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Ma T, Lee A, Eng B, Patel V, Michel SLJ, Kane MA, Dalby R, Schneider A. Aerosolized e-liquid base constituents induce cytotoxicity and genotoxicity in oral keratinocytes. Oral Dis 2024. [PMID: 39121459 DOI: 10.1111/odi.15104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/14/2024] [Accepted: 07/30/2024] [Indexed: 08/11/2024]
Abstract
OBJECTIVE Electronic cigarette (e-cigarette) use among adults in the United States continues to rise. Particularly concerning is the impact of e-cigarette aerosol inhalation on the oral mucosa. Aerosols are derived from a heated e-liquid base of propylene glycol/glycerin (PG/G) often mixed with nicotine and chemical flavors. Of note, harmful and potentially harmful constituents (HPHCs), including metals and volatile organic compounds, have been detected in e-cigarette aerosols. It remains unknown, however, whether aerosols exclusively derived from e-liquid PG/G are detrimental to oral keratinocytes. The present study analyzed toxicological outcomes in normal oral keratinocytes exposed to model nicotine-free, unflavored PG/G e-liquid aerosols. MATERIALS AND METHODS Cell viability/cytotoxicity, genotoxicity, and immunoblotting assays were conducted in NOKSI, a gingiva-derived oral keratinocyte cell line, following exposure to model e-liquid aerosols or non-aerosolized controls. The HPHC acrolein, reported to form DNA adducts in the buccal mucosa from e-cigarette users, was also used in similar assays. RESULTS PG/G e-liquid aerosol extracts significantly enhanced cytotoxic and DNA damaging responses in NOKSI cells when compared to non-aerosolized e-liquid treatment. Acrolein treatment led to similar results. CONCLUSIONS The aerosolization process of PG/G e-liquid is a critical determinant of marked cytotoxic and genotoxic stimuli in oral keratinocytes.
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Affiliation(s)
- Tao Ma
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Angela Lee
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Bryan Eng
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Vyomesh Patel
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sarah L J Michel
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Maureen A Kane
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Richard Dalby
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Abraham Schneider
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA
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Garcia BDFS, Nascimento BDB, Marques EF, Jesus CBDD, Santana Neto IC, Rocha LST, Oliveira GMSD, Bazaglia da Silva MI, Kasai MLHI, Takahama Junior A. The use of electronic cigarettes and other tobacco products among university students and their potential relationship with oral health: A cross-sectional study. J Am Dent Assoc 2024; 155:647-656. [PMID: 38878025 DOI: 10.1016/j.adaj.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 03/20/2024] [Accepted: 04/19/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND The aim of this study was to evaluate oral alterations among university students and explore possible associations with tobacco consumption in its various forms. METHODS A cross-sectional study was conducted in 2 phases: the first phase involved administering an electronic questionnaire to participants determine the prevalence of tobacco use and the second phase involved a physical examination of the participants. The participants were grouped on the basis of their reported habits and compared using statistical analysis (P < .05). RESULTS Of the 620 participants, 57.1% reported using tobacco in some form, with 47.4% reporting electronic cigarette (e-cigarette) use. In the clinical phase, comparing the presence of oral changes in tobacco users vs nonusers, e-cigarette users had a higher proportion of white-spot caries lesions (P = .041) and gingivitis (P = .012). When e-cigarette use was combined with other forms of tobacco use, additional oral changes were more prevalent, including coated tongue and nicotinic stomatitis (P < .05). CONCLUSIONS The use of alternative forms of tobacco consumption is common among university students, with e-cigarette use being the most prevalent form, and may lead to detrimental effects on the oral cavity, such as caries and gingivitis, particularly when used in conjunction with other tobacco products. PRACTICAL IMPLICATIONS The use of tobacco in alternative forms, such as e-cigarettes, can affect oral health directly or indirectly. Dentists should be familiar with the characteristics of this population and the potential oral repercussions associated with tobacco use to address the impact on health and raise awareness of the associated risks.
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Cameron A, Meng Yip H, Garg M. Current thinking about the effects of e-cigarettes on oral cancer risk. Br Dent J 2024; 236:397-400. [PMID: 38459320 DOI: 10.1038/s41415-024-7124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/21/2023] [Accepted: 07/10/2023] [Indexed: 03/10/2024]
Abstract
In the last decade there has been a significant increase in the appeal and popularity of e-cigarettes. Recent national news headlines outline that one million smokers will be given a free vaping starter kit to encourage them to give up tobacco products. An independent report commissioned by the UK Government has cited promotion of vaping as a critical recommendation to ensuring England is smoke-free by 2030. Undoubtedly, the dental team will now encounter many more questions from patients keen to know more regarding the safety of electronic nicotine delivery systems and their effects on the oral cavity. However, it is often difficult to answer these questions due to a lack of evidence regarding their impact. Although there are some preliminary animal and in vitro data, additional well-designed, long-term studies are required to investigate oral health outcomes of e-cigarette use.We aim to summarise the latest evidence to better inform clinicians about the effects of vaping on oral health, particularly regarding the risks of oral cancer, so they can better inform their patients.
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Affiliation(s)
- Alice Cameron
- Department of Oral and Maxillofacial Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Road, Gloucester, GL1 3NN, UK.
| | - Hao Meng Yip
- Department of Otolaryngology, Barts Health NHS Foundation Trust, Whipps Cross University Hospital, Whipps Cross Road, London, E11 1NR, UK
| | - Montey Garg
- Department of Oral and Maxillofacial Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital Old Road, Oxford, OX3 9DU, UK
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Cameron A, Meng Yip H, Garg M. e-Cigarettes and Oral Cancer: what do we know so far? Br J Oral Maxillofac Surg 2023; 61:380-382. [PMID: 37164806 DOI: 10.1016/j.bjoms.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
We aim to summarise the latest evidence to better inform OMFS practitioners about the deleterious effects of vaping on oral health and the risks of oral cancer, so they can better inform their patients. Current evidence suggests that e-cigarette use is not risk-free.
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Affiliation(s)
- Alice Cameron
- Department of Oral and Maxillofacial Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Road, Gloucester GL1 3NN, United Kingdom.
| | - Hao Meng Yip
- Department of Otolaryngology, Barts Health NHS Foundation Trust, Whipps Cross University Hospital, Whipps Cross Road, London E11 1NR, United Kingdom
| | - Montey Garg
- Department of Oral and Maxillofacial Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital Old Road, Oxford OX3 9DU, United Kingdom
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5
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Soo J, Easwaran M, Erickson‐DiRenzo E. Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers. OTO Open 2023; 7:e25. [PMID: 36998560 PMCID: PMC10046796 DOI: 10.1002/oto2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023] Open
Abstract
Objective The use and effects of electronic (e)-cigarettes (e-cigs) are particularly relevant for otolaryngology providers as tobacco plays a major role in benign and malignant diseases of the upper aerodigestive tract. This review aims to (1) summarize the recent policies regarding e-cigs and important patterns of use and (2) serve as a comprehensive resource for clinical providers on the known biologic and clinical effects of e-cigs on the upper aerodigestive tract. Data Sources PubMed/MEDLINE. Review Methods We conducted a narrative review on (1) general information on e-cig use and informative findings in the lower respiratory system and a comprehensive review on (2) the effects of e-cigs on cell and animal models and the clinical implications of these products on human health as is relevant to otolaryngology. Conclusions Although e-cigs are likely less harmful than conventional cigarettes, preliminary research on e-cigs suggest several deleterious effects including in the upper aerodigestive tract. Due to this, there has been increased interest in restricting e-cig usage, particularly among the adolescent population, and caution in recommending e-cigs to current smokers. Implications for Practice Chronic e-cig use is likely to have clinical implications. It is critical for otolaryngology providers to be aware of the rapidly changing regulations and use patterns regarding e-cigs and how e-cigs influence human health, particularly with regards to the upper aerodigestive tract, to accurately council patients regarding potential risks and benefits of use.
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Affiliation(s)
- Joanne Soo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Meena Easwaran
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Elizabeth Erickson‐DiRenzo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
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Thomas SC, Xu F, Pushalkar S, Lin Z, Thakor N, Vardhan M, Flaminio Z, Khodadadi-Jamayran A, Vasconcelos R, Akapo A, Queiroz E, Bederoff M, Janal MN, Guo Y, Aguallo D, Gordon T, Corby PM, Kamer AR, Li X, Saxena D. Electronic Cigarette Use Promotes a Unique Periodontal Microbiome. mBio 2022; 13:e0007522. [PMID: 35189698 PMCID: PMC8903898 DOI: 10.1128/mbio.00075-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
Electronic cigarettes (e-cigs) have become prevalent as an alternative to conventional cigarette smoking, particularly in youth. E-cig aerosols contain unique chemicals which alter the oral microbiome and promote dysbiosis in ways we are just beginning to investigate. We conducted a 6-month longitudinal study involving 84 subjects who were either e-cig users, conventional smokers, or nonsmokers. Periodontal condition, cytokine levels, and subgingival microbial community composition were assessed, with periodontal, clinical, and cytokine measures reflecting cohort habit and positively correlating with pathogenic taxa (e.g., Treponema, Saccharibacteria, and Porphyromonas). α-Diversity increased similarly across cohorts longitudinally, yet each cohort maintained a unique microbiome. The e-cig microbiome shared many characteristics with the microbiome of conventional smokers and some with nonsmokers, yet it maintained a unique subgingival microbial community enriched in Fusobacterium and Bacteroidales (G-2). Our data suggest that e-cig use promotes a unique periodontal microbiome, existing as a stable heterogeneous state between those of conventional smokers and nonsmokers and presenting unique oral health challenges. IMPORTANCE Electronic cigarette (e-cig) use is gaining in popularity and is often perceived as a healthier alternative to conventional smoking. Yet there is little evidence of the effects of long-term use of e-cigs on oral health. Conventional cigarette smoking is a prominent risk factor for the development of periodontitis, an oral disease affecting nearly half of adults over 30 years of age in the United States. Periodontitis is initiated through a disturbance in the microbial biofilm communities inhabiting the unique space between teeth and gingival tissues. This disturbance instigates host inflammatory and immune responses and, if left untreated, leads to tooth and bone loss and systemic diseases. We found that the e-cig user's periodontal microbiome is unique, eliciting unique host responses. Yet some similarities to the microbiomes of both conventional smokers and nonsmokers exist, with strikingly more in common with that of cigarette smokers, suggesting that there is a unique periodontal risk associated with e-cig use.
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Affiliation(s)
- Scott C. Thomas
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Fangxi Xu
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Smruti Pushalkar
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Ziyan Lin
- Applied Bioinformatics Labs, New York University School of Medicine, New York, New York, USA
| | - Nirali Thakor
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Mridula Vardhan
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Zia Flaminio
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | | | - Rebeca Vasconcelos
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Adenike Akapo
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Erica Queiroz
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Maria Bederoff
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Malvin N. Janal
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, New York, USA
| | - Yuqi Guo
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Deanna Aguallo
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Patricia M. Corby
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Angela R. Kamer
- Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York, USA
| | - Xin Li
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Deepak Saxena
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
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7
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The Effects of e-Cigarette Aerosol on Oral Cavity Cells and Tissues: A Narrative Review. TOXICS 2022; 10:toxics10020074. [PMID: 35202260 PMCID: PMC8878056 DOI: 10.3390/toxics10020074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 02/04/2023]
Abstract
A wealth of research has comprehensively documented the harmful effects of traditional cigarette smoking and nicotine on human health. The lower rate of exposure to harmful chemicals and toxic substances offered by alternative electronic smoking devices (e-cigarettes, vaping, etc.) has made these methods of smoking popular, especially among adolescents and young adults, and they are regarded frequently as safer than regular cigarettes. During vaporization of these so-called e-liquids, toxins, carcinogens and various other chemical substances may be released and inhaled by the user. Data on the potential human health effect attendant on exposure to e-vapor are based mainly on animal and in vitro studies. The oral tissues are the first locus of direct interaction with the components of the inhaled vapor. However, the short-term as well as long-term effects of the exposure are not known. The aim of the review is to briefly present data on the effects of the chemical components and toxins of e-cigarette vapor on oral cavity cells and tissues of oral health.
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8
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Wilson C, Tellez Freitas CM, Awan K, Ajdaharian J, Geiler J, Thirucenthilvelan P. Adverse Effects of E‐cigarettes on Head, Neck, and Oral Cells: A Systematic Review. J Oral Pathol Med 2022; 51:113-125. [DOI: 10.1111/jop.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/08/2022] [Accepted: 01/13/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Catherine Wilson
- College of Dental Medicine Roseman University South Jordan Utah USA
| | | | - Kamran Awan
- College of Dental Medicine Roseman University South Jordan Utah USA
| | - Janet Ajdaharian
- College of Dental Medicine Roseman University South Jordan Utah USA
| | - Jordan Geiler
- College of Dental Medicine Roseman University South Jordan Utah USA
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9
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Carvalho BFDC, Alves MGO, Marques SS, Lopes MA, Pérez-Sayáns Garcia M, Almeida JD. Dentists, are you ready to deal with the "smokers of the future "? Hum Exp Toxicol 2022; 41:9603271221101052. [PMID: 35574647 DOI: 10.1177/09603271221101052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Bruna Fernandes do Carmo Carvalho
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Mônica Ghislaine Oliveira Alves
- Technology Research Center (NPT), 133647Universidade Mogi das Cruzes, Mogi das Cruzes, São Paulo, Brazil.,School of Medicine, Anhembi Morumbi University, São José dos Campos, São Paulo, Brazil
| | - Sandra Silva Marques
- Sao Paulo State Reference Center on Alcohol, Tobacco and other Drugs-Secretary of Health, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, 28108University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Mário Pérez-Sayáns Garcia
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, 73089University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Janete Dias Almeida
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
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10
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Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Mens Health 2021; 15:15579883211016361. [PMID: 33993787 PMCID: PMC8127762 DOI: 10.1177/15579883211016361] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/14/2021] [Accepted: 04/20/2021] [Indexed: 12/15/2022] Open
Abstract
Sex and gender related health disparities in oral health remain an underappreciated and often over looked aspect of well-being. The goal of this narrative review is to identify sex and gender related oral health disparities by summarizing the current literature related to differences in oral health between men and women. The review identified that men are more likely to: ignore their oral health, have poorer oral hygiene habits, and experience higher rates of periodontal disease, oral cancer, and dental trauma. Men also visit dentists less frequently and compared to women seek oral treatment more often for an acute problem and less often for disease prevention. Women exhibit more positive attitudes about dental visits, greater oral health literacy, and demonstrate better oral health behaviors than men. Men disproportionately develop periodontal diseases due to a combination of biological and gender related reasons including immune system factors, hormone differences, poorer oral hygiene behaviors, and greater tobacco use. There is a male to female ratio of 2:1 for oral cancer, largely attributable to more tobacco use, heavier use of alcohol, and longer sun exposure. Minority men experience a disproportionate burden of oral health disparities because of both their gender and race/ethnic identities. In conclusion, this review identifies several differences between men and women related to oral health and highlights the need for further research to better understand these disparities and how to incorporate them into developing prevention, education and treatment strategies to improve oral health in men.
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Affiliation(s)
- Martin S. Lipsky
- Roseman University of Health Sciences College of Dental Medicine, South Jordan, UT, USA
- Oregon Health and Science University – Portland State University Institute on Aging, Portland, OR, USA
| | - Sharon Su
- Roseman University of Health Sciences College of Dental Medicine, South Jordan, UT, USA
| | - Carlos J. Crespo
- Oregon Health and Science University – Portland State University School of Public Health, Portland, OR, USA
| | - Man Hung
- Roseman University of Health Sciences College of Dental Medicine, South Jordan, UT, USA
- University of Utah Health, Society & Policy Program, Salt Lake City, UT, USA
- University of Utah School of Biological Sciences, Salt Lake City, UT, USA
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11
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Jessri M, Sultan AS, Magdy E, Hynes N, Sultan S. Nicotine e-vaping and cardiovascular consequences: a case series and literature review. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-7. [PMID: 33437920 PMCID: PMC7717206 DOI: 10.1093/ehjcr/ytaa330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/23/2020] [Accepted: 08/26/2020] [Indexed: 11/14/2022]
Abstract
Background Cardiovascular toxicity as a consequence of nicotine from conventional tobacco cigarette smoking is well documented. However, little is known about the cardiovascular consequences of nicotine e-vaping. We review the literature and report a case series of three cases of major adverse cardiovascular clinical effects post nicotine e-vaping. Case summary Three patients with known peripheral arterial disease who switched from heavy cigarette smoking consumption to a high-intensity dose of nicotine e-vaping all developed further arterial complications within 6-30 months. Discussion With the recent epidemic of e-vaping in young individuals and the national outbreak of e-vaping use-associated lung injury (EVALI), the dangers of e-vaping are now coming to light. The pulmonary effects are now well described, and this paper highlights three new cases of cardiovascular toxicity associated with e-vaping. The potential role of nicotine e-vaping and the risk of coronavirus disease-2019 (COVID-19) will also be discussed.
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Affiliation(s)
- Maryam Jessri
- Oral Health Centre of Western Australia, Perth, Western Australia, Australia
| | - Ahmed S Sultan
- University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Emad Magdy
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Ireland
| | - Niamh Hynes
- Department of Vascular Surgery and Endovascular Surgery, Galway Clinic, Doughiska, Royal College of Surgeons in Ireland Affiliated Hospitals, Galway, Ireland
| | - Sherif Sultan
- Western Vascular Institute, Department of Vascular and Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Ireland.,Department of Vascular Surgery and Endovascular Surgery, Galway Clinic, Doughiska, Royal College of Surgeons in Ireland Affiliated Hospitals, Galway, Ireland
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12
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Ebersole J, Samburova V, Son Y, Cappelli D, Demopoulos C, Capurro A, Pinto A, Chrzan B, Kingsley K, Howard K, Clark N, Khlystov A. Harmful chemicals emitted from electronic cigarettes and potential deleterious effects in the oral cavity. Tob Induc Dis 2020; 18:41. [PMID: 32435175 PMCID: PMC7233525 DOI: 10.18332/tid/116988] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/20/2019] [Accepted: 01/22/2020] [Indexed: 12/29/2022] Open
Abstract
Use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigs), is increasing across the US population and is particularly troubling due to their adoption by adolescents, teens, and young adults. The industry’s marketing approach for these instruments of addiction has been to promote them as a safer alternative to tobacco, a behavioral choice supporting smoking cessation, and as the ‘cool’ appearance of vaping with flavored products (e.g. tutti frutti, bubble gum, and buttered popcorn etc.). Thus, there is a clear need to better document the health outcomes of e-cig use in the oral cavity of the addicted chronic user. There appears to be an array of environmental toxins in the vapors, including reactive aldehydes and carbonyls resulting from the heating elements action on fluid components, as well as from the composition of chemical flavoring agents. The chemistry of these systems shows that the released vapors from the e-cigs frequently contain levels of environmental toxins that considerably exceed federal occupational exposure limits. Additionally, the toxicants in the vapors appear to be retained in the host fluids/tissues at levels often approximating 90% of the levels in the e-cig vapors. These water-soluble reactive toxins can challenge the oral cavity constituents, potentially contributing to alterations in the autochthonous microbiome and host cells critical for maintaining oral homeostasis. This review updates the existing chemistry/environmental aspects of e-cigs, as well as providing an overview of the somewhat limited data on potential oral health effects that could occur across the lifetime of daily e-cig users.
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Affiliation(s)
- Jeffrey Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Vera Samburova
- Organic Analytical Laboratory, Division of Atmospheric Sciences, Desert Research Institute, Reno, United States
| | - Yeongkwon Son
- Organic Analytical Laboratory, Division of Atmospheric Sciences, Desert Research Institute, Reno, United States
| | - David Cappelli
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Christina Demopoulos
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Antonina Capurro
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Andres Pinto
- Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western University, Cleveland, United States
| | - Brian Chrzan
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Karl Kingsley
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Katherine Howard
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Nathaniel Clark
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Andrey Khlystov
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
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13
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Vila T, Sultan AS, Montelongo-Jauregui D, Jabra-Rizk MA. Oral Candidiasis: A Disease of Opportunity. J Fungi (Basel) 2020; 6:jof6010015. [PMID: 31963180 PMCID: PMC7151112 DOI: 10.3390/jof6010015] [Citation(s) in RCA: 169] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/10/2020] [Accepted: 01/13/2020] [Indexed: 12/14/2022] Open
Abstract
Oral candidiasis, commonly referred to as “thrush,” is an opportunistic fungal infection that commonly affects the oral mucosa. The main causative agent, Candida albicans, is a highly versatile commensal organism that is well adapted to its human host; however, changes in the host microenvironment can promote the transition from one of commensalism to pathogen. This transition is heavily reliant on an impressive repertoire of virulence factors, most notably cell surface adhesins, proteolytic enzymes, morphologic switching, and the development of drug resistance. In the oral cavity, the co-adhesion of C. albicans with bacteria is crucial for its persistence, and a wide range of synergistic interactions with various oral species were described to enhance colonization in the host. As a frequent colonizer of the oral mucosa, the host immune response in the oral cavity is oriented toward a more tolerogenic state and, therefore, local innate immune defenses play a central role in maintaining Candida in its commensal state. Specifically, in addition to preventing Candida adherence to epithelial cells, saliva is enriched with anti-candidal peptides, considered to be part of the host innate immunity. The T helper 17 (Th17)-type adaptive immune response is mainly involved in mucosal host defenses, controlling initial growth of Candida and inhibiting subsequent tissue invasion. Animal models, most notably the mouse model of oropharyngeal candidiasis and the rat model of denture stomatitis, are instrumental in our understanding of Candida virulence factors and the factors leading to host susceptibility to infections. Given the continuing rise in development of resistance to the limited number of traditional antifungal agents, novel therapeutic strategies are directed toward identifying bioactive compounds that target pathogenic mechanisms to prevent C. albicans transition from harmless commensal to pathogen.
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Affiliation(s)
- Taissa Vila
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA; (T.V.); (A.S.S.); (D.M.-J.)
| | - Ahmed S. Sultan
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA; (T.V.); (A.S.S.); (D.M.-J.)
| | - Daniel Montelongo-Jauregui
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA; (T.V.); (A.S.S.); (D.M.-J.)
| | - Mary Ann Jabra-Rizk
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA; (T.V.); (A.S.S.); (D.M.-J.)
- Department of Microbiology and Immunology, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- Correspondence: ; Tel.: +1-410-706-0508; Fax: +1-410-706-0519
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Signes-Costa J, de Granda-Orive JI, Ramos Pinedo Á, Camarasa Escrig A, de Higes Martínez E, Rábade Castedo C, Cabrera César E, Jiménez-Ruiz CA. Declaración Oficial de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) sobre cigarrillos electrónicos e IQOS®. Arch Bronconeumol 2019; 55:581-586. [DOI: 10.1016/j.arbres.2019.04.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/22/2019] [Accepted: 04/29/2019] [Indexed: 12/25/2022]
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