Effect of smokeless tobacco on the development of the CD-1 mouse fetus

The Effects of Nicotine on Development

Recently, there has been a significant increase in the use of noncombustible nicotine-containing products, including electronic cigarettes (e-cigarettes). Of increasing popularity are e-cigarettes that can deliver high doses of nicotine over short periods of time. These devices have led to a rise in nicotine addiction in adolescent users who were nonsmokers. Use of noncombustible nicotine products by pregnant mothers is also increasing and can expose the developing fetus to nicotine, a known teratogen. In addition, young children are frequently exposed to secondhand and thirdhand nicotine aerosols generated by e-cigarettes, with little understanding of the effects these exposures can have on health. With the advent of these new nicotine-delivery systems, many concerns have arisen regarding the short- and long-term health effects of nicotine on childhood health during all stages of development. Although health studies on nicotine exposure alone are limited, educating policy makers and health care providers on the potential health effects of noncombustible nicotine is needed because public acceptance of these products has become so widespread. Most studies evaluating the effects of nicotine on health have been undertaken in the context of smoke exposure. Nevertheless, in vitro and in vivo preclinical studies strongly indicate that nicotine exposure alone can adversely affect the nervous, respiratory, immune, and cardiovascular systems, particularly when exposure occurs during critical developmental periods. In this review, we have included both preclinical and clinical studies to identify age-related health effects of nicotine exposure alone, examining the mechanisms underlying these effects.

Women and tobacco dependence

Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Tobacco marketing strategies skillfully link cigarette use to typical female values. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant.

Evidence for carbon monoxide as the major factor contributing to lower fetal weights in rats exposed to cigarette smoke

One of the major effects of cigarette smoking during pregnancy is bearing a child with lower birth weight. It has previously been demonstrated under experimental conditions in rats that exposure to reference cigarette smoke results in reduced birth weight (E. L. Carmines et al., 2003, Toxicol. Sci. 75, 134-147; C. L. Gaworski et al., 2004, Toxicol. Sci. 79, 157-169). The role of various smoke constituents on lower birth weight was evaluated by exposing time-pregnant Sprague-Dawley rats at the concentrations found in cigarette smoke. The rats were exposed for 2 h/day 7 days/week by nose-only inhalation. The target concentrations were designed to produce the same plasma levels of biomarkers as exposure to 2R4F reference cigarette smoke at a concentration of 600 mg/m(3) total particulate matter. The smoke constituents evaluated included carbon monoxide (CO), nicotine, and a mixture of aldehydes (acrolein, acetaldehyde, and formaldehyde). The smoke constituents were tested individually as well as in mixtures to evaluate potential interactions. Exposure to cigarette smoke during gestation produced a reduction in both maternal body weight gain and fetal weights. Exposure to nicotine reduced maternal body weight gain but had no effect on fetal weight. Exposure to CO had no effect on maternal body weight gain but reduced fetal weight to a degree comparable to cigarette smoke. Exposure to a mixture of aldehydes (acrolein, acetaldehyde, and formaldehyde) had no effect on either maternal body weight gain or fetal weight. Exposure to mixtures of nicotine and CO or nicotine, CO, and aldehydes did not demonstrate any interactions. The results of this study suggest that the observed reduction in fetal weight after exposure to cigarette smoke in rats is due to CO toxicity and not nicotine toxicity.

Effects of cigarette smoke on the Meckel's cartilage of rat fetus: morphologic, morphometric and stereologic study

The purpose of this study was to investigate the effects of cigarette smoke on the development of the embryo mandible (Meckel's) cartilage in rat fetuses. When inhaled by female Wistar rats between the 9th and the 12th day of pregnancy, cigarette smoke (5 cigarettes a day) caused intrauterine growth retardation, providing smaller fetuses and placentas. In fetuses from the experimental group, the histopathologic examination revealed a poorly developed Meckel's cartilage with smaller chondroblasts showing a scanty cytoplasm with spherical and paler central nuclei, as well as more abundant cartilage matrix. Morphometric analysis revealed that Meckel's cartilage lacunae were smaller in the fetuses from the experimental group, although not showing any remarkable alteration in shape. The results suggested that inhalation of cigarette smoke by pregnant rats during the organogenic period induced growth retardation and delayed cellular differentiation in rat fetal Meckel's cartilage.

Women and tobacco dependence

Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Tobacco marketing strategies skillfully link cigarette use to typical female values. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant.

An assessment of the long-term developmental and behavioral teratogenicity of prenatal nicotine exposure

Maternal tobacco use during pregnancy adversely affects prenatal and postnatal growth and increases the risk of developmental and behavioral deficits in children and adolescents. In the present study, the effects of prenatal nicotine exposure (infused at 6mg/kg/day) and maternal withdraw during neonatal development, was examined in Sprague-Dawley rats on an array of behavioral tasks during different stages of ontogenesis. Offspring of both genders were monitored for exploratory, locomotor, and novelty-seeking activity, anxiety, and learning and memory in an active-avoidance task. Nicotine-exposed animals showed growth retardation, hyperactivity, and poor adaptation in a new environment, increased level of anxiety during the early adolescent period, and robust cognitive deficits in early adulthood. In addition, the deficits were generally more severe in the female nicotine-exposed offspring. Cross-fostering also revealed that while maternal behavior and nicotine withdraw did not affect postnatal somatic growth retardation or cognitive ability of the offspring; measures of exploration and adaptation in a new environment were impacted during the post-weanling and early adolescence period. Nicotine-exposed offspring, and the saline-treated offspring cross-fostered to nicotine-exposed mothers, showed higher measures of anxiety in the elevated plus-maze and decreased novelty-seeking behavior on the hole-board apparatus. These studies demonstrated that prenatal nicotine exposure produced significant long-term developmental and behavioral teratogenic effects. The study design provides a model system for studying the mechanism(s) responsible for the decline in central nervous system function following prenatal nicotine exposure, as well as that of other neurological and behavioral teratogens during pregnancy.

Risks and benefits of nicotine to aid smoking cessation in pregnancy

Cigarette smoking during pregnancy is the single largest modifiable risk for pregnancy-related morbidity and mortality in the US. Addiction to nicotine prevents many pregnant women who wish to quit smoking from doing so. The safety and efficacy of nicotine replacement therapy (NRT) for smoking cessation during pregnancy have not been well studied. Nicotine is classified by the US Food and Drug Administration as a Pregnancy Category D drug. Animal studies indicate that nicotine adversely affects the developing fetal CNS, and nicotine effects on the brain may be involved in the pathophysiology of sudden infant death syndrome (SIDS). It has been assumed that the cardiovascular effects of nicotine resulting in reduced blood flow to the placenta (uteroplacental insufficiency) is the predominant mechanism of the reproductive toxicity of cigarette smoking during pregnancy. Short term high doses of nicotine in pregnant animals do adversely affect the maternal and fetal cardiovascular systems. However, studies of the acute effects of NRT in pregnant humans indicate that nicotine alone has minimal effects upon the maternal and fetal cardiovascular systems. Cigarette smoking delivers thousands of chemicals, some of which are well documented reproductive toxins (e.g. carbon monoxide and lead). A myriad of cellular and molecular biological abnormalities have been documented in placentas, fetuses, and newborns of pregnant women who smoke. The cumulative abnormalities produced by the various toxins in cigarette smoke are probably responsible for the numerous adverse reproductive outcomes associated with smoking. It is doubtful that the reproductive toxicity of cigarette smoking is primarily related to nicotine. We recommend the following. Efficacy trials of NRT as adjunctive therapy for smoking cessation during pregnancy should be conducted. The initial dose of nicotine in NRT should be similar to the dose of nicotine that the pregnant woman received from smoking. Intermittent-use formulations of NRT (gum, spray, inhaler) are preferred because the total dose of nicotine delivered to the fetus will be less than with continuous-use formulations (transdermal patch). A national registry for NRT use during pregnancy should be created to prospectively collect obstetrical outcome data from NRT efficacy trials and from individual use. The goal of this registry would be to determine the safety of NRT use during pregnancy, especially with respect to uncommon outcomes such as placental abruption. Finally, our review of the data indicate that minimal amounts of nicotine are excreted into breast milk and that NRT can be safely used by breast-feeding mothers.

Smokeless tobacco and osteoporosis: a new relationship?

Osteoporosis is a common disorder of bone predominantly affecting postmenopausal women in which bone mineral density declines making bone more likely to break. Although cigarette smoking is a well-established risk factor for osteoporosis, smokeless tobacco (ST) use has never been suggested or evaluated as a risk factor for this bone disorder. This would be important to consider since in certain regions of the world, ST use is more prevalent than cigarette smoking, particularly among women. This paper reviews the animal and human evidence lending support to this new hypothesis, as well as the epidemiology of ST use that underscores the potential impact this modifiable behavior might have on osteoporosis world wide.

Long-term effects of nicotine on bone and calciotropic hormones in adult female rats

This study determined the effects of nicotine on serum concentrations of several calciotropic hormones, and bone formation and resorption end-points in 7 month old, adult female rats. Animals were administered either saline (n= 9/group), low dose nicotine at 3.0 mg/kg/day (n=10/group) or high dose nicotine at 4.5 mg/kg/day (n=11/group) by subcutaneous osmotic minipumps. At the end of a three months treatment period, serum concentrations of calcium, phosphorus, parathyroid hormone, calcitonin, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were determined. Femora, tibiae, and lumbar vertebrae (3-5) were collected and bone parameters evaluated included mineral density and content (femora and vertebrae), strength (femora and vertebrae) and histomorphometry (tibiae). Animals given nicotine had significantly lower levels of 25-hydroxyvitamin D than controls [20.8+/-1.4 ng/ml for the low dose group and 20.7+/-1.0 ng/ ml for the high dose group versus 27.6+/-1.3 ng/ml for the control group (mean+/-S.E.M.), P<0.01]. The high dose nicotine group had smaller vertebral areas (5.4+/-0.2 mm2 versus 6.2+/-0.2 mm2, P<0.05) and a lower bone mineral content than the controls (0.024+/-0.001 g versus 0.030+/-0.001 g, P<0.05). Tibial endocortical mineral apposition rate was also significantly lower in the high dose nicotine group than in the control group (1.06+/-0.13 microm/day versus 1.42+/-0.08 microm/day. P<0.05). No significant treatment differences were detected in bone density, cancellous bone histomorphometry, or bone strength. Results from the present study suggest that nicotine administration may adversely affect bone formation and decrease body storage of vitamin D.

Postnatal effect of smokeless tobacco on phytic acid or the butylated hydroxyanisole-modulated hepatic detoxication system and antioxidant defense mechanism in suckling neonates and lactating mice

The present study evaluates the potential of smokeless tobacco to translactationally modify the chemopreventive efficacy of phytic acid and butylated hydroxyanisole (BHA) via modulation of the hepatic xenobiotic detoxication system and antioxidant defense mechanism in the murine system. Phytic acid (1000 mg/kg b.w./day) by gavage while BHA (1% w/w) in diet induced a significant increase in the levels of glutathione-S-transferase (GST), acid soluble sulfhydryl (-SH), cytochrome b5 (Cyt. b5) and cytochrome P-450 (Cyt. P-450) in lactating dams and suckling pups. The hepatic levels of GST and -SH were significantly depressed whereas microsomal Cyt. b5, Cyt. P-450 and MDA levels were elevated in groups treated with smokeless tobacco (50 or 100 mg/kg b.w./day). The data reveals the inhibitory potential of smokeless tobacco on phytic acid-induced GST/GSH system efficiency besides the significant augmentation by smokeless tobacco on phytic acid or BHA-induced microsomal phase I enzymes. The direct or translactational modulation in the levels of xenobiotic detoxication system enzymes suggests the potential of smokeless tobacco to modify the chemopreventive efficacy of phytic acid or BHA.

Modulatory potential of smokeless tobacco on the garlic, mace or black mustard-altered hepatic detoxication system enzymes, sulfhydryl content and lipid peroxidation in murine system

The present study evaluates the potential of smokeless tobacco to modify the chemopreventive efficacy of minor dietary constituents, including garlic, mace or black mustard, via modulating the competing pathways of hepatic detoxication system and antioxidant defense mechanism in murine system. Garlic (100 mg/kg b.w. per day) by gavage and mace (1% w/w) or black mustard (1% w/w) in diet induced a significant increase in the levels of glutathione-S-transferase (GST), acid-soluble sulfhydryl (-SH), cytochrome b5 (Cyt.b5) and cytochrome P-450 (Cyt.P-450) in murine liver. The hepatic levels of GST and -SH were significantly depressed whereas microsomal Cyt.b5, Cyt.P-450 and MDA levels were elevated in groups treated with smokeless tobacco (50 or 100 mg/kg b.w. per day). The data revealed the inhibitory potential of smokeless tobacco on garlic-induced hepatic GST/GSH system besides the significant augmentation by smokeless tobacco on garlic or mace or black mustard-induced microsomal cytochromes. The possible implications of modulation in competing bioactivation and detoxication pathways in the process of chemical carcinogenesis are discussed.

Smoking and the human vertebral column: a review of the impact of cigarette use on vertebral bone metabolism and spinal fusion

Chronic cigarette consumption has significant adverse effects on the human spinal column. Multiple mechanisms induced by tobacco use lead to less strong, less healthy, mineral-deficient vertebrae with reduced bone blood supply and fewer and less functional bone-forming cells among chronic smokers. Compared to nonsmokers, chronic smokers develop advanced bony degradation, are more likely to suffer from spinal column degenerative disease, and seem more susceptible to traumatic vertebral injury. Spinal fusion procedures in chronic smokers are less often clinically and radiographically successful, compared to similar procedures performed among nonsmokers for definitive biological, physiological, and mechanical reasons.

The effects of smokeless tobacco extract on bone nodule formation and mineralization by chick osteoblasts in vitro

Short-term exposure to smokeless tobacco extracts (STE) reportedly inhibits osteoblast metabolism. The objective of this study was to determine the effects of serial dilutions of a water-soluble extract of smokeless tobacco on osteoblast proliferation and their potential to form and mineralize bone nodules. STE significantly stimulated cell proliferation when diluted 10(2)-10(4) times; 10(3) and 10(4) dilutions produced the greatest effect. 10(2)-10(4) STE dilutions significantly increased alkaline phosphatase activity at day 7 but 10(6) STE dilutions significantly decreased it. 10(3) and 10(4) dilutions significantly increased bone nodule formation, but inhibited their mineralization. In contrast, 10(5) and 10(6) dilutions significantly decreased bone nodule formation, but increased their mineralization. Stimulation of in vitro bone nodule formation by STE was similar to that produced by 10(-7) M insulin-like growth factor 1 (IGF-1) in vivo. Heat and acid treatment of STE significantly reduced its beneficial effect on cell proliferation, suggesting that a peptide within STE may be responsible for enhancement of osteogenic cell proliferation. Thus, STE may contain a peptide capable of significantly stimulating osteoblast proliferation, differentiation and metabolism, similar to the effects of IGF-1. This peptide could have potential therapeutic benefits.

Behavioral effects of smokeless tobacco on the neonate and young Sprague Dawley rat

Three dosages of Smokeless Tobacco (ST) extract were given to pregnant Sprague-Dawley rats by oral gavage on gestational days (GD) 6-20. The three dosages contained ST extract equivalent to 1.33 mg/kg nicotine (STD-1), 4.0 mg/kg nicotine (STD-2), and 6.0 mg/kg nicotine (STD-3). Dams were intubated three times per day at 8 a.m., 11 a.m., and 2 p.m., providing total daily ST dosages of 4 mg/kg, 12 mg/kg, and 18 mg/kg, respectively. Controls received equivalent volumes of water by gavage. Dams were allowed to deliver, and all biological mothers raised their own pups. On postnatal day 1 (PND 1), litters were culled to 4 +/- 1 females and 4 +/- 1 males. Weights, physical landmark development, and behavioral performance of pups were monitored during pre- and post-weaning periods. Behavioral tests included surface righting, negative geotaxis, swimming development, open field activity, and active avoidance in shuttle box. Our results show that the two higher doses resulted in reduced maternal weight gain. During the pre-weaning period, significant pup weight reductions were noted in the STD-2 pups until PND6, and in the STD-3 group until PND15. In the STD-1 group no statistically significant weight reduction was noted on PNDs 1 and 3, but starting with PND6, pup weights surpassed control group weights. This weight difference persisted throughout the post-weaning period also (P < .05 on PND30 and PND42). The STD-3 pup weights continued to be consistently and significantly (P < .05) reduced throughout the post-weaning period (except on PND24); likewise, the STD-2 pups continued to have lower weights, but at a significant level (P < .05) on PND30 only. The incidence of deaths was increased in a dose-related manner. No significant differences were noted for pinna detachment and incisor eruption; however ST-treatment was significant in affecting earlier eye opening and vaginal patency. N significant ST treatment effects were seen on negative geotaxis, but for surface righting a decreased success rate was noted for the ST-treated groups. Significant differences were noted in swimming development, with the STD-2 pups performing best. Open field activity, as expected, increased from the pre-weaning to post-weaning periods. During the pre-weaning period the STD-3 pups were more active, and during post-weaning the STD-1 pups were more active, but no differences were noted in vertical activity or in the number of stereotypical movements. No treatment-related differences were noted in the active avoidance shuttle box.(ABSTRACT TRUNCATED AT 400 WORDS)

The consequences of prenatal substance use for the developing fetus, newborn, and young child

Although substance use has been a worldwide problem at all levels of society since ancient times, recent attention has been focused on the use of legal and illegal substances by the pregnant woman. Almost all drugs taken by the pregnant woman are known to cross the placenta and have some effect on the fetus. This article reviews the effects of the drugs most frequently used by pregnant women in the United States--nicotine, alcohol, marijuana, opiates, and cocaine--on the fetus and neonate; when possible, information regarding long-term medical problems is included.

Immunostimulatory potential of smokeless tobacco extract in in vitro cultures of murine lymphoid tissues

Despite numerous studies on the general toxicologic effects of smokeless tobacco (ST) little immunotoxicologic information is available. As a first step in assessing the potential activity of ST on the immune system, the effects of an aqueous extract of ST was studied in in vitro cultures of mouse lymphoid cells. There was a significant increase in the proliferation of spleen cells cultured with different concentrations of ST extract. The polyclonal IgM antibody responses as determined by protein A plaque assay were also elevated in ST stimulated spleen cell cultures. Similar immunostimulatory results were seen in the mesenteric lymph node cell cultures also. ST extract was able to stimulate the spleen cells of the immune defective CBA/N mice. The mitogenic ability of ST extract may not be due to lipopolysaccharide (LPS) contamination as determined by its response in the LPS resistant C3H/HeJ mice spleen cells. ST extract was mitogenic not only to B cells but also to T cells. However the magnitude of response was less in T cells than in B cells. The proliferation of T cells was not accompanied by secretion of IL-2 or expression of IL-2 receptors on T cells. However there was an increase of IL-1 activity in spleen cells cultured with ST extract. Finally, activation of B or T lymphocytes by ST did not result in the elevation of intracellular calcium levels. Since ST is consumed orally, the chronic immunostimulation by ST in oral mucosal lymphoid tissues may be associated with the increased incidence of gingivitis, leukoplakia and oral cancer seen in human ST users.

Forward mutation of S. typhimurium by smokeless tobacco extracts

Mutagenicity of 4 popular brands of smokeless tobaccos was studied using a S. typhimurium forward mutation assay. Aqueous extracts of 4 brands and dichloromethane and methanol extracts of 1 of the 4 brands of smokeless tobacco's did not induce significant mutagenicity either in the presence or absence of metabolic activation. Aqueous and organic extracts were however mutagenic when treated with physiological levels of sodium nitrite (0.25 mM) at acidic pH and without metabolic activation. The results indicate that smokeless tobacco contain polar and non-polar chemicals which become mutagenic to S. typhimurium under nitrosation conditions.