Aggravation of inflammation by smokeless tobacco in comparison of smoked tobacco

Occupational and Environmental Exposure Influences the Inflammatory (Pro-and Anti-) Status in Benign Prostate Hyperplasia and Prostate Carcinoma Patients: A Retrospective Analysis

Multiple diseases and disorders are connected with occupational and environmental exposure risk. It is also well-established that chemicals and chemical mixtures have an influence on the immune cells of humans. This is an important field of research that has been pursued extensively in relation to autoimmune illnesses, allergy/asthma, and lung cancer, but Prostate Carcinoma has received rare reports. Chronic chemical exposure is known to produce inflammation, which is one of the most prominent characteristics of all malignancies. Changes in the ratio of pro-inflammatory to anti-inflammatory molecules are thought to be a key factor in the emergence of inflammation. Prostate gland cells express the pro-inflammatory cytokine interleukin-18 (IL-18), which is a major facilitator of immunological responses. Conversely, interleukin-10 (IL-10) is an anti-inflammatory cytokine that is linked to immune responses and inhibits the development of an inflammatory environment. Our goal is to investigate the inflammatory status of IL-18 (pro-) and IL-10 (anti-) in a variety of occupationally exposed populations in patients with Benign Prostate Hyperplasia (BPH) and patients with Prostate Carcinoma. The present study was conducted with 664 subjects, comprising 285 Prostate Carcinoma patients, 94 BPH patients and 285 controls. The subjects of BPH and Prostate Carcinoma were screened and confirmed on the basis of Prostate Serum Antigen (PSA) and pathological biopsy. All subjects were categorized as per their occupational exposure into various groups. The pro-inflammatory and anti-inflammatory Interleukins (IL-18 and IL-10) and serum PSA levels were analysed by using corresponding quantitative ELISA kits. The results showed that as compared to control participants, the serum PSA levels were higher in the Prostate Carcinoma and BPH groups. When mean levels of IL-18 were compared between various occupational groups, Tanners (tanning industry), Agriculture, and Ordnance workers had significantly higher levels (P < 0.05) of IL-18 than sedentary workers. The pro-inflammatory cytokine (IL-18) levels were also found to be aggravated in Prostate Carcinoma compared to BPH and controls. According to the findings of the current study, the levels of inflammatory cytokines (IL-18 and IL-10) in various occupational groups of BPH, Prostate Carcinoma, and controls were altered. Long-term occupational exposure may have a negative influence on inflammation levels and the immune system; therefore, preventative measures should be explored for improved health.

Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research

Heterogeneity in the clinical presentation of SARS-CoV-2 infection and COVID-19 progression underscores the urgent need to identify individual-level susceptibility factors that affect infection vulnerability and disease severity. Tobacco product use is a potential susceptibility factor. In this Personal View, we provide an overview of the findings of peer-reviewed, published studies relating tobacco product use to SARS-CoV-2 infection and COVID-19 outcomes, with most studies focusing on cigarette smoking in adults. Findings pertaining to the effects of tobacco product use on the incidence of SARS-CoV-2 infection are inconsistent. However, evidence supports a role for cigarette smoking in increasing the risk of poor COVID-19 outcomes, including hospital admission, progression in disease severity, and COVID-19-related mortality. We discuss the potential effects of tobacco use behaviour on SARS-CoV-2 transmission and infection, and highlight the pathophysiological changes associated with cigarette smoking that could promote SARS-CoV-2 infection and increased disease severity. We consider the biological mechanisms by which nicotine and other tobacco product constituents might affect immune and inflammatory responses to SARS-CoV-2 infection. Finally, we identify current knowledge gaps and suggest priorities for research to address acute and post-acute health outcomes of COVID-19 during and after the pandemic.

Tobacco Use and Orofacial Pain: A Meta-analysis

Introduction

The relationship between smoking and general body ache has been shown to be bidirectional. The specific association between tobacco consumption and orofacial pain remains unclear, however.

Aim and Methods

The aim of this systematic review was to explore the association between pain related to diseases of the oral cavity and use of tobacco. A systematic search of PubMed, Embase, Web of Science, and Cochrane databases was carried out in September 2019. Tobacco exposure was included irrespective of the method of consumption (smokeless and smoked tobacco), and frequency of the habit. The outcome was defined as clinically diagnosed or self-reported pain in the orofacial region, with no limitation in the duration of the condition or the site of the pain.

Results

Altogether, eight studies were selected, with three of them demonstrating good methodology and none of them being of poor quality. Meta-analysis of six studies showed that orofacial pain was significantly worse in tobacco (smoked and smokeless) users (odds ratio [OR] = 3.55, 95% confidence interval [CI]: 1.92, 6.58) in comparison to nonusers. Subgroup analysis showed that the odds of orofacial pain was three times (OR = 3.13, 95% CI: 1.16, 8.46) higher among smokers, but was not associated with smokeless tobacco.

Conclusions

The odds of experiencing orofacial pain among patients with oral diseases increase for patients who are also smokers. The findings could help dentists and other health specialists more effectively manage patients with orofacial pain who are tobacco consumers.

Implications

This study shows that the odds of orofacial pain among patients with oral diseases increase for patients who are smokers. The results are a significant contribution to the literature because, while the relationship between smoking and general body ache has been shown to be bidirectional, the specific association between tobacco use and orofacial pain warranted further study. The findings could help dentists and other specialists more effectively manage patients with orofacial pain who are also tobacco consumers.

Cytological changes in oral mucosa induced by smokeless tobacco

INTRODUCTION

This study investigated the cellular changes in the mouth of smokeless tobacco (shamma) users among Saudi citizens from the Najran region.

METHODS

Healthy 61 shamma users and healthy 61 non-users participated in this study after informed consent. A mouth swap was taken from each study subject and investigated for cellular changes using a Papanicolaou stain. The results were analyzed using the t-test per cent of the StatPac statistical program.

RESULTS

Keratinization, binucleation and combined results were associated with shamma use. The number of shamma users with abnormal histology was 14 (22.9%) (p≤0.0001). The shamma types associated with the abnormal cytology were: Suhaily (9/36; p=0.0014), black (2/9; p=0.08), white (2/6; p=0.41), and red (1/1; p=1.00). The percentage of the tissues with abnormal histology decreased with the increase in the duration and frequency of smokeless tobacco use, except for the white shamma which increased with the increase in the frequency.

CONCLUSIONS

Shamma use affected the mouth epithelial cytology of 22.9% of its users. The histological changes were inflammation, keratinization, binucleation, and atypia. The Suhaily smokeless tobacco was associated with the highest percentage of the abnormal cytology results, while the duration and frequency of smokeless tobacco use decreased the number of tissues with abnormal histology.

Effect of Severity of Opiate Use on Cardiometabolic Profile of Chronic Opiate Dependents of Western Rajasthan

Lack of cardiometabolic profile data based on severity of opiate dependence for opiate abusers. The study aimed to evaluate the effect severity of opiate abuse on the cardiometabolic profile of male opiate abusers without co-morbidities. The study included 30 healthy controls (HCs), 90 prospective chronic opiate (opium and heroin) abusers, with and without co-dependence of smoking and tobacco-chewing. The subjects were categorized based on severity of opiate dependence questionnaire (SODQ) and metabolic syndrome (MS) based on NCEP ATP-III criteria and fasting blood samples analyzed for sugar, insulin, insulin resistance (IR), lipid profile, Hs-CRP and total antioxidant capacity (TAC). There was higher prevalence of MS in opiate abusers as compared to HCs. Majority of the patients fell in grade 2 and 3 of severity. There was significant difference across groups for WHR (p < 0.001), SBP (p < 0.03), FBS (p < 0.001), insulin (p < 0.02), IR (p < 0.03) and TAC (p < 0.01). Multiple regression analysis of SODQ grades 2 and 3 independently predicted TAC by Hs-CRP (p = 0.032 and 0.042). There was a significant correlation of TAC with serum insulin, IR and Hs-CRP in SODQ grade 2 and serum insulin and Hs-CRP in SODQ grade 3. Chronic opiate abuse is not benign and predisposes abusers to cardiometabolic risk with increasing severity of dependence, owing to oxidative stress and chronic low-grade inflammation.

Diseases and Molecular Diagnostics: A Step Closer to Precision Medicine

The current advent of molecular technologies together with a multidisciplinary interplay of several fields led to the development of genomics, which concentrates on the detection of pathogenic events at the genome level. The structural and functional genomics approaches have now pinpointed the technical challenge in the exploration of disease-related genes and the recognition of their structural alterations or elucidation of gene function. Various promising technologies and diagnostic applications of structural genomics are currently preparing a large database of disease-genes, genetic alterations etc., by mutation scanning and DNA chip technology. Further the functional genomics also exploring the expression genetics (hybridization-, PCR- and sequence-based technologies), two-hybrid technology, next generation sequencing with Bioinformatics and computational biology. Advances in microarray “chip” technology as microarrays have allowed the parallel analysis of gene expression patterns of thousands of genes simultaneously. Sequence information collected from the genomes of many individuals is leading to the rapid discovery of single nucleotide polymorphisms or SNPs. Further advances of genetic engineering have also revolutionized immunoassay biotechnology via engineering of antibody-encoding genes and the phage display technology. The Biotechnology plays an important role in the development of diagnostic assays in response to an outbreak or critical disease response need. However, there is also need to pinpoint various obstacles and issues related to the commercialization and widespread dispersal of genetic knowledge derived from the exploitation of the biotechnology industry and the development and marketing of diagnostic services. Implementation of genetic criteria for patient selection and individual assessment of the risks and benefits of treatment emerges as a major challenge to the pharmaceutical industry. Thus this field is revolutionizing current era and further it may open new vistas in the field of disease management.

Pro-(IL-18) and Anti-(IL-10) Inflammatory Promoter Genetic Variants (Intrinsic Factors) with Tobacco Exposure (Extrinsic Factors) May Influence Susceptibility and Severity of Prostate Carcinoma: A Prospective Study

BACKGROUND

It has been hypothesized that IL-18 (pro-) and IL-10 (anti-) inflammatory genetic variants at -607 C/A-137G/C and -819C/T,-592C/A, respectively, may generate susceptibility and severity risk with various modes of tobacco exposure in prostate carcinoma (PCa) patients. IL-18 is a pro-inflammatory cytokine expressed on various cells including prostate gland elements, and is a key mediator of immune responses with anti-cancerous properties. IL-10 is an anti-inflammatory cytokine that is associated with tumour malignancy which causes immune escape.

MATERIALS AND METHODS

The present study was conducted with 540 subjects, comprising 269 prostate carcinoma patients and 271 controls. Genotyping was performed by PCR-RFLP and confirmed by real time PCR probe-based methods.

RESULTS

The findings indicated that the mutant heterozygous and homozygous genotype CC and GC+CC showed significant negative associations (p=0.01, OR=0.21; 95% CI: 0.08-0.51 and p=0.011, OR=0.43; 95% CI: 0.22-0.81, respectively) thus, less chance to be diagnosed as cancer against GG genotype of tobacco smoking patients. In addition, a heterozygous GC genotype at the same locus of IL-18 pro-inflammatory cytokine may aggravate the severity (OR=2.82; 95%CI 1.09-7.29 :p=001) so that patients are more likely to be diagnosed in advanced stage than with the GG wild homozygous genotype. Our results also illustrated that anti-inflammatory cytokine (IL-10) genetic variants, although showing no significant association with susceptibility to cancer of the prostate, may gave profound effects on severity of the disease, as -819 TC (OR=4.60; 95%CI 1.35-15.73), and -592 AC (OR=5.04; 95%CI 1.08-25.43) of IL-10 in tobacco chewers and combined users (both chewers and smokers) respectively, are associated with diagnosis in more advanced stage than with other variants.

CONCLUSIONS

We conclude that promoter genetic variants of IL-18 and IL-10 with various modes of tobacco exposure may affect not only susceptibility risk but also severity in prostate cancer.

Blood Concentrations of Cadmium and Lead in Multiple Sclerosis Patients from Iran

Since industrial revolution heavy metals such as lead (Pb) and cadmium (Cd) have been extensively dispersed in environment which, unknown biological effects and prolong biological half-life make them as a major hazard to human health. In addition, the sharp increase in Multiple sclerosis incidence rateshas been recorded in Iran. The propose of this study was to measuring blood lead and cadmium concentration and their correlation with smoking habit in a group of 69 RRMS patients and 74 age/gender-matched healthy individuals resident in Tehran as most polluted city in Iran. All subjects were interviewed regarding age, medical history, possible chemical exposure, acute or chronic diseases, smoking and dietary habits. Blood Pb and Cd levels were measured by double beam GBC plus 932 atomic absorption spectrometer. Our result indicated a significant difference in Cd level (p = 0.006) in which, MS patients had higher blood concentration (1.82 ± 0.13 μg/L) in comparison with healthy individuals (1.47 ± 0.11 μg/L). A comparable blood Cd level to similar recent study (1.78 µg/L vs.1.82 µg/L) was observed. With respect to Pb there was no significant difference between cases and controls, however the geometric means of blood Pb concentration were considerably higher in males than in females in MS patients (57.1 ± 33.7 μg/L vs. 36.7 ± 21.9 μg/L. P = 0.02). Taking into consideration tobacco smoking, an elevated contents of each metal were observed in smoker subjects (p<0.0001). A significant correlation between cigarette smoking and risk of multiple sclerosis was shown before. Thus, high level of Cd in smokers might affect the susceptibility to multiple sclerosis and could increase the risk of disease development.