a substantial contributor to risks for cancer, cardiovascular and respiratory diseases. Less is known about the potential of cigarette composition to affect smoking risks. The use of cigarette flavoring ingredients such as menthol is currently of worldwide public health and regulatory interest. The unique conditions of menthol inhalation exposure that occur coincident with that of the complex cigarette smoke aerosol require specialized studies to support an assessment of its safety in cigarette flavoring applications. The present state of knowledge is sufficient to support an assessment of the safety of the use of menthol in cigarettes. Scientific, smoking behavioral and epidemiological data available through mid-2009 is critically reviewed and a broad convergence of findings supports a judgment that menthol employed as a cigarette tobacco flavoring ingredient does not meaningfully affect the inherent toxicity of cigarette smoke or the human risks that attend smoking. There remains a need for well-designed studies of the potential of menthol to affect smoking initiation, cessation and addiction in order to differentiate any independent effects of menthol in cigarettes from those imposed by socioeconomic, environmental and peer influences on these complex human behaviors.

Phosphoinositide regulation of non-canonical transient receptor potential channels

Transient receptor potential (TRP) channels are involved in a wide range of physiological processes, and characterized by diverse activation mechanisms. Phosphoinositides, especially phosphatidylinositol 4,5-bisphosphate [PIP(2), or PtdIns(4,5)P(2)] recently emerged as regulators of many TRP channels. Several TRP channels require PIP(2) for activity, and depletion of the lipid inhibits them. For some TRP channels, however, phosphoinositide regulation seems more complex, both activating and inhibitory effects have been reported. This review will discuss phosphoinositide regulation of members of the TRPM (Melastatin), TRPV (Vanilloid), TRPA (Ankyrin) and TRPP (Polycystin) families. Lipid regulation of TRPC (Canonical) channels is discussed elsewhere in this volume.

Transient receptor potential melastatin 8 channel involvement in the regulation of vascular tone

The transient receptor potential melastatin 8 (TRPM8) channel has been characterized as a cold and menthol receptor expressed in a subpopulation of sensory neurons but was recently identified in other tissues, including the respiratory tract, urinary system, and vasculature. Thus TRPM8 may play multiple functional roles, likely to be in a tissue- and activation state-dependent manner. We examined the TRPM8 channel presence in large arteries from rats and the functional consequences of their activation. We also aimed to examine whether these channels contribute to control of conscious human skin blood flow. TRPM8 mRNA and protein were detected in rat tail, femoral and mesenteric arteries, and thoracic aorta. This was confirmed in single isolated vascular myocytes by immunocytochemistry. Isometric contraction studies on endothelium-denuded relaxed rat vessels found small contractions on application of the TRPM8-specific agonist menthol (300 microM). However, both menthol and another agonist icilin (50 microM) caused relaxation of vessels precontracted with KCl (60 mM) or the alpha-adrenoceptor agonist phenylephrine (2 microM) and a reduction in sympathetic nerve-mediated contraction. These effects were antagonized by bromoenol lactone treatment, suggesting the involvement of Ca(2+)-independent phospholipase A(2) activation in TRPM8-mediated vasodilatation. In thoracic aorta with intact endothelium, menthol-induced inhibition of KCl-induced contraction was enhanced. This was unaltered by preincubation with either N(omega)-nitro-l-arginine methyl ester (l-NAME; 100 nM), a nitric oxide synthase inhibitor, or the ACh receptor antagonist atropine (1 microM). Application of menthol (3% solution, topical application) to skin caused increased blood flow in conscious humans, as measured by laser Doppler fluximetry. Vasodilatation was markedly reduced or abolished by prior application of l-NAME (passive application, 10 mM) or atropine (iontophoretic application, 100 nM, 30 s at 70 microA). We conclude that TRPM8 channels are present in rat artery vascular smooth muscle and on activation cause vasoconstriction or vasodilatation, dependent on previous vasomotor tone. TRPM8 channels may also contribute to human cutaneous vasculature control, likely with the involvement of additional neuronal mechanisms.

Vicks VapoRub induces mucin secretion, decreases ciliary beat frequency, and increases tracheal mucus transport in the ferret trachea

BACKGROUND

Vicks VapoRub (VVR) [Proctor and Gamble; Cincinnati, OH] is often used to relieve symptoms of chest congestion. We cared for a toddler in whom severe respiratory distress developed after VVR was applied directly under her nose. We hypothesized that VVR induced inflammation and adversely affected mucociliary function, and tested this hypothesis in an animal model of airway inflammation.

METHODS

[1] Trachea specimens excised from 15 healthy ferrets were incubated in culture plates lined with 200 mg of VVR, and the mucin secretion was compared to those from controls without VVR. Tracheal mucociliary transport velocity (MCTV) was measured by timing the movement of 4 microL of mucus across the trachea. Ciliary beat frequency (CBF) was measured using video microscopy. [2] Anesthetized and intubated ferrets inhaled a placebo or VVR that was placed at the proximal end of the endotracheal tube. We evaluated both healthy ferrets and animals in which we first induced tracheal inflammation with bacterial endotoxin (a lipopolysaccharide [LPS]). Mucin secretion was measured using an enzyme-linked lectin assay, and lung water was measured by wet/dry weight ratios.

RESULTS

[1] Mucin secretion was increased by 63% over the controls in the VVR in vitro group (p < 0.01). CBF was decreased by 35% (p < 0.05) in the VVR group. [2] Neither LPS nor VVR increased lung water, but LPS decreased MCTV in both normal airways (31%) and VVR-exposed airways (30%; p = 0.03), and VVR increased MCTV by 34% in LPS-inflamed airways (p = 0.002).

CONCLUSIONS

VVR stimulates mucin secretion and MCTV in the LPS-inflamed ferret airway. This set of findings is similar to the acute inflammatory stimulation observed with exposure to irritants, and may lead to mucus obstruction of small airways and increased nasal resistance.

Central mechanisms IV: conscious control of cough and the placebo effect

Early animal experiments on cough developed the concept that cough was an involuntary reflex controlled from areas in the brainstem and that cough could be inhibited by centrally acting medicines such as codeine. Studies on the voluntary control of cough, the urge to cough and the placebo effect of cough medicines have demonstrated that human cough is more complex than a brainstem reflex. The efficacy and mechanism of action of centrally acting cough medicines such as codeine and dextromethorphan is now in dispute, and codeine is no longer accepted as a gold-standard antitussive. This review puts forward a cough model that includes three types of cough: (1) reflex cough, caused by the presence of food or fluid in the airway--this type of cough is not under conscious control and can occur in the unconscious subject during general anaesthesia; (2) voluntary cough--under conscious control that is abolished with general anaesthesia; (3) cough in response to sensation of airway irritation--this type of cough causes an urge to cough that initiates voluntary cough and may only be present in the conscious subject. The review proposes that human cough associated with respiratory disease is under conscious control and is mainly related to a sensation of airway irritation and an urge to cough (type 3). The review discusses the summation of sensory input from the airway in a brainstem integrator that reaches a threshold to cause reflex cough. Subthreshold conditions in the cough integrator may be perceived as an urge to cough that is under voluntary control. The cough model presented in the review has implications for the development of cough medicines as it indicates that the older view of cough medicines acting in the brainstem area to inhibit the cough reflex may need to be revised to include conscious control of cough as an important mechanism of cough in man.

Clinical cough V: complementary and alternative medicine: therapy of cough

We review the actions of complementary and alternative medicines (CAMs) in the treatment of cough and of the conditions associated with it; in particular asthma and upper respiratory tract infections. These therapies may work (1) peripherally, at the sites in the airways and lungs at which cough is being activated, (2) in the brainstem, where the neural "cough center" is situated, or (3) at the cerebral cortex, where cough can be initiated, suppressed or modified by conscious or unconscious controls. Of the large number of trials of CAMs against cough, most are inadequate in design. It may be difficult to randomize selection. Blinding is often impossible both for the patient and the therapist, and adequate placebo controls may be difficult to devise. The patient can usually identify the "active" treatment by the taste or smell of a medicine, or from the approach and apparatus being used. Pure chemicals can be extracted from many of the herbs used as antitussives, and can be shown to be effective in randomized, blind, and controlled trials, but it does not follow that the herb itself, used in the recommended formula and shown to be antitussive, acts by this agency unless a placebo effect is ruled out. A few herbs are identified where the evidence points to a true antitussive action. Of nonherbal treatments, the few positive results are usually outweighed by the larger number of negative ones. Thus, in general, CAMs for cough are welcomed enthusiastically by the patient but lack sound evidence for their efficacy. Antitussive chemicals can be extracted from many herbs, but it is no more than a reasonable hypothesis that the herb itself acts through this pathway.

Identification of transmembrane domain 5 as a critical molecular determinant of menthol sensitivity in mammalian TRPA1 channels

TRPA1 is a member of the transient receptor potential (TRP) family of ion channels and is expressed in a subset of nociceptive neurons. An increasing body of evidence suggests that TRPA1 functions as a chemical nocisensor for a variety of reactive chemicals, such as pungent natural compounds and environmental irritants. Activation of TRPA1 by reactive compounds has been demonstrated to be mediated through covalent modification of cytoplasmic cysteines located in the N terminus of the channel, rather than classical lock-and-key binding. TRPA1 activity is also modulated by numerous nonreactive chemicals, but the underlying mechanism is unknown. Menthol, a natural nonreactive cooling compound, is best known as an activator of TRPM8, a related TRP ion channel required for cool thermosensation in vivo. More recently, menthol has been shown to be an activator of mouse TRPA1 at low concentrations, and a blocker, at high concentrations. Here, we show that human TRPA1 is only activated by menthol, whereas TRPA1 from nonmammalian species are insensitive to menthol. Mouse-human TRPA1 chimeras reveal the pore region [including transmembrane domain 5 (TM5) and TM6] as the critical domain determining whether menthol can act as an inhibitor. Furthermore, chimeras between Drosophila melanogaster and mammalian TRPA1 highlight specific residues within TM5 critical for menthol responsiveness. Interestingly, this TM5 region also determines the sensitivity of TRPA1 to other chemical modulators. These data suggest separable structural requirements for modulation of TRPA1 by covalent and nonreactive molecules. Whether this region is involved in binding or gating of TRPA1 channels is discussed.

Tobacco industry control of menthol in cigarettes and targeting of adolescents and young adults

OBJECTIVES

We examined whether tobacco manufacturers manipulate the menthol content of cigarettes in an effort to target adolescents and young adults.

METHODS

We analyzed data from tobacco industry documents describing menthol product development, results of laboratory testing of US menthol brands, market research reports, and the 2006 National Survey on Drug Use and Health.

RESULTS

The tobacco industry attracted new smokers by promoting cigarettes with lower menthol content, which were popular with adolescents and young adults, and provided cigarettes with higher menthol content to long-term smokers. Menthol cigarette sales remained stable from 2000 to 2005 in the United States, despite a 22% decline in overall packs sold.

CONCLUSIONS

Tobacco companies manipulate the sensory characteristics of cigarettes, including menthol content, thereby facilitating smoking initiation and nicotine dependence. Menthol brands that have used this strategy have been the most successful in attracting youth and young adult smokers and have grown in popularity.

[Advantages of the L-menthol test in assessing chronic nasal obstruction]

OBJECTIVES

In normal and anosmic patients, l-menthol inhalation is responsible for the subjective sensation of increased nasal permeability, related to a stimulation of the internal nasal nerve (branch of trigeminal nerve) endings connected with cold pressor receptors. At present, routine assessment of nasal obstruction does not include the l-menthol test. The aim of this case report was to show the advantages of this test in chronic nasal obstruction evaluation.

MATERIAL AND METHODS

The example of a patient with a medical history of facial trauma and anosmia for sequela is reported. This patient complained of chronic nasal obstruction that persisted despite several septorhinoplasties and that conflicted with clinical examination and rhinomanometry data.

RESULTS

An l-menthol test did not induce any mint smell recognition, any improvement of nasal permeability sensation, or any freshness sensation.

CONCLUSION

The authors suggest that the nasal obstruction sensation could result, in this case, from post-trauma anesthesia of the trigeminal nerve, particularly its internal nasal nerve branch. The l-menthol test could be a predictive test that may prevent recurrent functional failures of surgical treatment proposed for nasal obstruction.

TRPM8 activation suppresses cellular viability in human melanoma

The transient receptor potential melastatin subfamily (TRPM), which is a mammalian homologue of cell death-regulated genes in Caenorhabditis elegans and Drosophila, has potential roles in the process of the cell cycle and regulation of Ca2+signaling. Among this subfamily, TRPM8 (also known as Trp-p8) is a Ca2+-permeable channel that was originally identified as a prostate-specific gene upregulated in tumors. Here we showed that the TRPM8 channel was expressed in human melanoma G-361 cells, and activation of the channel produced sustainable Ca2+influx. The application of menthol, an agonist for TRPM8 channel, elevated cytosolic Ca2+concentration in a concentration-dependent manner with an EC50value of 286 μM in melanoma cells. Menthol-induced responses were significantly abolished by the removal of external Ca2+. Moreover, inward currents at a holding potential of −60 mV in melanoma cells were markedly potentiated by the addition of 300 μM menthol. The most striking finding was that the viability of melanoma cells was dose-dependently depressed in the presence of menthol. These results reveal that a functional TRPM8 protein is expressed in human melanoma cells to involve the mechanism underlying tumor progression via the Ca2+handling pathway, providing us with a novel target of drug development for malignant melanoma.

Inhibition by the cold receptor agonists menthol and icilin of airway smooth muscle contraction

Menthol, known as a cold receptor agonist, has widely been used in the relief of respiratory symptoms such as coughing and chest congestion. Previous studies have demonstrated that menthol reduces bronchoconstriction and airway hyperresponsiveness. The aim of this study was to examine the effects of menthol and icilin, another cold receptor agonist, on airway smooth muscle contraction. Isometric force was monitored using epithelium-denuded tracheal smooth muscle tissues isolated from guinea pigs. Intracellular Ca(2+) concentrations were assessed by fura-2 fluorescence. (-)Menthol (0.01-1mM) inhibited contraction induced by methacholine (MCh, 0.01-10microM) and high extracellular K(+) concentrations (20-60mM) in a concentration-dependent manner. Moreover, the increases of intracellular Ca(2+) concentrations induced by MCh or high K(+) were significantly reduced by (-)menthol. Icilin (100microM) also significantly attenuated contraction induced by MCh or high K(+). The inhibitory effect of 1mM (-)menthol on MCh-induced contraction was significantly higher at cool temperature (24-26 degrees C) than at 37 degrees C. The present results demonstrate that inhibition of Ca(2+) influx plays an important role in the menthol-mediated inhibition of contraction in airway smooth muscle. Furthermore, our findings indicate that stimulation of unknown cold receptors may be involved in these mechanisms. These findings suggest that the use of menthol is beneficial for reducing respiratory symptoms because of its inhibitory effects on airway smooth muscle contraction.

Does inhaling menthol affect nasal patency or cough?

OBJECTIVE

There is widespread use of menthol in over-the-counter medications, despite scant information on any beneficial effects. Our aim was to assess the effect of menthol on nasal air flow, perception of nasal patency and cough challenge testing.

MATERIALS AND METHODS

Subjects comprised 42 healthy children aged 10 and 11 in a school setting. We used a single-blind pseudo-randomized cross-over trial to compare the effect of an inhalation of either menthol or placebo(eucalyptus oil). Baseline and post-intervention measurements were made on each of 2 consecutive days. Main outcome measures were (i) nasal expiratory and inspiratory flows and volumes, measured by spirometer, (ii) perception of nasal patency, assessed with a visual analogue scale (VAS), and (iii) the number of coughs in response to nebulized citric acid.

RESULTS

There was no effect of menthol on any of the spirometric measurements. Following menthol, there was a significant increase in the perception of nasal patency (mean difference in log VAS (menthol-placebo) = -0.207, 95%CI -0.329, -0.085). The cough count after menthol inhalation was reduced when compared to baseline but the change was not different from that after placebo (mean difference in cough count (menthol-placebo) = -1.71, 95%CI -4.11, 0.69).

CONCLUSION

Menthol has no effect on objective measures of flow but significantly increases the perception of nasal patency. It may not be possible to extrapolate these findings to younger children and those with rhinitis. Extending the study of menthol to these groups, including investigations of the efficacy and safety profiles, will provide further valuable evidence for its common use.

Relationship between menthol cigarettes and smoking cessation among African American light smokers

AIMS

To determine whether African American light smokers who smoked menthol cigarettes had lower cessation when treated with nicotine replacement therapy and counseling.

DESIGN

Data were derived from a clinical trial that assessed the efficacy of 2 mg nicotine gum (versus placebo) and counseling (motivational interviewing counseling versus Health Education) for smoking cessation among African American light smokers (smoked < or = 10 cigarettes per day).

PARTICIPANTS

The sample consisted of 755 African American light smokers.

MEASUREMENTS

The primary outcome variable was verified 7-day point-prevalence smoking cessation at 26 weeks follow-up. Verification was by salivary cotinine.

FINDINGS

Compared to non-menthol smokers, menthol smokers were younger and less confident to quit smoking (P = 0.023). At 26 weeks post-randomization, 7-day verified abstinence rate was significantly lower for menthol smokers (11.2% versus 18.8% for non-menthol, P = 0.015).

CONCLUSIONS

Among African American light smokers, use of menthol cigarettes is associated with lower smoking cessation rates. Because the majority of African American smokers use menthol cigarettes, a better understanding of the mechanism for this lower quit rate is needed.

Bimodal action of menthol on the transient receptor potential channel TRPA1

TRPA1 is a calcium-permeable nonselective cation transient receptor potential (TRP) channel that functions as an excitatory ionotropic receptor in nociceptive neurons. TRPA1 is robustly activated by pungent substances in mustard oil, cinnamon, and garlic and mediates the inflammatory actions of environmental irritants and proalgesic agents. Here, we demonstrate a bimodal sensitivity of TRPA1 to menthol, a widely used cooling agent and known activator of the related cold receptor TRPM8. In whole-cell and single-channel recordings of heterologously expressed TRPA1, submicromolar to low-micromolar concentrations of menthol cause channel activation, whereas higher concentrations lead to a reversible channel block. In addition, we provide evidence for TRPA1-mediated menthol responses in mustard oil-sensitive trigeminal ganglion neurons. Our data indicate that TRPA1 is a highly sensitive menthol receptor that very likely contributes to the diverse psychophysical sensations after topical application of menthol to the skin or mucous membranes of the oral and nasal cavities.

Sensing the air around us: the voltage-gated-like ion channel family

Ion channels are a complex set of proteins having many important physiologic and potentially pathologic roles. The flow of ions through these channels and the subsequent cellular depolarization can trigger complex mechanisms such as cardiac rhythm, hormone secretion, and numerous sensory experiences. The transient receptor potential (TRP) channels are an important means for multiple organ systems to interact with their environment. The various TRP channel subfamilies respond to voltage or to ligands such as G-protein coupled receptors. Their ability to sense temperature, pain, stretch, and osmolarity among others enables them to mediate responses such as smooth muscle contraction, cough, or sensation of pain.

Menthol: a refreshing look at this ancient compound

Menthol is a naturally occurring cyclic terpene alcohol of plant origin, which has been used since antiquity for medicinal purposes. Its use in dermatology is ubiquitous, where it is frequently part of topical antipruritic, antiseptic, analgesic, and cooling formulations. Despite its widespread use, it was only recently that the mechanism by which menthol elicits the same cool sensation as low temperature was elucidated upon, with the discovery of the TRPM8 receptor. Although almost 5 years have passed since the discovery of this receptor, many dermatologists are still unaware of menthol's underlying target. The purpose of this review is to highlight the recent advances in the mechanism of action of menthol and to provide an overview of its dermatologic applications.

TRP Channel Knockout Mice Lose Their Cool

Heat and cold transduction by peripheral sensory neurons is a fundamental step in the avoidance of dangerous thermal extremes. In this issue of Neuron, Dhaka et al. and Colburn et al. report that mice lacking the cold- and menthol-gated ion channel TRPM8 exhibit deficient behavioral responses to cold temperatures.

TRPM8-independent Menthol-induced Ca2+ Release from Endoplasmic Reticulum and Golgi

Menthol, a secondary alcohol produced by the peppermint herb, Mentha piperita, is widely used in the food and pharmaceutical industries as a cooling/soothing compound and odorant. It induces Ca2+ influx in a subset of sensory neurons from dorsal root and trigeminal ganglia, due to activation of TRPM8, a Ca2+-permeable, cold-activated member of the TRP superfamily of cation channels. Menthol also induces Ca2+ release from intracellular stores in several TRPM8-expressing cell types, which has led to the suggestion that TRPM8 can function as an intracellular Ca2+-release channel. Here we show that menthol induces Ca2+ release from intracellular stores in four widely used cell lines (HEK293, lymph node carcinoma of the prostate (LNCaP), Chinese hamster ovary (CHO), and COS), and provide several lines of evidence indicating that this release pathway is TRPM8-independent: 1) menthol-induced Ca2+ release was potentiated at higher temperatures, which contrasts to the cold activation of TRPM8; 2) overexpression of TRPM8 did not enhance the menthol-induced Ca2+) release; 3) menthol-induced Ca2+ release was mimicked by geraniol and linalool, which are structurally related to menthol, but not by the more potent TRPM8 agonists icilin or eucalyptol; and 4) TRPM8 expression in HEK293 cells was undetectable at the protein and mRNA levels. Moreover, using a novel TRPM8-specific antibody we demonstrate that both heterologously expressed TRPM8 (in HEK293 cells) and endogenous TRPM8 (in LNCaP cells) are mainly localized in the plasma membrane, which contrast to previous localization studies using commercial anti-TRPM8 antibodies. Finally, aequorin-based measurements demonstrate that the TRPM8-independent menthol-induced Ca2+ release originates from both endoplasmic reticulum and Golgi compartments.

Cutoff in detection of eye irritation from vapors of homologous carboxylic acids and aliphatic aldehydes

Using neat vapors of selected homologous aldehydes (decanal, undecanal, dodecanal) and carboxylic acids (pentanoic, hexanoic, heptanoic, octanoic, nonanoic), we explored the point where a certain homolog (and all larger ones) becomes undetectable by eye irritation (i.e. by ocular chemesthesis). This phenomenon has been observed in other homologous series that also reach a break-point, or cutoff, in chemesthetic detection. Participants (11<or=n<or=32) were tested using a three-alternative, forced-choice procedure. Flow rate to the eye equaled 4 or 8 l/min and time of exposure was 6 s. The outcome showed that dodecanal and heptanoic acid were the shortest undetectable homologs. When the vapor concentration of the stimuli was increased by heating the liquid source to 37 degrees C, homologs located before the cutoff point (e.g. hexanoic acid) became readily detected by all subjects, whereas homologs located at the cutoff remained largely undetected. In addition, a comparison of calculated values of eye irritation thresholds for aldehydes and acids (from a successful model of ocular chemesthetic potency) with values of saturated vapor concentration at 23 and 37 degrees C indicated that the vapor concentration of dodecanal and heptanoic acid should have been enough to produce detection. The outcome suggests that the cutoff observed does not result from a low vapor concentration but from limitations in the structure or dimension(s) of the molecules that render them unsuitable to interact effectively with human chemesthetic receptors.

Temperature sensing across species

The ability to detect changes in temperature is a fundamental sensory mechanism for every species and provides organisms with a detailed view of the environment. This review focuses on what is known of the neuronal and molecular substrates for thermosensation across species, focusing on the three robust model systems extensively used to study sensory signaling, the nematode Caenorhabditis elegans, the fruit fly Drosophila melanogaster, and the laboratory mouse. Nematodes migrate to thermal climes that are amenable to their survival, a behavior that is regulated primarily through a single sensory neuron. Additionally, nematodes "learn" to seek out this temperate zone based upon their prior experience, a robust model of learning and memory. Drosophila larvae also prefer select thermal zones that are optimal for growth and have also developed vigorous mechanisms to avoid unfavorable conditions. In mammals, the transduction mechanisms for thermosensation have been identified primarily due to the fact that naturally occurring plant products evoke distinct psychophysical sensation of temperature change. More remarkably, the elucidation of the molecular sensors in mammals, along with those in Drosophila, has demonstrated conservation in the molecular mediators of temperature sensation across diverse species.

Are menthol cigarettes a starter product for youth?

This study assessed the relationship between menthol use and nicotine dependence. Data from the National Youth Tobacco Survey indicated that menthol cigarette use was significantly more common among newer, younger smokers. Additionally, youth who smoked menthol cigarettes had significantly higher scores on a scale of nicotine dependence compared with nonmenthol smokers, controlling for demographic background and the length, frequency, and level of smoking. The study suggests that menthol cigarettes are a starter product that may be associated with smoking uptake by youth.

Analgesia mediated by the TRPM8 cold receptor in chronic neuropathic pain

BACKGROUND

Chronic established pain, especially that following nerve injury, is difficult to treat and represents a largely unmet therapeutic need. New insights are urgently required, and we reasoned that endogenous processes such as cooling-induced analgesia may point the way to novel strategies for intervention. Molecular receptors for cooling have been identified in sensory nerves, and we demonstrate here how activation of one of these, TRPM8, produces profound, mechanistically novel analgesia in chronic pain states.

RESULTS

We show that activation of TRPM8 in a subpopulation of sensory afferents (by either cutaneous or intrathecal application of specific pharmacological agents or by modest cooling) elicits analgesia in neuropathic and other chronic pain models in rats, thereby inhibiting the characteristic sensitization of dorsal-horn neurons and behavioral-reflex facilitation. TRPM8 expression was increased in a subset of sensory neurons after nerve injury. The essential role of TRPM8 in suppression of sensitized pain responses was corroborated by specific knockdown of its expression after intrathecal application of an antisense oligonucleotide. We further show that the analgesic effect of TRPM8 activation is centrally mediated and relies on Group II/III metabotropic glutamate receptors (mGluRs), but not opioid receptors. We propose a scheme in which Group II/III mGluRs would respond to glutamate released from TRPM8-containing afferents to exert an inhibitory gate control over nociceptive inputs.

CONCLUSIONS

TRPM8 and its central downstream mediators, as elements of endogenous-cooling-induced analgesia, represent a novel analgesic axis that can be exploited in chronic sensitized pain states.

Possible effects on smokers of cigarette mentholation: a review of the evidence relating to key research questions

Menthol (2-isopropyl-5-methyl-cyclohexan-1-ol) is used in food, pharmaceutical, and tobacco products. Despite its long usage history and GRAS status, scientific literature on effects of cigarette mentholation is limited. Because African-American men have high lung cancer rates and predominantly smoke mentholated cigarettes, and because menthol's cooling effect might affect puffing and smoke inhalation, possible adverse effects of cigarette mentholation have been suggested. We review the evidence on the effects of mentholation on smokers, and we also identify areas for further study. Five large epidemiological studies provide no evidence that cigarette mentholation increases lung cancer risk. Mentholation cannot explain the higher risk for lung cancer in African-American male smokers, who also predominantly smoke mentholated cigarettes. Limited data on other cancers also suggest no risk from mentholation. The scientific literature suggests that cigarette mentholation does not increase puff number or puff volume of smoked cigarettes, and has little or no effect on heart rate, blood pressure, uptake of carbon monoxide, tar intake or retention, or blood cotinine concentration. Mentholation has little effect on other smoke constituents, and no apparent effect on nicotine absorption, airway patency and smoking initiation, dependency or cessation. Any toxicological effects of cigarette mentholation on adult smokers are probably quite limited.

Effects of capsaicin and menthol on oral thermal sensory thresholds

OBJECTIVE

To determine the long-term effect of capsaicin and short-term effect of menthol on oral thermal thresholds.

DESIGN

The thresholds for cold detection (CDT), warm detection (WDT), cold pain (CPT) and warm pain (WPT) were determined in 11 regular chilli-eaters (capsaicin group) and 11 control subjects that were closely matched for age, gender and ethnicity. The effect of menthol was determined by asking all 22 participants to suck a lozenge containing 0.52% menthol for 5min.

RESULTS

An ANOVA revealed a significant difference between the capsaicin and control groups (P=0.014), with the greatest difference in the WDT (capsaicin group 4.7+/-2.7[S.D.] degrees C; control group 2.3+/-2.2 degrees C). Immediately after sucking a menthol lozenge there was a significant rise in the CDT (2.2+/-1.1 degrees C to 5.9+/-6.2 degrees C; P<0.01) and WDT (3.6+/-2.7 degrees C to 7.6+/-4.4 degrees C; P<0.001).

CONCLUSIONS

The consumption of foods containing capsaicin and menthol significantly alters thermal sensory thresholds in the oral cavity. Dietary habits should therefore be taken into account when intra-oral thermal thresholds are determined.

Trp ion channels and temperature sensation

The abilities to sense environmental and internal temperatures are required for survival, both for maintenance of homeostasis and for avoidance of tissue-damaging noxious temperatures. Vertebrates can sense external physical stimuli via specialized classes of neurons in the peripheral nervous system that project to the skin. Temperature-sensitive neurons can be divided into two classes: innocuous thermosensors (warm or cool) and noxious thermonociceptors (hot or cold). ThermoTRPs, a subset of the transient receptor potential family of ion channels, which are expressed in sensory nerve endings and in skin, respond to distinct thermal thresholds. In this review, we examine the extent to which thermoTRPs are responsible for providing a molecular basis for thermal sensation.

Shorter time to first cigarette of the day in menthol adolescent cigarette smokers

Menthol smoking is thought to contribute to the addictiveness of smoking. Given the high prevalence of menthol smoking among youth, the aim of the current analysis was to examine differences in consumption and tobacco dependence, including smoking urgency among menthol and non-menthol adolescent smokers. Data for the current analysis were collected from telephone interviews with adolescent smokers applying to a cessation treatment study. Of 572 adolescent smokers (mean age=15.6+/-1.6 years; 55.1% female; 46.9% African American, 48.2% European American), 531 smoked menthol cigarettes and 41 smoked non-menthol as their usual brand. Analysis using Fisher's Exact (one-tailed) Test revealed that menthol smokers had a significantly shorter time to first (TTF) cigarette of the day compared to non-menthol smokers (smoking within the first 5 min of the day, 45% vs. 29%, respectively; p<0.04). Independent t tests revealed no significant difference in number of cigarettes per day (CPD) (mean=12.2+/-8.5 vs. 11.4+/-8.8; p<0.28) or Fagerstrom Test for Nicotine Dependence (FTND) scores (3.4+/-1.4 vs. 3.2+/-1.3; p<0.23). While preliminary, our findings suggest greater smoking urgency among menthol compared to non-menthol adolescent cessation-treatment seekers. Further study in a broader sample of adolescent smokers is warranted to elucidate the mechanisms underlying the effects of menthol smoking for youths.

Supramedullary influences on cough

The evidence for supramedullary influences on cough is largely indirect. Cough can be voluntarily induced or inhibited, functions usually thought to reside in the cerebral cortex. A sensation of 'urge-to-cough' usually precedes cough due to an airway irritant stimulus, and this may well involve the cerebral cortex. In conditions with interruption of the pathways between the cortex and the brainstem, such as strokes and Parkinson's disease, voluntary cough may be inhibited without disruption of reflex cough from the larynx or lower airways. 'Habit cough', like Tourette's syndrome, is assumed to be cortically mediated. Placebos and many treatments based on complementary medicine are effective in inhibiting clinical cough, and the site of action is likely to be the cerebral cortex. In sleep and in anaesthesia cough is depressed and, again, this seems likely to be at a cortical level. However there are few or no experimental or clinical observation as to the localization and functions of supramedullary areas responsible for cough. It is a field of research wide open for exploration.