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Xu B, Mei S, Wu W, Liu Q, Xie K. Association of formaldehyde concentration with depression risk in US adults: a population-based epidemiology study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:98261-98270. [PMID: 37606783 DOI: 10.1007/s11356-023-29290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
The association of formaldehyde exposure with depression remains unknown. We used the data from National Health and Nutrition Examination Survey (NHANES) 2015-2016 to evaluate the association between formaldehyde exposure and depression. Multivariable logistic regressions and restricted cubic spline (RCS) were implemented to examine the association between formaldehyde exposure and depression. A total of 1336 participants were included in the analysis, of which 110 (8.23%) participants were depressed. After adjusting for confounders, a significant association between formaldehyde exposure and depression (OR = 1.01, 95% CI: 1.00-1.02, P = 0.043) was observed. The RCS plot showed a positive association in a linear manner (PNonlinear = 0.109), and the risk began to rise rapidly with concentrations above 129.37 nmol/g HB. The positive association remained in participants with high-intensity physical activity (OR = 1.08, 95% CI: 1.02-1.13, P = 0.003), but not in participants with other physical activities. Moreover, we constructed a novel nomogram to easily estimate the individual-specific probabilities of depression. In conclusion, formaldehyde exposure was associated with an elevated risk of depression, and the effect exhibited differences in participants with different levels of physical activity.
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Affiliation(s)
- Bo Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Shijuan Mei
- Department of Women Health Care, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Wanke Wu
- Department of Women Health Care, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Qi Liu
- Department of Women Health Care, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, 210004, China
| | - Kaipeng Xie
- Department of Women Health Care, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, 210004, China.
- Department of Public Health, Nanjing Maternity and Child Health Care Hospital, Women's Hospital of Nanjing Medical University, Nanjing, 210004, China.
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Zang X, Qin W, Xiong Y, Xu A, Huang H, Fang T, Zang X, Chen M. Using three statistical methods to analyze the association between aldehyde exposure and markers of inflammation and oxidative stress. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27717-4. [PMID: 37286832 DOI: 10.1007/s11356-023-27717-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/13/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Exposure to aldehydes has been linked to adverse health outcomes such as inflammation and oxidative stress, but research on the effects of these compounds is limited. This study is aimed at assessing the association between aldehyde exposure and markers of inflammation and oxidative stress. METHODS The study used data from the NHANES 2013-2014 survey (n = 766) and employed multivariate linear models to investigate the relationship between aldehyde compounds and various markers of inflammation (alkaline phosphatase (ALP) level, absolute neutrophil count (ANC), and lymphocyte count) and oxidative stress (bilirubin, albumin, and iron levels) while controlling for other relevant factors. In addition to generalized linear regression, weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) analyses were applied to examine the single or overall effect of aldehyde compounds on the outcomes. RESULTS In the multivariate linear regression model, each 1 standard deviation (SD) change in propanaldehyde and butyraldehyde was significantly associated with increases in serum iron levels (beta and 95% confidence interval, 3.25 (0.24, 6.27) and 8.40 (0.97, 15.83), respectively) and the lymphocyte count (0.10 (0.04, 0.16) and 0.18 (0.03, 0.34), respectively). In the WQS regression model, a significant association was discovered between the WQS index and both the albumin and iron levels. Furthermore, the results of the BKMR analysis showed that the overall impact of aldehyde compounds was significantly and positively correlated with the lymphocyte count, as well as the levels of albumin and iron, suggesting that these compounds may contribute to increased oxidative stress. CONCLUSIONS This study reveals the close association between single or overall aldehyde compounds and markers of chronic inflammation and oxidative stress, which has essential guiding value for exploring the impact of environmental pollutants on population health.
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Affiliation(s)
- Xiaodong Zang
- Department of Pediatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Wengang Qin
- Department of Pediatrics, Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230001, Anhui, China
| | - Yingying Xiong
- Department of Pediatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Anlan Xu
- Department of Pediatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Hesuyuan Huang
- Orthopedics Department, Peking University Shougang Hospital, Beijing, 100144, China
| | - Tao Fang
- Department of Pediatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Xiaowei Zang
- College of Safety Science and Engineering, Nanjing Tech University, Nanjing, 211816, China
| | - Mingwu Chen
- Department of Pediatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
- Department of Pediatrics, Provincial Hospital Affiliated to Anhui Medical University, Hefei, 230001, Anhui, China.
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Wang S, Han Q, Wei Z, Wang Y, Deng L, Chen M. Formaldehyde causes an increase in blood pressure by activating ACE/AT1R axis. Toxicology 2023; 486:153442. [PMID: 36706861 DOI: 10.1016/j.tox.2023.153442] [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: 10/29/2022] [Revised: 01/14/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
Previous studies suggest some link between formaldehyde exposure and harmful cardiovascular effects. But whether exposure to formaldehyde can cause blood pressure to rise, and if so, what the underlying mechanism is, remains unclear. In this study, C57BL/6 male mice were exposed to 0.1, 0.5, 2.5 mg/m3 of gaseous formaldehyde for 4 h daily over a three-week period. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and heart rate (HR) of the mice were measured by tail-cuff plethysmography, and any histopathological changes in the target organs of hypertension were investigated. The results showed that exposure to formaldehyde did cause a significant increase in blood pressure and heart rate, and resulted in varying degrees of damage to the heart, aortic vessels and kidneys. To explore the underlying mechanism, a specific inhibitor of angiotensin converting enzyme (ACE) was used to block the ACE/AT1R axis. We observed the levels of ACE and angiotensin II type 1 receptor (AT1R), as well as the bradykinin (BK) in cardiac cytoplasm. The data suggest that exposure to formaldehyde induced an increase in the expression of ACE and AT1R, and decreased the levels of BK. Strikingly, treatment with 5 mg/kg/d ACE inhibitor can attenuate the increase in blood pressure and the pathological changes caused by formaldehyde exposure. This result has improved our understanding of whether, and how, formaldehyde exposure affects the development of hypertension.
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Affiliation(s)
- Shuwei Wang
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan 430079 Hubei, China
| | - Qi Han
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan 430079 Hubei, China
| | - Zhaolan Wei
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan 430079 Hubei, China
| | - Yunyi Wang
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan 430079 Hubei, China
| | - Lingfu Deng
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan 430079 Hubei, China
| | - Mingqing Chen
- Hubei Key Laboratory of Genetic Regulation and Integrative Biology, School of Life Sciences, Central China Normal University, Wuhan 430079 Hubei, China.
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Province VM, Szeghy RE, Stute NL, Augenreich MA, Behrens CE, Stickford JL, Stickford ASL, Ratchford S. Tracking peripheral vascular function for six months in young adults following SARS-CoV-2 infection. Physiol Rep 2022; 10:e15552. [PMID: 36541342 PMCID: PMC9768737 DOI: 10.14814/phy2.15552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023] Open
Abstract
SARS-CoV-2 infection is known to instigate a range of physiologic perturbations, including vascular dysfunction. However, little work has concluded how long these effects may last, especially among young adults with mild symptoms. To determine potential recovery from acute vascular dysfunction in young adults (8 M/8F, 21 ± 1 yr, 23.5 ± 3.1 kg⋅m-2 ), we longitudinally tracked brachial artery flow-mediated dilation (FMD) and reactive hyperemia (RH) in the arm and hyperemic response to passive limb movement (PLM) in the leg, with Doppler ultrasound, as well as circulating biomarkers of inflammation (interleukin-6, C-reactive protein), oxidative stress (thiobarbituric acid reactive substances, protein carbonyl), antioxidant capacity (superoxide dismutase), and nitric oxide bioavailability (nitrite) monthly for a 6-month period post-SARS-CoV-2 infection. FMD, as a marker of macrovascular function, improved from month 1 (3.06 ± 1.39%) to month 6 (6.60 ± 2.07%; p < 0.001). FMD/Shear improved from month one (0.10 ± 0.06 AU) to month six (0.18 ± 0.70 AU; p = 0.002). RH in the arm and PLM in the leg, as markers of microvascular function, did not change during the 6 months (p > 0.05). Circulating markers of inflammation, oxidative stress, antioxidant capacity, and nitric oxide bioavailability did not change during the 6 months (p > 0.05). Together, these results suggest some improvements in macrovascular, but not microvascular function, over 6 months following SARS-CoV-2 infection. The data also suggest persistent ramifications for cardiovascular health among those recovering from mild illness and among young, otherwise healthy adults with SARS-CoV-2.
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Affiliation(s)
- Valesha M. Province
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Rachel E. Szeghy
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Nina L. Stute
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Marc A. Augenreich
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Christian E. Behrens
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | - Jonathon L. Stickford
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
| | | | - Stephen M. Ratchford
- Department of Health & Exercise ScienceAppalachian State UniversityBooneNorth CarolinaUSA
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5
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Liu XC, Strodl E, Huang LH, Lu Q, Liang Y, Chen WQ. First Trimester of Pregnancy as the Sensitive Period for the Association between Prenatal Mosquito Coil Smoke Exposure and Preterm Birth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11771. [PMID: 36142044 PMCID: PMC9517152 DOI: 10.3390/ijerph191811771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
Mosquito coils are efficient mosquito repellents and mosquito coil smoke (MCS) contributes to indoor air pollution. However, no prior population-based study has investigated whether prenatal MCS exposure is a risk factor for preterm birth (PTB) and whether exposure to MCS in different trimesters of pregnancy is associated with different levels of risk. The sample involved 66,503 mother-child dyads. Logistic regression models were used to examine the relationships between prenatal MCS exposure during different trimesters of pregnancy and PTB. We found that prenatal MCS exposure was associated with a greater likelihood of PTB (OR = 1.12, 95%CI: 1.05-1.20). The prenatal MCS exposure during the first trimester was associated with 1.17 (95%CI: 1.09-1.25) times the odds of being PTB, which was higher than exposure during the second trimester (OR = 1.11, 95%CI: 1.03-1.19) and during the third trimester (OR = 1.08, 95%CI: 1.01-1.16). In the stratified analysis, prenatal MCS exposure significantly increased PTB risk among girls but not among boys. Our results indicated that maternal MCS exposure during pregnancy was associated with PTB and that the first trimester might be the sensitive period. In light of these findings, public health interventions are needed to reduce prenatal exposure to MCS, particularly during the first trimester of pregnancy.
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Affiliation(s)
- Xin-Chen Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Li-Hua Huang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qing Lu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yang Liang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- School of Health, Xinhua College of Guangzhou, Guangzhou 510080, China
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6
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Ban J, Su W, Zhong Y, Liu C, Li T. Ambient formaldehyde and mortality: A time series analysis in China. SCIENCE ADVANCES 2022; 8:eabm4097. [PMID: 35776800 PMCID: PMC10883368 DOI: 10.1126/sciadv.abm4097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The potential health impact of low-level ambient formaldehyde has been historically overlooked. We conducted a two-stage time series analysis to investigate associations between ambient formaldehyde and daily nonaccidental, circulatory, and respiratory mortality and six subtypes based on 5,325,585 deaths in 275 Chinese counties between 2013 and 2018 and estimated a concentration-response curve to identify overall associations. After controlling for confounders from meteorological factors, air pollutants, time trend, and day of the week effect, with a 1-part per billion (ppb) increase in the daily concentration of formaldehyde on lag0 day, we found that mortality risks in nonaccidental, circulatory, and respiratory diseases increased by 0.36%, 0.36% and 0.41%, respectively. The curve indicated a possible threshold concentration at approximately 5 ppb for significant impact on nonaccidental and circulatory diseases. We suggest that ambient formaldehyde may represent a potential threat to public health and needs further investigation to support timely pollution regulation and health protection.
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Affiliation(s)
- Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Wenjing Su
- Department of Environmental Science and Engineering, University of Science and Technology of China, Hefei 230026, China
| | - Yu Zhong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Cheng Liu
- Department of Precision Machinery and Precision Instrumentation, University of Science and Technology of China, Hefei 230026, China
- Key Laboratory of Environmental Optics and Technology, Anhui Institute of Optics and Fine Mechanics, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, China
- Center for Excellence in Regional Atmospheric Environment, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
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7
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Stute NL, Stickford JL, Augenreich MA, Kimball KC, Cope JM, Bennett C, Grosicki GJ, Ratchford SM. Arterial stiffness and carotid distensibility following acute formaldehyde exposure in female adults. Toxicol Ind Health 2021; 37:535-546. [PMID: 34396864 DOI: 10.1177/07482337211031692] [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] [Indexed: 11/15/2022]
Abstract
Formaldehyde (FA) is a ubiquitous organic preservative used in several industries and represents an occupational health hazard. Short-term exposure to FA can increase oxidative stress and cause a decrease in conduit vessel function. These decrements in vascular function may extend to the arterial architecture, predisposing individuals to increased risk of cardiovascular disease. The purpose of this study was to investigate the impact of an acute 90-minute FA exposure period (259 ± 95 ppb) on indices of arterial architecture. Arterial stiffness and carotid distensibility as determined by central pressures, augmentation index (AIx), and carotid-femoral pulse wave velocity (cfPWV) (n=13F, 24 ± 1 year) as well as carotid stiffness and intima media thickness (IMT) (n = 9F, 23 ± 1 year) were assessed prior to (Pre-FA) and immediately following (Post-FA) exposure to FA in human cadaver dissection laboratories. Central pressures and cfPWV (Pre-FA: 5.2 ± 0.8 m.s-1, Post-FA: 5.2 ± 1.1 m s-1) were unchanged by acute FA exposure (p > 0.05). Carotid stiffness parameters and distension were unchanged by acute FA exposure (p > 0.05), although distensibility (Pre-FA: 33.9 ± 10.5[10-3*kPa-1], Post-FA: 25.9 ± 5.5[10-3*kPa-1], p < 0.05), and IMT (Pre-FA: 0.42 ± 0.05 mm, Post-FA: 0.51 ± 0.11 mm, p < 0.05) decreased and increased, respectively. Individual Pre- to Post-FA changes in these markers of arterial architecture did not correlate with levels of FA exposure ([FA]: 20-473 ppb) (p > 0.05). Our group previously found vascular function decrements following acute FA exposure in human cadaver laboratories; here we found that carotid distensibility and intima media thickness are altered following FA exposure.
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Affiliation(s)
- Nina L Stute
- Department of Health & Exercise Science, 1801Appalachian State University, Boone, NC, USA
| | - Jonathon L Stickford
- Department of Health & Exercise Science, 1801Appalachian State University, Boone, NC, USA
| | - Marc A Augenreich
- Department of Health & Exercise Science, 1801Appalachian State University, Boone, NC, USA
| | - Kyle C Kimball
- Department of Health & Exercise Science, 1801Appalachian State University, Boone, NC, USA
| | - Janet M Cope
- Department of Physical Therapy Education, 3202Elon UniversitySchool of Health Sciences, Elon, NC, USA
| | - Cynthia Bennett
- Department of Physician Assistant Studies, 3202Elon UniversitySchool of Health Sciences, Elon, NC, USA
| | - Gregory J Grosicki
- Biodynamics and Human Performance Center, Georgia Southern University, Savannah, GA, USA
| | - Stephen M Ratchford
- Department of Health & Exercise Science, 1801Appalachian State University, Boone, NC, USA
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8
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Zhang Y, Yang Y, He X, Yang P, Zong T, Sun P, Sun RC, Yu T, Jiang Z. The cellular function and molecular mechanism of formaldehyde in cardiovascular disease and heart development. J Cell Mol Med 2021; 25:5358-5371. [PMID: 33973354 PMCID: PMC8184665 DOI: 10.1111/jcmm.16602] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/07/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022] Open
Abstract
As a common air pollutant, formaldehyde is widely present in nature, industrial production and consumer products. Endogenous formaldehyde is mainly produced through the oxidative deamination of methylamine catalysed by semicarbazide-sensitive amine oxidase (SSAO) and is ubiquitous in human body fluids, tissues and cells. Vascular endothelial cells and smooth muscle cells are rich in this formaldehyde-producing enzyme and are easily damaged owing to consequent cytotoxicity. Consistent with this, increasing evidence suggests that the cardiovascular system and stages of heart development are also susceptible to the harmful effects of formaldehyde. Exposure to formaldehyde from different sources can induce heart disease such as arrhythmia, myocardial infarction (MI), heart failure (HF) and atherosclerosis (AS). In particular, long-term exposure to high concentrations of formaldehyde in pregnant women is more likely to affect embryonic development and cause heart malformations than long-term exposure to low concentrations of formaldehyde. Specifically, the ability of mouse embryos to effect formaldehyde clearance is far lower than that of the rat embryos, more readily allowing its accumulation. Formaldehyde may also exert toxic effects on heart development by inducing oxidative stress and cardiomyocyte apoptosis. This review focuses on the current progress in understanding the influence and underlying mechanisms of formaldehyde on cardiovascular disease and heart development.
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Affiliation(s)
- Ying Zhang
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yanyan Yang
- Department of Immunology, Basic Medicine School, Qingdao University, Qingdao, China
| | - Xiangqin He
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Panyu Yang
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tingyu Zong
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Pin Sun
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Rui-Cong Sun
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tao Yu
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China.,Institute for Translational Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhirong Jiang
- Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
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9
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Jin L, Lynch J, Richardson A, Lorkiewicz P, Srivastava S, Theis W, Shirk G, Hand A, Bhatnagar A, Srivastava S, Conklin DJ. Electronic cigarette solvents, pulmonary irritation, and endothelial dysfunction: role of acetaldehyde and formaldehyde. Am J Physiol Heart Circ Physiol 2021; 320:H1510-H1525. [PMID: 33543686 PMCID: PMC8260384 DOI: 10.1152/ajpheart.00878.2020] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 12/20/2022]
Abstract
After more than a decade of electronic cigarette (E-cig) use in the United States, uncertainty persists regarding E-cig use and long-term cardiopulmonary disease risk. As all E-cigs use propylene glycol and vegetable glycerin (PG-VG) and generate abundant saturated aldehydes, mice were exposed by inhalation to PG-VG-derived aerosol, formaldehyde (FA), acetaldehyde (AA), or filtered air. Biomarkers of exposure and cardiopulmonary injury were monitored by mass spectrometry (urine metabolites), radiotelemetry (respiratory reflexes), isometric myography (aorta), and flow cytometry (blood markers). Acute PG-VG exposure significantly affected multiple biomarkers including pulmonary reflex (decreased respiratory rate, -50%), endothelium-dependent relaxation (-61.8 ± 4.2%), decreased WBC (-47 ± 7%), and, increased RBC (+6 ± 1%) and hemoglobin (+4 ± 1%) versus air control group. Notably, FA exposure recapitulated the prominent effects of PG-VG aerosol on pulmonary irritant reflex and endothelial dysfunction, whereas AA exposure did not. To attempt to link PG-VG exposure with FA or AA exposure, urinary formate and acetate levels were measured by GC-MS. Although neither FA nor AA exposure altered excretion of their primary metabolite, formate or acetate, respectively, compared with air-exposed controls, PG-VG aerosol exposure significantly increased post-exposure urinary acetate but not formate. These data suggest that E-cig use may increase cardiopulmonary disease risk independent of the presence of nicotine and/or flavorings. This study indicates that FA levels in tobacco product-derived aerosols should be regulated to levels that do not induce biomarkers of cardiopulmonary harm. There remains a need for reliable biomarkers of exposure to inhaled FA and AA.NEW & NOTEWORTHY Use of electronic cigarettes (E-cig) induces endothelial dysfunction (ED) in healthy humans, yet the specific constituents in E-cig aerosols that contribute to ED are unknown. Our study implicates formaldehyde that is formed in heating of E-cig solvents (propylene glycol, PG; vegetable glycerin, VG). Exposure to formaldehyde or PG-VG-derived aerosol alone stimulated ED in female mice. As ED was independent of nicotine and flavorants, these data reflect a "universal flaw" of E-cigs that use PG-VG.Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/e-cigarettes-aldehydes-and-endothelial-dysfunction/.
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Affiliation(s)
- Lexiao Jin
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Jordan Lynch
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Superfund Research Center, University of Louisville, Louisville, Kentucky
| | - Andre Richardson
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Department of Pharmacology and Toxicology, School of Medicine, University of Louisville, Louisville, Kentucky
| | - Pawel Lorkiewicz
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Superfund Research Center, University of Louisville, Louisville, Kentucky
- Department of Chemistry, University of Louisville, Louisville, Kentucky
| | - Shweta Srivastava
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Whitney Theis
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Gregg Shirk
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Alexis Hand
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
| | - Aruni Bhatnagar
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Superfund Research Center, University of Louisville, Louisville, Kentucky
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Sanjay Srivastava
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Superfund Research Center, University of Louisville, Louisville, Kentucky
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Daniel J Conklin
- American Heart Association-Tobacco Regulation and Addiction Center, University of Louisville, Louisville, Kentucky
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky
- Superfund Research Center, University of Louisville, Louisville, Kentucky
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky
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Keith R, Bhatnagar A. Cardiorespiratory and Immunologic Effects of Electronic Cigarettes. CURRENT ADDICTION REPORTS 2021; 8:336-346. [PMID: 33717828 PMCID: PMC7935224 DOI: 10.1007/s40429-021-00359-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW Although e-cigarettes have become popular, especially among youth, the health effects associated with e-cigarette use remain unclear. This review discusses current evidence relating to the cardiovascular, pulmonary, and immunological effects of e-cigarettes. RECENT FINDINGS The use of e-cigarettes by healthy adults has been shown to increase blood pressure, heart rate, and arterial stiffness, as well as resistance to air flow in lungs. Inhalation of e-cigarette aerosol has been shown to elicit immune responses and increase the production of immunomodulatory cytokines in young tobacco-naïve individuals. In animal models, long-term exposure to e-cigarettes leads to marked changes in lung architecture, dysregulation of immune genes, and low-grade inflammation. Exposure to e-cigarette aerosols in mice has been shown to induce DNA damage, inhibit DNA repair, and promote carcinogenesis. Chronic exposure to e-cigarettes has also been reported to result in the accumulation of lipid-laden macrophages in the lung and dysregulation of lipid metabolism and transport in mice. Although, the genotoxic and inflammatory effects of e-cigarettes are milder than those of combustible cigarettes, some of the cardiorespiratory effects of the two insults are comparable. The toxicity of e-cigarettes has been variably linked to nicotine, as well as other e-cigarette constituents, operating conditions, and use patterns. SUMMARY The use of e-cigarettes in humans is associated with significant adverse cardiorespiratory and immunological changes. Data from animal models and in vitro studies support the notion that long-term use of e-cigarettes may pose significant health risks.
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Affiliation(s)
- Rachel Keith
- American Heart Association Tobacco Regulation and Addiction Center & The Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville, 302E Muhammad Ali Blvd, Louisville, KY 40202 USA
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center & The Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville, 302E Muhammad Ali Blvd, Louisville, KY 40202 USA
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