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Li X, Yuan L, Wang F. Health outcomes of electronic cigarettes. Chin Med J (Engl) 2024:00029330-990000000-01135. [PMID: 38973260 DOI: 10.1097/cm9.0000000000003098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Indexed: 07/09/2024] Open
Abstract
ABSTRACT The usage of electronic cigarettes (e-cigarettes) sparked an outbreak of unidentified vaping-related lung disease in the US during late 2019. With e-cigarettes becoming more and more popular, smokers have more options other than conventional cigarettes. Under these circumstances, a comprehensive evaluation of the general safety of new tobacco and tobacco-related products, represented by e-cigarettes, to human health is necessary. In this review, we summarize the current research on potential negative impacts of e-cigarette exposure on human health. In particular, studies detailing the relationship between e-cigarettes and the digestive system are summarized, with mechanisms mainly including hepatic metabolic dysfunction, impaired gut barrier, and worsened outcomes of inflammatory bowel disease (IBD). Although believed to be safer than traditional cigarettes, e-cigarettes exert adverse effects on systemic health and induce the development of multiple diseases containing asthma, cardiovascular disease, and IBD. Moreover, nicotine-containing e-cigarettes have a negative impact on the childhood development and increase the risk of arterial stiffness compared to the non-nicotine e-cigarettes. However, non-nicotine e-cigarette components have detrimental effects including promoting liver damage and metabolic disorders.
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Affiliation(s)
- Xinmeng Li
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Non-resolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Lingzhi Yuan
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Fen Wang
- Department of Gastroenterology, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
- Hunan Key Laboratory of Non-resolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
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Freda CT, Yin W, Ghebrehiwet B, Rubenstein DA. Complement component C1q initiates extrinsic coagulation via the receptor for the globular head of C1q in adventitial fibroblasts and vascular smooth muscle cells. Immun Inflamm Dis 2023; 11:e769. [PMID: 36705413 PMCID: PMC9868878 DOI: 10.1002/iid3.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Vascular diseases are highly associated with inflammation and thrombosis. Elucidating links between these two processes may provide a clearer understanding of these diseases, allowing for the design of more effective treatments. The activation of complement component 1 (C1) is a crucial contributor to innate immunity and is associated with significant concentrations of circulating C1q. Many pathological pathways initiate when C1q interacts with gC1qR. This interaction plays a major role in inflammation observed during atherosclerosis and the initiation of intrinsic coagulation. However, the effects of C1 and the role of C1q/gC1qR on extrinsic coagulation, which is the more physiologically relevant coagulation arm, has not been studied. We hypothesized that C1q binding to gC1qR enhances the expression of tissue factor (TF) in adventitial fibroblasts and vascular smooth muscle cells, the primary TF bearing cells in the body. METHODS Using an enzyme-linked immunosorbent assay approach, TF expression and the role of gC1qR was observed. Cells were conditioned for 1 h with C1q or a gC1qR blocker and C1q, to assess the role of gC1qR. Additionally, cell growth characteristics were monitored to assess changes in viability and metabolic activity. RESULTS Our results indicate that the expression of TF increased significantly after incubation with C1q as compared with unconditioned cells. Cells conditioned with gC1qR blockers and C1q exhibited no change in TF expression when compared with cells conditioned with the blocking antibodies alone. Our results show no significant differences in metabolic activity or cell viability under these conditions. CONCLUSIONS This indicates that gC1qR association with C1q induces TF expression and may initiate extrinsic coagulation. Overall, this data illustrates a role for C1q in the activation of extrinsic coagulation and that gC1qR activity may link inflammation and thrombosis.
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Affiliation(s)
- Christopher T. Freda
- Department of Biomedical EngineeringStony Brook UniversityStony BrookNew YorkUSA
| | - Wei Yin
- Department of Biomedical EngineeringStony Brook UniversityStony BrookNew YorkUSA
| | | | - David A. Rubenstein
- Department of Biomedical EngineeringStony Brook UniversityStony BrookNew YorkUSA
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Ren X, Lin L, Sun Q, Li T, Sun M, Sun Z, Duan J. Metabolomics-based safety evaluation of acute exposure to electronic cigarettes in mice. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 839:156392. [PMID: 35660447 DOI: 10.1016/j.scitotenv.2022.156392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/10/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION A growing number of epidemiological evidence reveals that electronic cigarettes (E-cigs) were associated with pneumonia, hypertension and atherosclerosis, but the toxicological evaluation and mechanism of E-cigs were largely unknown. OBJECTIVE Our study was aimed to explore the adverse effects on organs and metabolomics changes in C57BL/6J mice after acute exposure to E-cigs. METHODS AND RESULTS Hematoxylin and eosin (H&E) staining found pathological changes in tissues after acute exposure to E-cigs, such as inflammatory cell infiltration, nuclear pyknosis, and intercellular interstitial enlargement. E-cigs could increase apoptosis-positive cells in a time-dependent way using Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay. Oxidative damage indicators of reactive oxygen species (ROS), malondialdehyde (MDA) and 4-hydroxynonena (4-HNE) were also elevated after E-cigs exposure. There was an increasing trend of total glycerol and cholesterol in serum, while the glucose and liver enzymes including alanine aminotransferase (ALT), aspartate transaminase (AST), gamma-glutamyltranspeptidase (γ-GT) had no significant change compared to that of control. Further, Q Exactive high field (HF) mass spectrometer was used to conduct metabolomics, which revealed that differential metabolites including l-carnitine, Capryloyl glycine, etc. Trend analysis showed the type of compounds that change over time. Pathway enrichment analysis indicated that E-cigs affected 24 metabolic pathways, which were mainly regulated amino acid metabolism, further affected the tricarboxylic acid (TCA) cycle. Additionally, metabolites-diseases network analysis found that the type 2 diabetes mellitus, propionic acidemia, defect in long-chain fatty acids transport and lung cancer may be related to E-cigs exposure. CONCLUSIONS Our findings provided important clues for metabolites biomarkers of E-cigs acute exposure and are beneficial for disease prevention.
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Affiliation(s)
- Xiaoke Ren
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Lisen Lin
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Qinglin Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Tianyu Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Mengqi Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
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Gao Y, Xie Z, Li D. Investigating the Impact of New York State Flavor Ban on E-cigarettes Discussion on Twitter: Observational Study (Preprint). JMIR Public Health Surveill 2021; 8:e34114. [PMID: 35802417 PMCID: PMC9308079 DOI: 10.2196/34114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/08/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background On May 18, 2020, the New York State Department of Health implemented a statewide flavor ban to prohibit the sales of all flavored vapor products, except for tobacco or any other authorized flavor. Objective This study aims to investigate the discussion changes in e-cigarette–related tweets over time with the implementation of the New York State flavor ban. Methods Through the Twitter streaming application programming interface, 59,883 e-cigarette–related tweets were collected within the New York State from February 6, 2020, to May 17, 2020 (period 1, before the implementation of the flavor ban), May 18, 2020-June 30, 2020 (period 2, between the implementation of the flavor ban and the online sales ban), July 1, 2020-September 15, 2020 (period 3, the short term after the online sales ban), and September 16, 2020-November 30, 2020 (period 4, the long term after the online sales ban). Sentiment analysis and topic modeling were conducted to investigate the changes in public attitudes and discussions in e-cigarette–related tweets. The popularity of different e-cigarette flavor categories was compared before and after the implementation of the New York State flavor ban. Results Our results showed that the proportion of e-cigarette–related tweets with negative sentiment significantly decreased (4305/13,246, 32.5% vs 3855/14,455, 26.67%, P<.001), and tweets with positive sentiment significantly increased (5246/13,246, 39.6% vs 7038/14,455, 48.69%, P<.001) in period 4 compared to period 3. “Teens and nicotine products” was the most frequently discussed e-cigarette–related topic in the negative tweets. In contrast, “nicotine products and quitting” was more prevalent in positive tweets. The proportion of tweets mentioning mint and menthol flavors significantly increased right after the flavor ban and decreased to lower levels over time. The proportions of fruit and sweet flavors were most frequently mentioned in period 1, decreased in period 2, and dominated again in period 4. Conclusions The proportion of e-cigarette–related tweets with different attitudes and frequently discussed flavor categories changed over time after the implementation of the New York State ban of flavored vaping products. This change indicated a potential impact of the flavor ban on public discussions of flavored e-cigarettes.
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Affiliation(s)
- Yankun Gao
- University of Rochester Medical Center, Rochester, NY, United States
| | - Zidian Xie
- University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- University of Rochester Medical Center, Rochester, NY, United States
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5
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Freda CT, Yin W, Ghebrehiwet B, Rubenstein DA. SARS-CoV-2 Structural Proteins Exposure Alter Thrombotic and Inflammatory Responses in Human Endothelial Cells. Cell Mol Bioeng 2021; 15:43-53. [PMID: 34484458 PMCID: PMC8407404 DOI: 10.1007/s12195-021-00696-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction We have experienced a pandemic induced by the interaction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) structural proteins with innate structures. These interactions are especially prevalent for patients with underlying pathologies, such as cardiovascular diseases. However, there has been limited work to uncover the range of responses induced by SARS-CoV-2 structural proteins. Thus, our objective was to investigate how endothelial cell pro-thrombotic and pro-inflammatory responses are altered after exposure to SARS-CoV-2 spike, nucleocapsid, and membrane-envelope proteins. We hypothesized that after a short duration exposure, endothelial cells would have a heightened thrombotic and inflammatory potential. With longer exposures, this may lead to altered disease progression and the observed increased mortality and morbidity rates in patients with underlying vascular pathologies. Methods To test this hypothesis, human endothelial cells were exposed to SARS-CoV-2 structural proteins. After the exposure, the expression of thrombomodulin, PECAM-1, connexin-43, and gC1qR were assessed. In parallel, standard cell culture readouts were assessed to determine if these incubations altered cell growth and metabolism. Results and Conclusions We observed significant increases in thrombotic and inflammatory marker expression, with no change to the cell culture parameters (with the exception of a reduction in cell density in response to one SARS-CoV-2 structural protein). Importantly, these observations were dependent on the viral structural protein the cells were exposed to, suggesting that the interactions of SARS-CoV-2 with innate cells is complex and must be uncovered. Combined, this suggests that SARS-CoV-2 structural proteins can regulate inflammatory and thrombotic responses that underlie common pathologies observed during COVID-19.
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Affiliation(s)
- Christopher Thor Freda
- Department of Biomedical Engineering, Stony Brook University, 101 Bioengineering, Stony Brook, NY 11794-5281 USA
| | - Wei Yin
- Department of Biomedical Engineering, Stony Brook University, 101 Bioengineering, Stony Brook, NY 11794-5281 USA
| | | | - David A Rubenstein
- Department of Biomedical Engineering, Stony Brook University, 101 Bioengineering, Stony Brook, NY 11794-5281 USA
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Pham K, DeFina S, Wang H. E-Cigarettes Promote Macrophage-Tumor Cells Crosstalk: Focus on Breast Carcinoma Progression and Lung Metastasis. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2021; 6:60-66. [PMID: 35419501 PMCID: PMC9005083 DOI: 10.14218/erhm.2021.00002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recurrence and metastasis are the foremost causes of morbidity and mortality for breast cancer (BC). Recent studies have highlighted the critical role of the tumor microenvironment, in particular, because it is related to tumor-associated macrophages (TAMs), in metastasis of BC. TAMs are mainly derived from macrophages that are recruited by C-C motif chemokine ligand 5, which are secreted by cancer cells and cancer-related stromal cells. Although E-cigarettes (E-cigs) were originally proposed as a healthy substitute for conventional cigarette smoking, clinical and experimental evidence has highlighted the potentially lethal effects of this alternative. Several studies have illustrated the immune or macrophage activation and DNA damaging effects of E-cigs. However, the potentially pivotal role of TAM-BC crosstalk during BC progression and metastasis for E-cig vaping has not been explored. This review discussed the significant effect that E-cig use had on the BC tumor microenvironment, which ultimately led to enhanced tumor malignancy and metastasis, with an emphasis on the extent that E-cig uses had on the crosstalk between cancer and immune cells, as well as the potential underlying mechanisms that drive this aggressive phenotype of BC. This review advances our understanding of this matter and provides scientific evidence that could highlight risks associated with vaping and suggest a potential intervention for the treatment of aggressive BCs that present an increased risk of metastasis.
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Affiliation(s)
- Kien Pham
- Correspondence to: Kien Pham, Department of Pathology, Yale University, New Haven, CT, USA. Fax: +1- 203-785-7303, Tel: +1-203-737-4557, ; He Wang, Department of Pathology, Yale University, New Haven, CT, USA. Fax: +1- 203-785-7303, Tel: +1-203-789-3073,
| | | | - He Wang
- Correspondence to: Kien Pham, Department of Pathology, Yale University, New Haven, CT, USA. Fax: +1- 203-785-7303, Tel: +1-203-737-4557, ; He Wang, Department of Pathology, Yale University, New Haven, CT, USA. Fax: +1- 203-785-7303, Tel: +1-203-789-3073,
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7
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Freda CT, Yin W, Ghebrehiwet B, Rubenstein DA. SARS-CoV-2 proteins regulate inflammatory, thrombotic and diabetic responses in human arterial fibroblasts. Clin Immunol 2021; 227:108733. [PMID: 33895357 PMCID: PMC8061629 DOI: 10.1016/j.clim.2021.108733] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/21/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for many pathological processes, including altered vascular disease development, dysfunctional thrombosis and a heightened inflammatory response. However, there is limited work to determine the underlying cellular responses induced by exposure to SARS-CoV-2 structural proteins. Thus, our objective was to investigate how human arterial adventitial fibroblasts inflammation, thrombosis and diabetic disease markers are altered in response to Spike, Nucleocapsid and Membrane-Envelope proteins. We hypothesized that after a short-term exposure to SARS-CoV-2 proteins, adventitial fibroblasts would have a higher expression of inflammatory, thrombotic and diabetic proteins, which would support a mechanism for altered vascular disease progression. After incubation, the expression of gC1qR, ICAM-1, tissue factor, RAGE and GLUT-4 was significantly up-regulated. In general, the extent of expression was different for each SARS-CoV-2 protein, suggesting that SARS-CoV-2 proteins interact with cells through different mechanisms. Thus, SARS-CoV-2 protein interaction with vascular cells may regulate vascular disease responses.
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Affiliation(s)
- Christopher Thor Freda
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, United States of America
| | - Wei Yin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, United States of America
| | - Berhane Ghebrehiwet
- Department of Medicine, Stony Brook University, Stony Brook, NY 11794, United States of America
| | - David A Rubenstein
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, United States of America.
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8
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Sheng B, Li X, Nussler AK, Zhu S. The relationship between healthy lifestyles and bone health: A narrative review. Medicine (Baltimore) 2021; 100:e24684. [PMID: 33663079 PMCID: PMC7909112 DOI: 10.1097/md.0000000000024684] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Bone health, especially osteoporosis among ageing populations, has become an important topic for both clinical and basic researchers. The relationship between bone health and healthy lifestyles has been frequently discussed. The present study focuses on the relationship between bone health and healthy lifestyles among older adults, based on a global comparison. METHODS This narrative review was performed by collecting clinical trials, basic research and reviews on lifestyle and bone health in PubMed database. RESULTS Positive effects of physical activity and negative effects of malnutrition, alcohol abuse, and cigarette smoking on bone health were revealed. The relationship between bone health and drinking coffee and tea is still inconclusive. Moreover, the diversity of each region should be aware when considering healthy lifestyles to improve bone health. CONCLUSION Healthy lifestyles are highly related to bone health, and different lifestyles may have different influences on regions with a high risk of bone diseases. It is practical to acknowledge the diversity of economic, religious, environmental and geological conditions in each region when providing suitable and effective recommendations for healthy lifestyles that can improve overall bone health.
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Affiliation(s)
- Bin Sheng
- The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, PR China
| | - Xin Li
- The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, PR China
| | - Andreas K. Nussler
- Siegfried Weller Institute for Trauma Research, Eberhard Karls University Tuebingen, Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
| | - Sheng Zhu
- Siegfried Weller Institute for Trauma Research, Eberhard Karls University Tuebingen, Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
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Heldt NA, Reichenbach N, McGary HM, Persidsky Y. Effects of Electronic Nicotine Delivery Systems and Cigarettes on Systemic Circulation and Blood-Brain Barrier: Implications for Cognitive Decline. THE AMERICAN JOURNAL OF PATHOLOGY 2020; 191:243-255. [PMID: 33285126 DOI: 10.1016/j.ajpath.2020.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/23/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022]
Abstract
Electronic nicotine delivery systems (often known as e-cigarettes) are a novel tobacco product with growing popularity, particularly among younger demographics. The implications for public health are twofold, as these products may represent a novel source of tobacco-associated disease but may also provide a harm reduction strategy for current tobacco users. There is increasing recognition that e-cigarettes impact vascular function across multiple organ systems. Herein, we provide a comparison of evidence regarding the role of e-cigarettes versus combustible tobacco in vascular disease and implications for blood-brain barrier dysfunction and cognitive decline. Multiple non-nicotinic components of tobacco smoke have been identified in e-cigarette aerosol, and their involvement in vascular disease is discussed. In addition, nicotine and nicotinic signaling may modulate peripheral immune and endothelial cell populations in a highly context-dependent manner. Direct preclinical evidence for electronic nicotine delivery system-associated neurovascular impairment is provided, and a model is proposed in which non-nicotinic elements exert a proinflammatory effect that is functionally antagonized by the presence of nicotine.
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Affiliation(s)
- Nathan A Heldt
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania; Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
| | - Nancy Reichenbach
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Hannah M McGary
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Yuri Persidsky
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania; Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
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Crotty Alexander LE, Ware LB, Calfee CS, Callahan SJ, Eissenberg T, Farver C, Goniewicz ML, Jaspers I, Kheradmand F, King TE, Jr, Meyer NJ, Mikheev VB, Shields PG, Shihadeh A, Strongin R, Tarran R. E-Cigarette or Vaping Product Use-associated Lung Injury: Developing a Research Agenda. An NIH Workshop Report. Am J Respir Crit Care Med 2020; 202:795-802. [PMID: 32243764 DOI: 10.1164/rccm.201912-2332ws] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The NHLBI convened a working group on October 23, 2019, to identify the most relevant and urgent research priorities and prevailing challenges in e-cigarette or vaping product use-associated lung injury (EVALI). Experts across multiple disciplines discussed the complexities of the EVALI outbreak, identified research priorities, and recommended strategies to address most effectively its causal factors and improve diagnosis, treatment, and prevention of this disease. Many research priorities were identified, including the need to create national and international registries of patients with EVALI, to track accurately those affected and assess outcomes. The group concluded that biospecimens from subjects with EVALI are urgently needed to help define EVALI pathogenesis and that vaping has disease risks that are disparate from smoking, with the occurrence of EVALI highlighting the importance of broadening e-cigarette research beyond comparators to smoking-related diseases.
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Affiliation(s)
- Laura E Crotty Alexander
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of California San Diego, San Diego, California.,Pulmonary Critical Care Section, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Lorraine B Ware
- Department of Medicine and.,Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Carolyn S Calfee
- Division of Pulmonary and Critical Care, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Sean J Callahan
- Division of Pulmonary and Critical Care, University of Utah Health, Salt Lake City, Utah.,Pulmonary and Critical Care Medicine, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Thomas Eissenberg
- Department of Psychology and.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia
| | - Carol Farver
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Farrah Kheradmand
- Baylor College of Medicine, Houston, Texas.,Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | | | - Jr
- Division of Pulmonary and Critical Care, Department of Medicine, University of California San Francisco, San Francisco, California
| | - Nuala J Meyer
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | - Peter G Shields
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Alan Shihadeh
- Aerosol Research Lab, American University of Beirut, Beirut, Lebanon; and
| | - Robert Strongin
- Department of Chemistry, Portland State University, Portland, Oregon
| | - Robert Tarran
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
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11
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Gao Y, Xie Z, Sun L, Xu C, Li D. Electronic Cigarette-Related Contents on Instagram: Observational Study and Exploratory Analysis. JMIR Public Health Surveill 2020; 6:e21963. [PMID: 33151157 PMCID: PMC7677028 DOI: 10.2196/21963] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022] Open
Abstract
Background Instagram is a popular social networking platform for users to upload pictures sharing their experiences. Instagram has been widely used by vaping companies and stores to promote electronic cigarettes (e-cigarettes), as well as by public health entities to communicate the risks of e-cigarette use (vaping) to the public. Objective We aimed to characterize current vaping-related content on Instagram through descriptive analyses. Methods From Instagram, 42,951 posts were collected using vaping-related hashtags in November 2019. The posts were grouped as (1) pro-vaping, (2) vaping warning, (3) neutral to vaping, and (4) not related to vaping based on the attitudes to vaping expressed within the posts. From these Instagram posts and the corresponding 18,786 unique Instagram user accounts, 200 pro-vaping and 200 vaping-warning posts as well as 200 pro-vaping and 200 vaping-warning user accounts were randomly selected for hand coding. Furthermore, follower counts and media counts of the Instagram user accounts as well as the “like” counts and hashtags of the posts were compared between pro-vaping and vaping-warning groups. Results There were more posts in the pro-vaping group (41,412 posts) than there were in the vaping-warning group (1539 posts). The majority of pro-vaping images were product display images (163/200, 81.5%), and the most popular image type in vaping-warning posts was educational (95/200, 47.5%). The highest proportion of pro-vaping user account type was vaping store (110/189, 58.1%), and the store account type had the highest mean number of posts (10.33 posts/account). The top 3 vaping-warning user account types were personal (79/155, 51%), vaping-warning community (37/155, 23.9%), and community (35/155, 22.6%), of which the vaping-warning community had the highest mean number of posts (3.68 posts/account). Pro-vaping user accounts had more followers (median 850) and media (median 232) than vaping-warning user accounts had (follower count: median 191; media count: 92). Pro-vaping posts had more “likes” (median 22) and hashtags (mean 20.39) than vaping-warning posts had (“like” count: median 12; hashtags: mean 7.16). Conclusions Instagram is dominated by pro-vaping content, and pro-vaping posts and user accounts seem to have more user engagement than vaping-warning accounts have. These results highlight the importance of regulating e-cigarette posts on social media and the urgency of identifying effective communication content and message delivery methods with the public about the health effects of e-cigarettes to ameliorate the epidemic of vaping in youth.
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Affiliation(s)
- Yankun Gao
- University of Rochester Medical Center, Rochester, NY, United States
| | - Zidian Xie
- University of Rochester Medical Center, Rochester, NY, United States
| | - Li Sun
- University of Rochester, Rochester, NY, United States
| | - Chenliang Xu
- University of Rochester, Rochester, NY, United States
| | - Dongmei Li
- University of Rochester Medical Center, Rochester, NY, United States
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Smart DJ, Phillips G. Collecting e-cigarette aerosols for in vitro applications: A survey of the biomedical literature and opportunities to increase the value of submerged cell culture-based assessments. J Appl Toxicol 2020; 41:161-174. [PMID: 33015847 PMCID: PMC7756347 DOI: 10.1002/jat.4064] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 12/11/2022]
Abstract
Electronic nicotine delivery systems (ENDS) are being developed as potentially reduced‐risk alternatives to the continued use of combustible tobacco products. Because of the widespread uptake of ENDS—in particular, e‐cigarettes—the biological effects, including the toxic potential, of their aerosols are under investigation. Preclinically, collection of such aerosols is a prerequisite for testing in submerged cell culture‐based in vitro assays; however, despite the growth in this research area, there is no apparent standardized collection method for this application. To this end, through an Institute for in vitro Sciences, Inc. workshop initiative, we surveyed the biomedical literature catalogued in PubMed® to map the types of methods hitherto used and reported publicly. From the 47 relevant publications retrieved, we identified seven distinct collection methods. Bubble‐through (with aqueous solvents) and Cambridge filter pad (CFP) (with polar solvents) collection were the most frequently cited methods (57% and 18%, respectively), while the five others (CFP + bubble‐through; condensation; cotton filters; settle‐upon; settle‐upon + dry) were cited less often (2–10%). Critically, the collected aerosol fractions were generally found to be only minimally characterized chemically, if at all. Furthermore, there was large heterogeneity among other experimental parameters (e.g., vaping regimen). Consequently, we recommend that more comprehensive research be conducted to identify the method(s) that produce the fraction(s) most representative of the native aerosol. We also endorse standardization of the aerosol generation process. These should be regarded as opportunities for increasing the value of in vitro assessments in relation to predicting effects on human health. Collection of e‐cigarette aerosols is a prerequisite to enable testing in submerged culture‐based in vitro assays; however, there is no standardized method for this. Thus, we surveyed the biomedical literature to map the types of published methods. Bubble‐through and Cambridge filter pad methods were most common, although there was heterogeneity among other parameters, and moreover, the resulting fractions were only minimally characterized. Comprehensive research is required to identify the method(s) that produce the fraction(s) most representative of the native aerosol.
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Affiliation(s)
- Daniel J Smart
- PMI R&D, Philip Morris Products SA, Neuchâtel, Switzerland
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13
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Lechasseur A, Morissette MC. The fog, the attractive and the addictive: pulmonary effects of vaping with a focus on the contribution of each major vaping liquid constituent. Eur Respir Rev 2020; 29:29/157/200268. [PMID: 33060167 DOI: 10.1183/16000617.0268-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/25/2020] [Indexed: 11/05/2022] Open
Abstract
Vaping has become increasingly popular over the past decade. This pragmatic review presents the published biological effects of electronic cigarette vapour inhalation with a focus on the pulmonary effects. Special attention has been devoted to providing the documented effects specific to each major ingredient, namely propylene glycol/glycerol, nicotine and flavouring agents. For each ingredient, findings are divided according to the methodology used, being in vitro studies, animal studies and clinical studies. Finally, we provide thoughts and insights on the current state of understanding of the pulmonary effects of vaping, as well as novel research avenues and methodologies.
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Affiliation(s)
- Ariane Lechasseur
- Quebec Heart and Lung Institute, Université Laval, Quebec, Canada.,Faculty of Medicine, Université Laval, Quebec, Canada
| | - Mathieu C Morissette
- Quebec Heart and Lung Institute, Université Laval, Quebec, Canada.,Dept of Medicine, Université Laval, Quebec, Canada
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14
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Kuntic M, Hahad O, Daiber A, Münzel T. Could E-cigarette vaping contribute to heart disease? Expert Rev Respir Med 2020; 14:1131-1139. [PMID: 32757856 DOI: 10.1080/17476348.2020.1807332] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION E-cigarettes have become a controversial topic. While their benefits are questioned by the scientific community, a part of the medical profession is still supporting them as an effective harm reduction tool for smoking cessation. The impact of E-cigarettes on the cardiovascular system is still elusive. AREAS COVERED We assessed results from animal, pre(clinical), and epidemiological studies to critically evaluate and synthesize evidence relevant to the cardiovascular effects of E-cigarettes. Animal studies have demonstrated that E-cigarette vapor exposure can cause endothelial and cardiac dysfunction. However, there have also been reports on the less harmful effects of E-cigarette vapor exposure in comparison to classical tobacco cigarettes. Measurements of flow-mediated dilation in acute human exposure settings have mostly demonstrated that E-cigarettes cause vascular endothelial dysfunction. Epidemiological studies have shown that E-cigarette use is associated with an increased risk for cardiovascular disease, although switching from classical tobacco cigarettes to E-cigarettes can have beneficial cardiovascular effects. Misinterpretation of scientific data by activists on either side is another problem. EXPERT OPINION In conclusion, we need more and better (pre)clinical data comparing the health effects of E-cigarette vaping as compared with tobacco cigarette smoking, in order to counsel the legislation for better health policies.
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Affiliation(s)
- Marin Kuntic
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz, Germany
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main , Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main , Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main , Mainz, Germany
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15
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Heldt NA, Seliga A, Winfield M, Gajghate S, Reichenbach N, Yu X, Rom S, Tenneti A, May D, Gregory BD, Persidsky Y. Electronic cigarette exposure disrupts blood-brain barrier integrity and promotes neuroinflammation. Brain Behav Immun 2020; 88:363-380. [PMID: 32243899 PMCID: PMC7899242 DOI: 10.1016/j.bbi.2020.03.034] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 12/23/2022] Open
Abstract
Electronic cigarette (e-cigarette) use has grown substantially since inception, particularly among adolescents and combustible tobacco users. Several cigarette smoke constituents with known neurovascular effect are present in e-cigarette liquids or formed during the vapor generation. The present study establishes inhaled models of cigarette and e-cigarette use with normalized nicotine delivery, then characterizes the impact on blood-brain barrier (BBB) function. Sequencing of microvessel RNA following exposure revealed downregulation of several genes with critical roles in BBB function. Reduced protein expression of Occludin and Glut1 is also observed at the tight junction in all groups following exposure. Pro-inflammatory changes in leukocyte-endothelial cell interaction are also noted, and mice exposed to nicotine-free e-cigarettes have impaired novel object recognition performance. On this basis, it is concluded that long term e-cigarette use may adversely impact neurovascular health. The observed effects are noted to be partly independent of nicotine content and nicotine may even serve to moderate the effects of non-nicotinic components on the blood-brain barrier.
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Affiliation(s)
- Nathan A Heldt
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA; Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
| | - Alecia Seliga
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Malika Winfield
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Sachin Gajghate
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Nancy Reichenbach
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Xiang Yu
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Slava Rom
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA; Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Amogha Tenneti
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Dana May
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Brian D Gregory
- Department of Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuri Persidsky
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA; Center for Substance Abuse Research, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
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16
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Effects of combustible tobacco smoking and novel tobacco products on oxidative stress: Different sides of the same coin? CURRENT OPINION IN TOXICOLOGY 2020. [DOI: 10.1016/j.cotox.2020.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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D'Amario D, Migliaro S, Borovac JA, Vergallo R, Galli M, Restivo A, Bonini M, Romagnoli E, Leone AM, Crea F. Electronic Cigarettes and Cardiovascular Risk: Caution Waiting for Evidence. Eur Cardiol 2019; 14:151-158. [PMID: 31933682 PMCID: PMC6950284 DOI: 10.15420/ecr.2019.16.2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 05/29/2019] [Indexed: 12/30/2022] Open
Abstract
Electronic cigarettes use is a growing trend in contemporary societies, with the propensity to compete with traditional tobacco smoking. Some preclinical studies demonstrated the toxic and detrimental effects of electronic cigarettes liquid components. Its impact on human health remains unknown and insufficiently studied. While some studies suggest that electronic cigarettes use might be associated with endothelial dysfunction, impaired platelet function and increased risk of adverse clinical events, other studies did not confirm these findings and epidemiological data mostly suggest that the use of electronic cigarettes appears to be safer than that of traditional tobacco cigarettes. This article provides an up-to-date overview of the current state of knowledge regarding electronic cigarettes and their impact on human health, with special emphasis on their effect on cardiovascular diseases.
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Affiliation(s)
- Domenico D'Amario
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Stefano Migliaro
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Josip Andjelo Borovac
- Department of Pathophysiology, University Hospital of Split Split, Croatia.,Department of Cardiology, University Hospital of Split Split, Croatia
| | - Rocco Vergallo
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Mattia Galli
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Attilio Restivo
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Matteo Bonini
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Enrico Romagnoli
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Antonio Maria Leone
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
| | - Filippo Crea
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS Rome, Italy
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18
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Versella MV, Leyro TM. Electronic cigarettes and nicotine harm-reduction. Curr Opin Psychol 2019; 30:29-34. [DOI: 10.1016/j.copsyc.2019.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/14/2019] [Accepted: 01/18/2019] [Indexed: 01/05/2023]
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19
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Mehra VM, Keethakumar A, Bohr YM, Abdullah P, Tamim H. The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017. BMC Public Health 2019; 19:1208. [PMID: 31477067 PMCID: PMC6721192 DOI: 10.1186/s12889-019-7546-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/25/2019] [Indexed: 12/11/2022] Open
Abstract
Background E-cigarettes have grown in popularity around the world since 2003. Although marketed as a smoking cessation tool, e-cigarettes can lead to tobacco cigarette smoking in youth. In Canada, among all age groups, youth and young adults have the highest prevalence of e-cigarette use. The objective of this study was to assess the factors associated with e-cigarette use among youth and young adults in Canada, and to specifically examine the association between alcohol, marijuana and illicit drug use. Methods Data from the 2017 Canadian Tobacco, Alcohol and Drugs Survey were used. The sample was restricted to those aged 15–24 years (n = 10,322), and main outcome defined as ‘E-cigarette use in the past 30-days’. Multivariable logistic regression was performed to assess the association between the main outcome and substance use variables (illicit drug, marijuana and alcohol use), tobacco exposure variables, and demographic and health-related factors. Results 6.2% Canadians aged 15–24 reported using e-cigarettes in the past 30-days, while 23.9% reported having ever tried e-cigarettes. Twenty-three percent of the past 30-day users reported using e-cigarettes every day and 72.5% of the past 30-day users reported having nicotine in their last e-cigarette. Additionally, youth aged 15–17 were 4.95 times more likely to be e-cigarette users as compared to those aged 22–24 (OR: 4.95, 95% CI: 3.1–7.9). Moreover, e-cigarette use was significantly associated with marijuana use (OR:4.17, 95% CI: 2.6–6.7) and alcohol use (OR: 5.08, 95% CI: 2.9–9.0), and approached significance with illicit drug use (OR: 1.68, 95% CI: 1.0–2.9). Furthermore, being a current smoker (OR: 2.93, 95% CI: 1.8–4.7) and male (OR: 2.28, 95% CI: 1.5–3.4) was significantly associated with the outcome. Conclusion This study is nationally representative and provides insight into e-cigarette use among youth and young adults aged 15–24 years. Given that e-cigarettes can be used as illicit drug delivery systems, more studies are needed to understand how Canadian youth and young adults are using e-cigarettes. Stricter restrictions on public e-cigarette smoking, and awareness campaigns informing youth of risks of e-cigarette smoking should be implemented.
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Affiliation(s)
- Vrati M Mehra
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada.
| | - Asvini Keethakumar
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
| | - Yvonne M Bohr
- Department of Psychology, York University, 4700 Keele Street, Toronto, Canada
| | - Peri Abdullah
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
| | - Hala Tamim
- School of Kinesiology and Health Sciences, Faculty of Health, York University, Toronto, Canada
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20
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Polosa R, O'Leary R, Tashkin D, Emma R, Caruso M. The effect of e-cigarette aerosol emissions on respiratory health: a narrative review. Expert Rev Respir Med 2019; 13:899-915. [PMID: 31375047 DOI: 10.1080/17476348.2019.1649146] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Due to the uptake in the use of e-cigarettes (ECs), evidence on their health effects is needed to inform health care and policy. Some regulators and health professionals have raised concerns that the respirable aerosols generated by ECs contain several constituents of potential toxicological and biological relevance to respiratory health. Areas covered: We critically assess published research on the respiratory system investigating the effects of ECs in preclinical models, clinical studies of people who switched to ECs from tobacco cigarettes, and population surveys. We assess the studies for the quality of their methodology and accuracy of their interpretation. To adequately assess the impact of EC use on human health, addressing common mistakes and developing robust and realistic methodological recommendations is an urgent priority. The findings of this review indicate that ECs under normal conditions of use demonstrate far fewer respiratory risks than combustible tobacco cigarettes. EC users and smokers considering ECs have the right to be informed about the relative risks of EC use, and to be made aware that findings of studies published by the media are not always reliable. Expert opinion: Growing evidence supports the relative safety of EC emission aerosols for the respiratory tract compared to tobacco smoke.
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Affiliation(s)
- Riccardo Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", Università of Catania , Catania , Italy.,Center of Excellence for the acceleration of HArm Reduction (CoEHAR), University of Catania , Catania , Italy
| | - Renée O'Leary
- Canadian Institute for Substance Use Research , Victoria , Canada
| | - Donald Tashkin
- David Geffen School of Medicine at the University of California, Los Angeles (UCLA) , Los Angeles , CA , USA
| | - Rosalia Emma
- Dipartimento di Medicina Clinica e Sperimentale (MEDCLIN), University of Catania , Catania , Italy.,Dipartimento di Scienze biomediche e biotecnologiche (BIOMETEC), University of Catania , Catania , Italy
| | - Massimo Caruso
- Dipartimento di Medicina Clinica e Sperimentale (MEDCLIN), University of Catania , Catania , Italy.,Dipartimento di Scienze biomediche e biotecnologiche (BIOMETEC), University of Catania , Catania , Italy
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21
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Chen IL, Todd I, Fairclough LC. Immunological and pathological effects of electronic cigarettes. Basic Clin Pharmacol Toxicol 2019; 125:237-252. [PMID: 30861614 DOI: 10.1111/bcpt.13225] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/04/2019] [Indexed: 12/12/2022]
Abstract
Electronic cigarettes (E-cigarettes) are considered a preferable alternative to conventional cigarettes due to the lack of combustion and the absence of tobacco-specific toxicants. E-cigarettes have rapidly gained in popularity in recent years amongst both existing smokers and previous non-smokers. However, a growing literature demonstrates that E-cigarettes are not as safe as generally believed. Here, we discuss the immunological, and other, deleterious effects of E-cigarettes on a variety of cell types and host defence mechanisms in humans and in murine models. We review not only the effects of complete E-cigarette liquids, but also each of the main components-nicotine, humectants and flavourings. This MiniReview thus highlights the possible role of E-cigarettes in the pathogenesis of disease and raises awareness of the potential harm that E-cigarettes may cause.
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Affiliation(s)
- I-Ling Chen
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Ian Todd
- School of Life Sciences, University of Nottingham, Nottingham, UK
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22
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Oxidative stress induced by electronic nicotine delivery systems (ENDS): Focus on respiratory system. CURRENT OPINION IN TOXICOLOGY 2019. [DOI: 10.1016/j.cotox.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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23
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Bals R, Boyd J, Esposito S, Foronjy R, Hiemstra PS, Jiménez-Ruiz CA, Katsaounou P, Lindberg A, Metz C, Schober W, Spira A, Blasi F. Electronic cigarettes: a task force report from the European Respiratory Society. Eur Respir J 2019; 53:13993003.01151-2018. [PMID: 30464018 DOI: 10.1183/13993003.01151-2018] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/09/2018] [Indexed: 01/10/2023]
Abstract
There is a marked increase in the development and use of electronic nicotine delivery systems or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as "electrical devices that generate an aerosol from a liquid" and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on the epidemiology of ECIG use; their ingredients and accompanied health effects; second-hand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact; in vitro and animal studies; and user perspectives.ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support ECIGs as an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licenced stop-smoking treatments. So far, there are conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Based on current knowledge, negative health effects cannot be ruled out.
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Affiliation(s)
- Robert Bals
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | | | - Susanna Esposito
- Pediatric Clinic, Dept of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Robert Foronjy
- Pulmonary and Critical Care Medicine, SUNY Downstate Medical Center, New York, NY, USA
| | - Pieter S Hiemstra
- Dept of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Paraskevi Katsaounou
- 1st ICU Evangelismos Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Anne Lindberg
- Dept of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
| | - Carlos Metz
- Dept of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
| | - Wolfgang Schober
- Bavarian Health and Food Safety Authority, Dept of Chemical Safety and Toxicology, Munich, Germany
| | - Avrum Spira
- Boston University School of Medicine, Boston, MA, USA
| | - Francesco Blasi
- Dept of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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24
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Haddad C, Salman R, El-Hellani A, Talih S, Shihadeh A, Saliba NA. Reactive Oxygen Species Emissions from Supra- and Sub-Ohm Electronic Cigarettes. J Anal Toxicol 2019; 43:45-50. [PMID: 30192935 PMCID: PMC6376456 DOI: 10.1093/jat/bky065] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/25/2018] [Indexed: 12/24/2022] Open
Abstract
Electronic cigarettes (ECIGs) are battery-powered devices that heat and vaporize solutions containing propylene glycol (PG) and/or vegetable glycerin (VG), nicotine and possible trace flavorants to produce an inhalable aerosol. The heating process can lead to the formation of reactive oxygen species (ROS), which are linked to various oxidative damage-initiated diseases. Several studies in the literature have addressed ROS emissions in ECIG aerosols, but the effects of power, ECIG device design and liquid composition on ROS are relatively unknown. In addition, ROS emissions have not been examined in the emerging high power, sub-Ohm device (SOD) category. In this study, an acellular 2',7'-dichlorofluorescin (DCFH) probe technique was optimized to measure ROS in ECIG aerosols. The technique was deployed to measure ROS emissions in SOD and supra-Ohm ECIGs while varying power, heater coil head design and liquid composition (PG/VG ratio and nicotine concentration). Liquids were made from analytical standards of PG, VG and nicotine and contained no flavorants. At high powers, ROS emissions in ECIGs and combustible cigarettes were similar. Across device designs, ROS emissions were uncorrelated with power (R2 = 0.261) but were highly correlated with power per unit area (R2 = 0.78). It was noticed that an increase in the VG percentage in the liquid yielded higher ROS flux, and nicotine did not affect ROS emissions. ROS emissions are a function of device design and liquid composition at a given power. For a given liquid composition, a promising metric for predicting ROS emissions across device designs and operating conditions is power per unit area of the heating coil. Importantly, ROS formation is significant even when the ECIG liquid consists of pure analytical solutions of PG and VG; it can therefore be viewed as intrinsic to ECIG operation and not solely a by-product of particular flavorants, contaminants or additives.
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Affiliation(s)
- Christina Haddad
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rola Salman
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Ahmad El-Hellani
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Najat Aoun Saliba
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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26
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Alanazi H, Park HJ, Chakir J, Semlali A, Rouabhia M. Comparative study of the effects of cigarette smoke and electronic cigarettes on human gingival fibroblast proliferation, migration and apoptosis. Food Chem Toxicol 2018; 118:390-398. [PMID: 29800583 DOI: 10.1016/j.fct.2018.05.049] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/08/2018] [Accepted: 05/19/2018] [Indexed: 12/12/2022]
Abstract
In an effort to reduce smoking-related diseases, alternative products such as e-cigarettes have been proposed. However, despite their growing popularity, the potential toxicity of e-cigarettes remains largely unknown. In this study, human gingival fibroblasts were repeatedly exposed to cigarette smoke condensate (CSC) and to nicotine-rich (NR) or nicotine-free (NF) e-vapor condensates for 60 min once a day for various time periods. They were then used to perform different analyses. Results indicate that cells exposed to CSC or NR condensates showed an altered morphology and a reduced proliferation rate, as ascertained by MTT and BrdU assays. Fibroblast cultures exposed to either CSC or e-vapor condensates also showed increased levels of TUNEL-positive apoptotic cells, compared to that recorded in the control. Furthermore, the cell scratch test revealed that repeated exposures to CSC or to e-vapor condensates delayed both fibroblast migration and wound healing. It should be noted that CSC was much more damageable to gingival fibroblasts than were the NR and NF e-vapor condensates. The representative chain of damage thus translates to CSC > NR e-vapor condensate > NF e-vapor condensate.
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Affiliation(s)
- Humidah Alanazi
- Groupe de Recherche en Ecologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada
| | - Hyun Jin Park
- Groupe de Recherche en Ecologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada
| | - Jamila Chakir
- Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Abdelhabib Semlali
- Department of Biochemistry, Genome Research Chair, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Mahmoud Rouabhia
- Groupe de Recherche en Ecologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada.
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Huang SJ, Xu YM, Lau ATY. Electronic cigarette: A recent update of its toxic effects on humans. J Cell Physiol 2018; 233:4466-4478. [PMID: 29215738 DOI: 10.1002/jcp.26352] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 11/29/2017] [Indexed: 02/05/2023]
Abstract
Electronic cigarettes (e-cigarettes), battery-powered and liquid-vaporizing devices, were invented to replace the conventional cigarette (c-cigarette) smoking for the sake of reducing the adverse effects on multiple organ systems that c-cigarettes have induced. Although some of the identified harmful components in e-cigarettes were alleged to be measured in lower quantity than those in c-cigarettes, researchers unveiled that the toxic effects of e-cigarettes should not be understated. This review is sought for an attempt to throw light on several typical types of e-cigarette components (tobacco-specific nitrosamines, carbonyl compounds, and volatile organic compounds) by revealing their possible impacts on human bodies through different action mechanisms characterized by alteration of specific biomarkers on cellular and molecular levels. In addition, this review is intended to draw the limelight that like c-cigarettes, e-cigarettes could also be accompanied with toxic effects on whole human body, which are especially apparent on respiratory system. From head to foot, from physical aspect to chemical aspect, from genotype to phenotype, potential alterations will take place upon the intake of the liquid aerosol.
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Affiliation(s)
- Shu-Jie Huang
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Yan-Ming Xu
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Andy T Y Lau
- Laboratory of Cancer Biology and Epigenetics, Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, People's Republic of China
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Kaur G, Muthumalage T, Rahman I. Mechanisms of toxicity and biomarkers of flavoring and flavor enhancing chemicals in emerging tobacco and non-tobacco products. Toxicol Lett 2018; 288:143-155. [PMID: 29481849 PMCID: PMC6549714 DOI: 10.1016/j.toxlet.2018.02.025] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/19/2018] [Accepted: 02/21/2018] [Indexed: 01/11/2023]
Abstract
Tobacco products containing flavorings, such as electronic nicotine delivery devices (ENDS) or e-cigarettes, cigars/cigarillos, waterpipes, and heat-not-burn devices (iQOS) are continuously evolving. In addition to increasing the exposure of teenagers and adults to nicotine containing flavoring products and flavoring enhancers, chances of nicotine addiction through chronic use and abuse also increase. These flavorings are believed to be safe for ingestion, but little information is available about their effects on the lungs. In this review, we have discussed the in vitro and in vivo data on toxicity of flavoring chemicals in lung cells. We have further discussed the common flavoring agents, such as diacetyl and menthol, currently available detection methods, and the toxicological mechanisms associated with oxidative stress, inflammation, mucociliary clearance, and DNA damage in cells, mice, and humans. Finally, we present potential biomarkers that could be utilized for future risk assessment. This review provides crucial parameters important for evaluation of risk associated with flavoring agents and flavoring enhancers used in tobacco products and ENDS. Future studies can be designed to address the potential toxicity of inhaled flavorings and their biomarkers in users as well as in chronic exposure studies.
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Affiliation(s)
- Gurjot Kaur
- Human and Environmental Toxicology, Department of Biology, University of Konstanz, Konstanz, Germany
| | - Thivanka Muthumalage
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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Wadia R, Booth V, Yap HF, Moyes DL. A pilot study of the gingival response when smokers switch from smoking to vaping. Br Dent J 2018; 221:722-726. [PMID: 27932811 DOI: 10.1038/sj.bdj.2016.914] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 01/17/2023]
Abstract
Introduction Tobacco smoking is one of the most important risk factors for periodontitis as it alters the host response to plaque. Although the prevalence of tobacco smoking has declined in recent years, the use of electronic-cigarettes (vaping) has increased. The effect of vaping on the gingiva is unknown and an evidence-base needs to be established before providing dental advice about the use of these products.Objective To compare the gingival health of a group of established smokers before and after substituting vaping for smoking tobacco.Design Pilot.Setting Guy's Dental Hospital (England) from April-December 2015.Materials and methods Twenty established smokers (all staff members at Guy's Hospital) with mild periodontal disease replaced their regular smoking habits with the use of e-cigarettes for two weeks.Main outcome measure The primary outcome measure of gingival inflammation was bleeding on probing. Levels of selected pro-inflammatory cytokines in GCF, saliva and serum samples were also determined.Results and conclusions There was a statistically significant increase in gingival inflammation when tobacco smokers switched from smoking to vaping for two weeks. However, this result must be interpreted with extreme caution since this is only a pilot study. Nonetheless, this study should provide a stepping stone to encourage further investigation of the effects of vaping on periodontal health.
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Affiliation(s)
- R Wadia
- Kings College London, Dental Institute, Guy's Tower Wing, Great Maze Pond, London, SE1 9RT
| | - V Booth
- Kings College London, Dental Institute, Guy's Tower Wing, Great Maze Pond, London, SE1 9RT
| | - H F Yap
- Kings College London, Dental Institute, Guy's Tower Wing, Great Maze Pond, London, SE1 9RT
| | - D L Moyes
- Kings College London, Dental Institute, Guy's Tower Wing, Great Maze Pond, London, SE1 9RT
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Abstract
Electronic cigarettes (ECs) have been growing rapidly in popularity among youth and adults in the United States over the last decade. This increasing prevalence is driven partially by the ability to customize devices, flavors, and nicotine content and the general notion that ECs are harmless, particularly in comparison with conventional cigarettes. In vitro and in vivo murine models have demonstrated a number of harmful biological effects of e-liquids and their aerosols. However, limited clinical data exist on whether these effects translate into detrimental long-term outcomes in human subjects. The short-term harmful respiratory effects of EC use demonstrated in nonsmokers argue against their use. However, slightly more favorable data exist for the respiratory benefits of substituting conventional cigarettes with ECs and the short-term efficacy of ECs as smoking cessation tools. Nonetheless, available research is severely limited in regard to long-term outcomes and by study designs fraught with bias, pointing to the need for additional research efforts with well-designed longitudinal studies to guide US Food and Drug Administration regulatory efforts. The hurdle presented by diverse device designs and e-liquid permutations, which contribute to the inconsistency of available data, also highlights the need for legislative standardization of ECs.
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Affiliation(s)
- Amika K Sood
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Matthew J Kesic
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michelle L Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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31
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Pokhrel P, Fagan P, Herzog TA, Laestadius L, Buente W, Kawamoto CT, Lee HR, Unger JB. Social media e-cigarette exposure and e-cigarette expectancies and use among young adults. Addict Behav 2018; 78:51-58. [PMID: 29127784 DOI: 10.1016/j.addbeh.2017.10.017] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 10/17/2017] [Accepted: 10/25/2017] [Indexed: 11/16/2022]
Abstract
A vast majority of U.S. young adults use social media such as Facebook and Instagram daily. Research suggests that young adults are commonly exposed to e-cigarette-related marketing or user-generated content on the social media they use. Currently, however, there is limited empirical evidence as to how social media e-cigarette exposure is associated with e-cigarette use beliefs and behavior. In particular, limited evidence exists to support the proposition that social media e-cigarette exposure is uniquely associated with e-cigarette use, even after adjusting for the effects of e-cigarette use in young adults' in-person or 'offline' social networks. This study was conducted to test the hypotheses that 1) social media e-cigarette exposure is associated with e-cigarette use outcome expectancies and current e-cigarette use; and 2) the association between social media and e-cigarette use is linked via outcome expectancies. We collected cross-sectional data from a sample of 470 young adult college students in Hawaii. Hypotheses were tested by fitting a structural equation model to the data. The model accounted for the associations of demographic variables, cigarette smoking history, as well as e-cigarette use in individuals' actual social networks with expectancies and behavior. Results indicated that social media e-cigarette exposure was associated with current e-cigarette use indirectly through two of the four positive outcome expectancies examined, namely, positive "smoking" experience and positive sensory experience. We discuss the implications of the findings in the context of tobacco control efforts.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo St., Honolulu, HI 96813, USA.
| | - Pebbles Fagan
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham, #820, Little Rock, AR 72205, USA
| | - Thaddeus A Herzog
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo St., Honolulu, HI 96813, USA
| | - Linnea Laestadius
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N 10th St., Milwaukee, WI 53205, USA
| | - Wayne Buente
- School of Communications, University of Hawaii at Manoa, 2550 Campus Road, Honolulu, HI 96822, USA
| | - Crissy T Kawamoto
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo St., Honolulu, HI 96813, USA
| | - Hye-Ryeon Lee
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo St., Honolulu, HI 96813, USA; Department of Communocology, University of Hawaii at Manoa, 2560 Campus Road, Honolulu, HI 96822, USA
| | - Jennifer B Unger
- Preventive Medicine, University of Southern California, 2001 N. Soto St., Los Angeles, CA 90089, USA
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Zhao J, Zhang Y, Sisler JD, Shaffer J, Leonard SS, Morris AM, Qian Y, Bello D, Demokritou P. Assessment of reactive oxygen species generated by electronic cigarettes using acellular and cellular approaches. JOURNAL OF HAZARDOUS MATERIALS 2018; 344:549-557. [PMID: 29102637 PMCID: PMC5848214 DOI: 10.1016/j.jhazmat.2017.10.057] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/11/2017] [Accepted: 10/27/2017] [Indexed: 05/11/2023]
Abstract
Electronic cigarettes (e-cigs) have fast increased in popularity but the physico-chemical properties and toxicity of the generated emission remain unclear. Reactive oxygen species (ROS) are likely present in e-cig emission and can play an important role in e-cig toxicity. However, e-cig ROS generation is poorly documented. Here, we generated e-cig exposures using a recently developed versatile exposure platform and performed systematic ROS characterization on e-cig emissions using complementary acellular and cellular techniques: 1) a novel acellular Trolox-based mass spectrometry method for total ROS and hydrogen peroxide (H2O2) detection, 2) electron spin resonance (ESR) for hydroxyl radical detection in an acellular and cellular systems and 3) in vitro ROS detection in small airway epithelial cells (SAEC) using the dihydroethidium (DHE) assay. Findings confirm ROS generation in cellular and acellular systems and is highly dependent on the e-cig brand, flavor, puffing pattern and voltage. Trolox method detected a total of 1.2-8.9nmol H2O2eq./puff; H2O2 accounted for 12-68% of total ROS. SAEC cells exposed to e-cig emissions generated up to eight times more ROS compared to control. The dependency of e-cig emission profile on e-cig features and operational parameters should be taken into consideration in toxicological studies.
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Affiliation(s)
- Jiayuan Zhao
- Department of Environmental Health, Center for Nanotechnology and Nanotoxicology, Harvard School of Public Health, Boston, MA 02115, USA
| | - Yipei Zhang
- Department of Public Health, University of Massachusetts Lowell, MA 01854, USA
| | - Jennifer D Sisler
- Pathology and Physiology Research Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Morgantown, WV 26505, USA
| | - Justine Shaffer
- Pathology and Physiology Research Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Morgantown, WV 26505, USA
| | - Stephen S Leonard
- Pathology and Physiology Research Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Morgantown, WV 26505, USA
| | - Anna M Morris
- Pathology and Physiology Research Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Morgantown, WV 26505, USA
| | - Yong Qian
- Pathology and Physiology Research Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health (NIOSH), Morgantown, WV 26505, USA
| | - Dhimiter Bello
- Department of Environmental Health, Center for Nanotechnology and Nanotoxicology, Harvard School of Public Health, Boston, MA 02115, USA; Department of Public Health, University of Massachusetts Lowell, MA 01854, USA.
| | - Philip Demokritou
- Department of Environmental Health, Center for Nanotechnology and Nanotoxicology, Harvard School of Public Health, Boston, MA 02115, USA.
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Moazed F, Calfee CS. The Canary in the Coal Mine Is Coughing: Electronic Cigarettes and Respiratory Symptoms in Adolescents. Am J Respir Crit Care Med 2017; 195:974-976. [PMID: 28409686 DOI: 10.1164/rccm.201611-2259ed] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Farzad Moazed
- 1 Department of Medicine University of California San Francisco San Francisco, California
| | - Carolyn S Calfee
- 2 Department of Medicine Department of Anesthesia.,3 Cardiovascular Research Institute and.,4 Center for Tobacco Control Research and Education University of California San Francisco San Francisco, California
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Shaito A, Saliba J, Husari A, El-Harakeh M, Chhouri H, Hashem Y, Shihadeh A, El-Sabban M. Electronic Cigarette Smoke Impairs Normal Mesenchymal Stem Cell Differentiation. Sci Rep 2017; 7:14281. [PMID: 29079789 PMCID: PMC5660168 DOI: 10.1038/s41598-017-14634-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/05/2017] [Indexed: 12/13/2022] Open
Abstract
Electronic cigarettes (e-cigarettes) are promoted as low-risk alternatives to combustible cigarettes. However, the effects of chronic inhalation of potential toxicants emitted by ecigarettes remain largely unexamined. It is conceivable that smoking-induced chronic diseases result in cellular injury, in the absence of effective repair by stem cells. This study evaluates the effect of cigarette and e-cigarette aerosol extracts on the survival and differentiation of bone marrow-derived mesenchymal stem cells (MSCs). MSC growth and osteogenic differentiation were examined after exposure to smoke extracts. Data revealed detrimental effects of both cigarette and e-cigarette extracts on MSC morphology and growth. Levels and activity of alkaline phosphatase, an osteogenic marker, decreased and induction of osteoblastic differentiation was impaired. Both smoke extracts prevented osteogenic differentiation from progressing, evident by decreased expression of terminal osteogenic markers and mineralization. Elevated levels of reactive oxygen species (ROS) were detected in cells exposed to smoke extracts. Moreover, decreased differentiation potential was concomitant with severe down-regulation of Connexin 43 expression, leading to the loss of gap junction-mediated communication, which together with elevated ROS levels, could explain decreased proliferation and loss of differentiation potential. Hence, e-cigarettes present similar risk as combustible cigarettes with respect to tissue repair impairment.
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Affiliation(s)
- A Shaito
- Department of Biological and Chemical Sciences, Faculty of Arts and Sciences, Lebanese International University, Beirut, Lebanon
| | - J Saliba
- Department of Biology, Faculty of Science, Lebanese University, Beirut, Lebanon
| | - A Husari
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - M El-Harakeh
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - H Chhouri
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Y Hashem
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - A Shihadeh
- Department of Mechanical Engineering, Faculty of Engineering, American University of Beirut, Beirut, Lebanon
| | - M El-Sabban
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
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Ge CX, Qin YT, Lou DS, Li Q, Li YY, Wang ZM, Yang WW, Wang M, Liu N, Wang Z, Zhang PX, Tu YY, Tan J, Xu MX. iRhom2 deficiency relieves TNF-α associated hepatic dyslipidemia in long-term PM2.5-exposed mice. Biochem Biophys Res Commun 2017; 493:1402-1409. [PMID: 28965953 DOI: 10.1016/j.bbrc.2017.09.152] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 09/27/2017] [Indexed: 02/06/2023]
Abstract
Accumulating researches reported that particulate matter (PM2.5) is a risk factor for developing various diseases, including metabolic syndrome. Recently, inactive rhomboid protein 2 (iRhom2) was considered as a necessary modulator for shedding of tumor necrosis factor-α (TNF-α) in immune cells. TNF-α, a major pro-inflammatory cytokine, was linked to various pathogenesis of diseases, including dyslipidemia. Here, wild type (WT) and iRhom2-knockout (iRhom2-/-) mice were used to investigate the effects of iRhom2 on PM2.5-induced hepatic dyslipidemia. The hepatic histology, inflammatory response, glucose tolerance, serum parameters and gene expressions were analyzed. We found that long-term inhalation of PM2.5 resulted in hepatic steatosis. And a significant up-regulation of iRhom2 in liver tissues was observed, accompanied with elevated TNF-α, TNF-α converting enzyme (TACE), TNFα receptor (TNFR)2 and various inflammatory cytokines expressions. Additionally, PM2.5 treatment caused TG and TC accumulation in serum and liver, probably attributed to changes of genes modulating lipid metabolism. Intriguingly, hepatic injury and dyslipidemia were attenuated by iRhom2-/- in mice with PM2.5 challenge. In vitro, iRhom2-knockdwon reduced TNF-α expressions and its associated inflammatory cytokines in Kupffer cells, implying that liver-resident macrophages played an important role in regulating hepatic inflammation and lipid metabolism in cells treated with PM2.5. The findings indicated that long-term PM2.5 exposure caused hepatic steatosis and dyslipidemia through triggering inflammation, which was, at least partly, dependent on iRhom2/TNF-α pathway in liver-resident macrophages.
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Affiliation(s)
- Chen-Xu Ge
- College of Engineering and Applied Sciences, Nanjing University, Nanjing, 210023, PR China; School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China
| | - Yu-Ting Qin
- School of Medicine and Pharmacy, Ocean University of China, Qingdao, 266100, PR China
| | - De-Shuai Lou
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China
| | - Qiang Li
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China
| | - Yuan-Yuan Li
- School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China
| | - Zhong-Ming Wang
- School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China
| | - Wei-Wei Yang
- Department of Nephrology, Huai'an First People's Hospital, Nanjing Medical University, Nanjing, 210023, PR China
| | - Ming Wang
- School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310000, PR China
| | - Nan Liu
- Department of Experimental Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, PR China
| | - Zhen Wang
- Department of Experimental Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, PR China
| | - Peng-Xing Zhang
- Department of Experimental Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, PR China
| | - Yan-Yang Tu
- Department of Experimental Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, PR China
| | - Jun Tan
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China.
| | - Min-Xuan Xu
- Chongqing Key Laboratory of Medicinal Resources in the Three Gorges Reservoir Region, School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, PR China; College of Engineering and Applied Sciences, Nanjing University, Nanjing, 210023, PR China.
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36
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Cai H, Wang C. Graphical review: The redox dark side of e-cigarettes; exposure to oxidants and public health concerns. Redox Biol 2017; 13:402-406. [PMID: 28667909 PMCID: PMC5493817 DOI: 10.1016/j.redox.2017.05.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 05/23/2017] [Indexed: 10/29/2022] Open
Abstract
Since the initial marketing in 2005, the use of e-cigarettes has increased exponentially. Nonetheless, accumulating evidence has demonstrated the ineffectiveness of e-cigarettes in leading to smoking cessation, and decreasing the adverse health impacts of cigarette smoking. The number of adolescents adapted to e-cigarettes has been increasing substantially each year, and this adaptation has promoted openness to tobacco smoking. The present review discusses controversies regarding the smoking cessation effects of e-cigarettes, recent governmental policies and regulations of e-cigarette use, toxic components and vaporization products of e-cigarettes, and the novel molecular mechanisms underlying the adverse health impacts of e-cigarettes leading to oxidative stress in target tissues, and consequent development of cardiopulmonary diseases (i.e. COPD), neurodegenerative disorders (i.e. Alzheimer's' disease), and cancer. Health warning signs on the packaging and professional consultation to avoid adaptation in risk groups might be helpful solutions to control negative impacts of e-cigarettes. It is also recommended to further expand basic and clinical investigations to reveal more detailed oxidative stress mechanisms of e-cigarette induced damages, which would ultimately result in more effective protective strategies.
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Affiliation(s)
- Hua Cai
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China; Division of Molecular Medicine, Department of Anesthesiology, Division of Cardiology, Department of Medicine, Cardiovascular Research Laboratories, David Geffen School of Medicine at University of California Los Angeles (UCLA), Los Angeles, CA 90095, United States.
| | - Chen Wang
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China
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Electronic cigarette aerosols suppress cellular antioxidant defenses and induce significant oxidative DNA damage. PLoS One 2017; 12:e0177780. [PMID: 28542301 PMCID: PMC5436899 DOI: 10.1371/journal.pone.0177780] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 05/03/2017] [Indexed: 01/30/2023] Open
Abstract
Background Electronic cigarette (EC) aerosols contain unique compounds in addition to toxicants and carcinogens traditionally found in tobacco smoke. Studies are warranted to understand the public health risks of ECs. Objective The aim of this study was to determine the genotoxicity and the mechanisms induced by EC aerosol extracts on human oral and lung epithelial cells. Methods Cells were exposed to EC aerosol or mainstream smoke extracts and DNA damage was measured using the primer anchored DNA damage detection assay (q-PADDA) and 8-oxo-dG ELISA assay. Cell viability, reactive oxygen species (ROS) and total antioxidant capacity (TAC) were measured using standard methods. mRNA and protein expression were evaluated by RT-PCR and western blot, respectively. Results EC aerosol extracts induced DNA damage in a dose-dependent manner, but independently of nicotine concentration. Overall, EC aerosol extracts induced significantly less DNA damage than mainstream smoke extracts, as measured by q-PADDA. However, the levels of oxidative DNA damage, as indicated by the presence of 8-oxo-dG, a highly mutagenic DNA lesion, were similar or slightly higher after exposure to EC aerosol compared to mainstream smoke extracts. Mechanistically, while exposure to EC extracts significantly increased ROS, it decreased TAC as well as the expression of 8-oxoguanine DNA glycosylase (OGG1), an enzyme essential for the removal of oxidative DNA damage. Conclusions Exposure to EC aerosol extracts suppressed the cellular antioxidant defenses and led to significant DNA damage. These findings emphasize the urgent need to investigate the potential long-term cancer risk of exposure to EC aerosol for vapers and the general public.
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Palamidas A, Tsikrika S, Katsaounou PA, Vakali S, Gennimata SA, Kaltsakas G, Gratziou C, Koulouris N. Acute effects of short term use of ecigarettes on Airways Physiology and Respiratory Symptoms in Smokers with and without Airway Obstructive Diseases and in Healthy non smokers. Tob Prev Cessat 2017; 3:5. [PMID: 32432180 PMCID: PMC7232825 DOI: 10.18332/tpc/67799] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/31/2016] [Accepted: 12/15/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although the use of e-cigarettes is increasing worldwide, their short and long-term effects remain undefined. We aimed to study the acute effect of short-term use of e-cigarettes containing nicotine on lung function and respiratory symptoms in smokers with airways obstructive disease (COPD, asthma), "healthy" smokers, and healthy never smokers. METHODS Respiratory symptoms, vital signs, exhaled NO, airway temperature, airway resistance (Raw), specific airway conductance (sGaw) and single nitrogen breath test were assessed before and immediately after short term use of an e-cigarette containing 11mg of nicotine among adults with COPD, asthma, "healthy" smokers, and never-smokers. The effect of the use of nicotine-free e-cigarettes among "healthy" never smokers was also studied. RESULTS The majority of participants reported acute cough. Short term use of nicotine e-cigarettes was associated: a) with increased heart rate in all subjects except in the COPD group, b) decreased oxygen saturation in "healthy" and COPD smokers, c) increased Raw in asthmatic smokers, "healthy" smokers, and healthy never smokers, d) decreased sGaw in healthy subjects, and e) changed slope of phase III curve in asthmatic smokers. Short-term use of nicotine-free e-cigarettes increased Raw and decreased sGaw among healthy never smokers. CONCLUSIONS Short-term use of an e-cigarette has acute effects on airways physiology and respiratory symptoms in COPD smokers, asthmatic smokers, "healthy" smokers and healthy never smokers. E-cigarette use was associated with effects in "healthy" never smokers irrespectively of nicotine concentration. More studies are needed to investigate both short and long-term effects of e-cigarette use.
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Affiliation(s)
- Anastasios Palamidas
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
| | - Stamatoula Tsikrika
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
| | - Paraskevi A Katsaounou
- 1rst ICU, "Evaggelismos" General Hospital, National and Kapodistrian University of Athens
| | - Sofia Vakali
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
| | - Sofia-Antiopi Gennimata
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
| | - George Kaltsakas
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
| | - Christina Gratziou
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
| | - Nikolaos Koulouris
- 1rst Respiratory Medicine Department, "Sotiria" General Hospital of Chest Diseases, National and Kapodistrian University of Athens
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Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
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Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Zhao J, Pyrgiotakis G, Demokritou P. Development and characterization of electronic-cigarette exposure generation system (Ecig-EGS) for the physico-chemical and toxicological assessment of electronic cigarette emissions. Inhal Toxicol 2016; 28:658-669. [PMID: 27829296 PMCID: PMC5496446 DOI: 10.1080/08958378.2016.1246628] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/05/2016] [Indexed: 12/31/2022]
Abstract
Electronic cigarettes (e-cig) have been introduced as a nicotine replacement therapy and have gained increasing attention and popularity. However, while findings on possible toxicological implications continue to grow, major knowledge gaps on both the complex chemistry of the exposure and toxicity exist, prohibiting public health assessors from assessing risks. Here, a versatile electronic cigarette exposure generation system (Ecig-EGS) has been developed and characterized. Ecig-EGS allows generation of real world e-cig emission profiles under controlled operational conditions, real time monitoring and time-integrated particle/gas sampling for physico-chemical characterization, and toxicological assessment (both in vitro and in vivo). The platform is highly versatile and can be used with all e-cig types. It enables generation of precisely controlled e-cig exposure while critical operational parameters and environmental mixing conditions can be adjusted in a systematic manner to assess their impact on complex chemistry and toxicity of emissions. Results proved the versatility and reproducibility of Ecig-EGS. E-cig emission was found to contain 106-107 particles/cm3 with the mode diameter around 200 nm, under air change rate of 60/h. Elevated CO2 and volatile organic specie generation was also observed. Furthermore, environmental mixing conditions also influenced e-cig emission profile. The versatility of Ecig-EGS will enable linking of operational and environmental parameters with exposure chemistry and toxicology and help in assessing health risks.
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Affiliation(s)
- Jiayuan Zhao
- Department of Environmental Health, Center for Nanotechnology and Nanotoxicology, Harvard School of Public Health, Boston, MA, USA
| | - Georgios Pyrgiotakis
- Department of Environmental Health, Center for Nanotechnology and Nanotoxicology, Harvard School of Public Health, Boston, MA, USA
| | - Philip Demokritou
- Department of Environmental Health, Center for Nanotechnology and Nanotoxicology, Harvard School of Public Health, Boston, MA, USA
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C1q as an autocrine and paracrine regulator of cellular functions. Mol Immunol 2016; 84:26-33. [PMID: 27914690 DOI: 10.1016/j.molimm.2016.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/01/2016] [Accepted: 11/03/2016] [Indexed: 12/20/2022]
Abstract
Most of the complement proteins in circulation are, by and large, synthesized in the liver. However data accumulated over the past several decades provide incontrovertible evidence that some if not most of the individual complement proteins are also synthesized extrahepatically by activated as well as non-activated cells. The question that is finally being addressed by various investigators is: are the locally synthesized proteins solely responsible for the myriad of biological functions in situ without the contribution of systemic complement? The answer is probably "yes". Among the proteins that are synthesized locally, C1q takes center stage for several reasons. First, it is synthesized predominantly by potent antigen presenting cells such as monocytes, macrophages and dendritic cells (DCs), which by itself is a clue that it plays an important role in antigen presentation and/or DC maturation. Second, it is transiently anchored on the cell surface via a transmembrane domain located in its A chain before it is cleaved off and released into the pericellular milieu. The membrane-associated C1q in turn, is able to sense danger patterns via its versatile antigen-capturing globular head domains. More importantly, locally synthesized C1q has been shown to induce a plethora of biological functions through the induction of immunomodulatory molecules by an autocrine- or paracrine- mediated signaling in a manner that mimics those of TNFα. These include recognition of pathogen- and danger- associated molecular patterns, phagocytosis, angiogenesis, apoptosis and induction of cytokines or chemokines that are important in modulating the inflammatory response. The functional convergence between C1q and TNFα in turn is attributed to their shared genetic ancestry. In this paper, we will infer to the aforementioned "local-synthesis-for-local function" paradigm using as an example, the role played by locally synthesized C1q in autoimmunity in general and in systemic lupus erythematosus in particular.
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Hiemstra PS, Bals R. Basic science of electronic cigarettes: assessment in cell culture and in vivo models. Respir Res 2016; 17:127. [PMID: 27717371 PMCID: PMC5055681 DOI: 10.1186/s12931-016-0447-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 10/05/2016] [Indexed: 12/20/2022] Open
Abstract
Electronic cigarettes (e-cigarettes, ECIGs) were introduced into the market a decade ago as an alternative to tobacco smoking. Whether ECIGs are safe and whether they qualify as smoking cessation tool is currently unknown. Their use has markedly expanded in that period, despite the fact that potential toxic effects of the vapour created by the e-cigarette and the nicotine-containing cartridge fluid have been incompletely studied. Marketing targets diverse groups including older smokers but also young people. Whereas the adverse health effects of nicotine inhaled by users of ECIGs has been well documented, less is known about the other components. An increasing number of in vitro and in vivo studies demonstrate a range of adverse effects of both the vapour created by ECIGs as well as the nicotine-containing fluid. Importantly, these studies demonstrate that toxicity from ECIGs, although this may be less than that caused by tobacco products, not only arises from its nicotine content. Furthermore, there are no data on the long-term consequences of ECIG use. The wide range of ECIG products available to consumers and the lack of standardisation of toxicological approaches towards ECIG evaluation complicates the assessment of adverse health effects of their use. Here we review the current data on preclinical studies on ECIGs describing their effects in cell culture and animal models.
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Affiliation(s)
- Pieter S Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert Bals
- Department of Internal Medicine V - Pulmonology, Allergology and Critical Care Medicine, Saarland University, D-66421, Homburg, Germany.
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Affiliation(s)
- Chitra Dinakar
- From the Division of Allergy, Asthma, and Immunology, Children's Mercy Kansas City and the University of Missouri, Kansas City (C.D.); and the Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University School of Medicine, Boston (G.T.O.)
| | - George T O'Connor
- From the Division of Allergy, Asthma, and Immunology, Children's Mercy Kansas City and the University of Missouri, Kansas City (C.D.); and the Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston University School of Medicine, Boston (G.T.O.)
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Barber KE, Ghebrehiwet B, Yin W, Rubenstein DA. Endothelial Cell Inflammatory Reactions Are Altered in the Presence of E-Cigarette Extracts of Variable Nicotine. Cell Mol Bioeng 2016; 10:124-133. [PMID: 31719854 DOI: 10.1007/s12195-016-0465-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/19/2016] [Indexed: 12/28/2022] Open
Abstract
Exposure to tobacco smoke has been associated with heightened endothelial cell activities associated with cardiovascular diseases (CVD). Conversely, the exposure to nicotine both activates and inhibits particular endothelial cell functions. However, which constituent(s) of tobacco smoke is responsible for these changes is unknown, since toxic gases and fine particulate matter cannot be isolated. Electronic cigarette vapor allows us to isolate these constituents, providing us the ability to evaluate individual constituents. Here, we used e-cigarettes to (1) identify which constituents of tobacco products are most responsible for altered CVD functions and (2) elucidate the underlying risk of e-cigarette exposure. To accomplish this goal, endothelial cells were exposed to extracts produced from tobacco cigarettes or e-cigarettes. Endothelial cell inflammatory processes, viability, density and metabolic activity were observed. In general, a significant increase in complement deposition, the expression of the receptors for C1q, coupled with a decrease in cell proliferation and metabolic activity was observed. These results were independent of nicotine and the exposure to e-vapor was just as harmful as tobacco smoke extracts. Thus, the exposure to fine particulate matter and not toxic combustion gases or nicotine may be the most critical for regulating CVD progression.
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Affiliation(s)
- Kirstin E Barber
- 1Department of Biomedical Engineering, Stony Brook University, 101 Bioengineering Building, Stony Brook, NY 11794 USA
| | - Berhane Ghebrehiwet
- 2School of Medicine, Department of Medicine, Stony Brook University, Stony Brook, NY 11794 USA
| | - Wei Yin
- 1Department of Biomedical Engineering, Stony Brook University, 101 Bioengineering Building, Stony Brook, NY 11794 USA
| | - David A Rubenstein
- 1Department of Biomedical Engineering, Stony Brook University, 101 Bioengineering Building, Stony Brook, NY 11794 USA
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Poulianiti K, Karatzaferi C, Flouris AD, Fatouros IG, Koutedakis Y, Jamurtas AZ. Antioxidant responses following active and passive smoking of tobacco and electronic cigarettes. Toxicol Mech Methods 2016; 26:455-61. [PMID: 27464467 DOI: 10.1080/15376516.2016.1196281] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONTEXT It has been indicated that acute active and passive tobacco cigarette smoking may cause changes on redox status balance that may result in significant pathologies. However, no study has evaluated the effects of active and passive e-cigarette smoking on redox status of consumers. OBJECTIVE To examine the acute effects of active and passive e-cigarette and tobacco cigarette smoking on selected redox status markers. METHODS Using a randomized single-blind crossover design, 30 participants (15 smokers and 15 nonsmokers) were exposed to three different experimental conditions. Smokers underwent a control session, an active tobacco cigarette smoking session (smoked 2 cigarettes within 30-min) and an active e-cigarette smoking session (smoked a pre-determined number of puffs within 30-min using a liquid with 11 ng/ml nicotine). Similarly, nonsmokers underwent a control session, a passive tobacco cigarette smoking session (exposure of 1 h to 23 ± 1 ppm of CO in a 60 m(3) environmental chamber) and a passive e-cigarette smoking session (exposure of 1 h to air enriched with pre- determined number of puffs in a 60 m(3) environmental chamber). Total antioxidant capacity (TAC), catalase activity (CAT) and reduced glutathione (GSH) were assessed in participants' blood prior to, immediately after, and 1-h post-exposure. RESULTS TAC, CAT and GSH remained similar to baseline levels immediately after and 1-h-post exposure (p > 0.05) in all trials. CONCLUSIONS Tobacco and e-cigarette smoking exposure do not acutely alter the response of the antioxidant system, neither under active nor passive smoking conditions. Overall, there is not distinction between tobacco and e-cigarette active and passive smoking effects on specific redox status indices.
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Affiliation(s)
- Konstantina Poulianiti
- a Department of Physical Education & Sport Science , University of Thessaly, TEFAA Karies , Trikala , Greece ;,b Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas , Trikala , Greece
| | - Christina Karatzaferi
- a Department of Physical Education & Sport Science , University of Thessaly, TEFAA Karies , Trikala , Greece ;,b Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas , Trikala , Greece
| | - Andreas D Flouris
- a Department of Physical Education & Sport Science , University of Thessaly, TEFAA Karies , Trikala , Greece ;,b Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas , Trikala , Greece
| | - Ioannis G Fatouros
- a Department of Physical Education & Sport Science , University of Thessaly, TEFAA Karies , Trikala , Greece ;,b Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas , Trikala , Greece
| | - Yiannis Koutedakis
- a Department of Physical Education & Sport Science , University of Thessaly, TEFAA Karies , Trikala , Greece ;,b Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas , Trikala , Greece ;,c Faculty of Education , Health and Wellbeing, Wolverhampton University , Walsall Campus , UK
| | - Athanasios Z Jamurtas
- a Department of Physical Education & Sport Science , University of Thessaly, TEFAA Karies , Trikala , Greece ;,b Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas , Trikala , Greece
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