In vitro human epidermal permeation of nicotine from electronic cigarette refill liquids and implications for dermal exposure assessment

An update of skin permeability data based on a systematic review of recent research

The cutaneous absorption parameters of xenobiotics are crucial for the development of drugs and cosmetics, as well as for assessing environmental and occupational chemical risks. Despite the great variability in the design of experimental conditions due to uncertain international guidelines, datasets like HuskinDB have been created to report skin absorption endpoints. This review updates available skin permeability data by rigorously compiling research published between 2012 and 2021. Inclusion and exclusion criteria have been selected to build the most harmonized and reusable dataset possible. The Generative Topographic Mapping method was applied to the present dataset and compared to HuskinDB to monitor the progress in skin permeability research and locate chemotypes of particular concern. The open-source dataset (SkinPiX) includes steady-state flux, maximum flux, lag time and permeability coefficient results for the substances tested, as well as relevant information on experimental parameters that can impact the data. It can be used to extract subsets of data for comparisons and to build predictive models.

Oral nicotine pouches with an aftertaste? Part 2: in vitro toxicity in human gingival fibroblasts

Nicotine pouches contain fewer characteristic toxicants than conventional tobacco products. However, the associated risks in terms of toxicity and addiction potential are still unclear. Therefore, endpoints of toxicity and contents of flavoring substances were investigated in this study. The in vitro toxicity of five different nicotine pouches and the reference snus CRP1.1 were studied in human gingival fibroblasts (HGF-1). Cells were exposed to product extracts (nicotine contents: 0.03-1.34 mg/mL) and sampled at different time points. Cytotoxicity, total cellular reactive oxygen species (ROS) levels, and changes in the expression levels of inflammatory and oxidative stress genes were assessed. Flavor compounds used in the nicotine pouches were identified by GC-MS. Cytotoxicity was observed in two nicotine pouches. Gene expression of interleukin 6 (IL6) and heme oxygenase 1 (HMOX1) was upregulated by one and three pouches, respectively. ROS production was either increased or decreased, by one pouch each. CRP1.1 caused an upregulation of IL6 and elevated ROS production. Toxicity was not directly dependent on nicotine concentration and osmolarity. A total of 56 flavorings were detected in the five nicotine pouches. Seven flavorings were classified according to the harmonized hazard classification system as laid down in the European Classification, Labelling and Packaging regulation. Nine flavorings are known cytotoxins. Cytotoxicity, inflammation, and oxidative stress responses indicate that adverse effects such as local lesions in the buccal mucosa may occur after chronic product use. In conclusion, flavorings used in nicotine pouches likely contribute to the toxicity of nicotine pouches.

Differential associations of hand nicotine and urinary cotinine with children's exposure to tobacco smoke and clinical outcomes

BACKGROUND

Children's overall tobacco smoke exposure (TSE) consists of both inhalation of secondhand smoke (SHS) and ingestion, dermal uptake, and inhalation of thirdhand smoke (THS) residue from dust and surfaces in their environments.

OBJECTIVES

Our objective was to compare the different roles of urinary cotinine as a biomarker of recent overall TSE and hand nicotine as a marker of children's contact with nicotine pollution in their environments. We explored the differential associations of these markers with sociodemographics, parental smoking, child TSE, and clinical diagnoses.

METHODS

Data were collected from 276 pediatric emergency department patients (Median age = 4.0 years) who lived with a cigarette smoker. Children's hand nicotine and urinary cotinine levels were determined using LC-MS/MS. Parents reported tobacco use and child TSE. Medical records were reviewed to assess discharge diagnoses.

RESULTS

All children had detectable hand nicotine (GeoM = 89.7ng/wipe; 95 % CI = [78.9; 102.0]) and detectable urinary cotinine (GeoM = 10.4 ng/ml; 95%CI = [8.5; 12.6]). Although hand nicotine and urinary cotinine were highly correlated (r = 0.62, p < 0.001), urinary cotinine geometric means differed between racial groups and were higher for children with lower family income (p < 0.05), unlike hand nicotine. Independent of urinary cotinine, age, race, and ethnicity, children with higher hand nicotine levels were at increased risk to have discharge diagnoses of viral/other infectious illness (aOR = 7.49; 95%CI = [2.06; 27.24], p = 0.002), pulmonary illness (aOR = 6.56; 95%CI = [1.76; 24.43], p = 0.005), and bacterial infection (aOR = 5.45; 95%CI = [1.50; 19.85], p = 0.03). In contrast, urinary cotinine levels showed no associations with diagnosis independent of child hand nicotine levels and demographics.

DISCUSSION

The distinct associations of hand nicotine and urinary cotinine suggest the two markers reflect different exposure profiles that contribute differentially to pediatric illness. Because THS in a child's environment directly contributes to hand nicotine, additional studies of children of smokers and nonsmokers are warranted to determine the role of hand nicotine as a marker of THS exposure and its potential role in the development of tobacco-related pediatric illnesses.

Toxicology of flavoring- and cannabis-containing e-liquids used in electronic delivery systems

Electronic cigarettes (e-cigarettes) were introduced in the United States in 2007 and by 2014 they were the most popular tobacco product amongst youth and had overtaken use of regular tobacco cigarettes. E-cigarettes are used to aerosolize a liquid (e-liquid) that the user inhales. Flavorings in e-liquids is a primary reason for youth to initiate use of e-cigarettes. Evidence is growing in the scientific literature that inhalation of some flavorings is not without risk of harm. In this review, 67 original articles (primarily cellular in vitro) on the toxicity of flavored e-liquids were identified in the PubMed and Scopus databases and evaluated critically. At least 65 individual flavoring ingredients in e-liquids or aerosols from e-cigarettes induced toxicity in the respiratory tract, cardiovascular and circulatory systems, skeletal system, and skin. Cinnamaldehyde was most frequently reported to be cytotoxic, followed by vanillin, menthol, ethyl maltol, ethyl vanillin, benzaldehyde and linalool. Additionally, modern e-cigarettes can be modified to aerosolize cannabis as dried plant material or a concentrated extract. The U.S. experienced an outbreak of lung injuries, termed e-cigarette, or vaping, product use-associated lung injury (EVALI) that began in 2019; among 2,022 hospitalized patients who had data on substance use (as of January 14, 2020), 82% reported using a delta-9-tetrahydrocannabinol (main psychoactive component in cannabis) containing e-cigarette, or vaping, product. Our literature search identified 33 articles related to EVALI. Vitamin E acetate, a diluent and thickening agent in cannabis-based products, was strongly linked to the EVALI outbreak in epidemiologic and laboratory studies; however, e-liquid chemistry is highly complex, and more than one mechanism of lung injury, ingredient, or thermal breakdown product may be responsible for toxicity. More research is needed, particularly with regard to e-cigarettes (generation, power settings, etc.), e-liquids (composition, bulk or vaped form), modeled systems (cell type, culture type, and dosimetry metrics), biological monitoring, secondhand exposures and contact with residues that contain nicotine and flavorings, and causative agents and mechanisms of EVALI toxicity.

Highly Sensitive and Discriminative Detection of BTEX in the Vapor Phase: A Film-Based Fluorescent Approach

BTEX (benzene, toluene, ethylbenzene, o-xylene, m-xylene, and p-xylene) represents a group of volatile organic compounds (VOCs) and constitutes a great threat to human health. However, sensitive, selective, and speedy detection of them on-site and in the vapor phase remains a challenge for years. Herein, we report a film-based fluorescent approach and a conceptual sensor, which shows unprecedented sensitivity, speed, and reversibility to the aromatic hydrocarbons in the vapor phase. In the studies, pentiptycene was employed to produce a nonplanar perylene bisimide (PBI) derivative, P-PBI. The compound was further utilized to fabricate the film. The novelty of the design is the combination of capillary condensation and solvent effect, which is expected to enrich the analytes from vapor phase and shows outputs at the same time. Importantly, the film permits instant response (∼3 s) and real-time identification (<1 min) of benzene and toluene from other aromatic hydrocarbons. The experimental detection limits (DLs) of the six analytes are lower than 9.2, 2.7, 1.9, 0.2, 0.4, and 0.4 ppm, which with the exception of benzene, are significantly lower than the NIOSH recommended long-term exposure limits. More importantly, the film is photochemically stable, and more than 300 repetitive tests showed no observable bleaching. In addition, the sensing is fully reversible. The superior performance of the film device is in support of the assumption that the combination of capillary condensation and solvation effect would constitute an effective way to design high-performance fluorescent films, especially for challenging chemical inert and photoelectronically inactive VOCs.

Spectral Reflectance Measurement of Evaporating Chemical Films: Initial Results and Application to Skin Permeation

The present study has 2 aims. First, the method of spectral reflectance was used to measure evaporation rates of thin (∼25-300 μm) films of neat liquid volatile organic chemicals exposed to a well-regulated wind speed u. Gas-phase evaporation mass transfer coefficient (k_evap) measurements of 10 chemicals, 9 of which were measured at similar u, are predicted (slope of log-log data = 1.01; intercept = 0.08; R² = 0.996) by a previously proposed mass transfer correlation. For one chemical, isoamyl alcohol, the dependence of k_evap on u^0.52 was measured, in support of the predicted exponent value of ½. Second, measured k_evap of nicotine was used as an input in analytical models based on diffusion theory to estimate the absorbed fraction (F_abs) of a small dose (5 μL/cm²) applied to human epidermis in vitro. The measured F_abs was 0.062 ± 0.023. Model-estimated values are 0.066 and 0.115. Spectral reflectance is a precise method of measuring k_evap of liquid chemicals, and the data are well described by a simple gas-phase mass transfer coefficient. For nicotine under the single exposure condition measured herein, F_abs is well-predicted from a theoretical model that requires knowledge of k_evap, maximal dermal flux, and membrane lag time.

In vitro human skin permeation of benzene in gasoline: Effects of concentration, multiple dosing and skin preparation

In vitro human skin benzene permeation was measured from gasoline formulations with benzene concentrations ranging from 0.8 to 10 vol% and from neat benzene. Steady-state fluxes (JSS), permeability coefficients (kp) and lag times (tlag) were calculated from infinite dose exposures. Permeation of benzene from small gasoline doses administered over a two-day period was also studied. The thermodynamic activity of benzene in gasoline at 30 °C was determined and the solution is near-ideal over the range from 0.8 to 100 vol%. JSS through human epidermal membranes were linear (R2=0.92) with concentration over the range from 0.8 to 10 vol%. JSS (μg/cm2/h) from gasoline (0.8 vol% benzene=6.99 mg/ml) through epidermis and full-thickness skin were 9.37±1.41 and 1.82±0.44, respectively. Neat benzene JSS was 566±138. Less than 0.25% of the total applied benzene mass from finite doses (10 μl/cm2) of gasoline was detected in receptor cells, and a small reduction of barrier function was observed from six total doses administered over 2 days. Application of these results to dermal exposure assessment examples demonstrates a range of systemic benzene uptakes that can be expected from occupational and consumer dermal exposures to gasoline, depending on the type and extent of exposure.

E-cigarettes: Impact of E-Liquid Components and Device Characteristics on Nicotine Exposure

BACKGROUND

Electronic cigarette (e-cigarette) use has increased substantially in recent years. While e-cigarettes have been proposed as a potentially effective smoking cessation tool, dualuse in smokers is common and e-cigarettes are widely used by non-smokers, including youth and young-adult non-smokers. Nicotine, the primary addictive component in cigarettes, is present at varying levels in many e-liquids. E-cigarettes may lead to initiation of nicotine use in adult and youth non-smokers, re-initiation of nicotine dependence in ex-smokers or increased severity of nicotine dependence in dual-users of cigarettes and e-cigarettes. As such, there are important clinical and policy implications to understanding factors impacting nicotine exposure from e-cigarettes. However, the broad and rapidly changing range of e-liquid constituents and e-cigarette hardware which could impact nicotine exposure presents a challenge. Recent changes in regulatory oversight of e-cigarettes underscore the importance of synthesizing current knowledge on common factors which may impact nicotine exposure.

METHODS

This review focuses on factors which may impact nicotine exposure by changing e-cigarette use behavior, puff topography, altering the nicotine yield (amount of nicotine exiting the e-cigarette mouth piece including nicotine exhaled as vapor) or more directly by altering nicotine absorption and bioavailability.

RESULTS

Topics reviewed include e-liquid components or characteristics including flavor additives (e.g., menthol), base e-liquid ingredients (propylene glycol, vegetable glycerin), components commonly used to dissolve flavorants (e.g., ethanol), and resulting properties of the e-liquid (e.g., pH), e-cigarette device characteristics (e.g., wattage, temperature, model) and user behavior (e.g., puff topography) which may impact nicotine exposure.

CONCLUSION

E-liquid characteristics and components, e-cigarette hardware and settings, and user behavior can all contribute substantially to nicotine exposure from e-cigarettes.

Effect of stratum corneum heterogeneity, anisotropy, asymmetry and follicular pathway on transdermal penetration

The impact of the complex structure of the stratum corneum on transdermal penetration is not yet fully described by existing models. A quantitative and thorough study of skin permeation is essential for chemical exposure assessment and transdermal delivery of drugs. The objective of this study is to analyze the effects of heterogeneity, anisotropy, asymmetry, follicular diffusion, and location of the main barrier of diffusion on percutaneous permeation. In the current study, the solution of the transient diffusion through a two-dimensional-anisotropic brick-and-mortar geometry of the stratum corneum is obtained using the commercial finite element program COMSOL Multiphysics. First, analytical solutions of an equivalent multilayer geometry are used to determine whether the lipids or corneocytes constitute the main permeation barrier. Also these analytical solutions are applied for validations of the finite element solutions. Three illustrative compounds are analyzed in these sections: diethyl phthalate, caffeine and nicotine. Then, asymmetry with depth and follicular diffusion are studied using caffeine as an illustrative compound. The following findings are drawn from this study: the main permeation barrier is located in the lipid layers; the flux and lag time of diffusion through a brick-and-mortar geometry are almost identical to the values corresponding to a multilayer geometry; the flux and lag time are affected when the lipid transbilayer diffusivity or the partition coefficients vary with depth, but are not affected by depth-dependent corneocyte diffusivity; and the follicular contribution has significance for low transbilayer lipid diffusivity, especially when flux between the follicle and the surrounding stratum corneum is involved. This study demonstrates that the diffusion is primarily transcellular and the main barrier is located in the lipid layers.