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Zong H, Hu Z, Li W, Wang M, Zhou Q, Li X, Liu H. Electronic cigarettes and cardiovascular disease: epidemiological and biological links. Pflugers Arch 2024; 476:875-888. [PMID: 38376568 PMCID: PMC11139732 DOI: 10.1007/s00424-024-02925-0] [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: 01/04/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Electronic cigarettes (e-cigarettes), as alternative nicotine delivery methods, has rapidly increased among youth and adults in recent years. However, cardiovascular safety is an important consideration regarding e-cigarettes usage. e-cigarette emissions, including nicotine, propylene glycol, flavorings, nitrosamine, and metals, might have adverse effects on cardiovascular health. A large body of epidemiological evidence has indicated that e-cigarettes are considered an independent risk factor for increased rates of cardiovascular disease occurrence and death. The incidence and mortality of various types of cardiovascular disease, such as cardiac arrhythmia, hypertension, acute coronary syndromes, and heart failure, have a modest growth in vapers (users of e-cigarettes). Although the underlying biological mechanisms have not been fully understood, studies have validated that oxidative stress, inflammation, endothelial dysfunction, atherosclerosis, hemodynamic effects, and platelet function play important roles in which e-cigarettes work in the human body. This minireview consolidates and discusses the epidemiological and biological links between e-cigarettes and various types of cardiovascular disease.
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Affiliation(s)
- Huiqi Zong
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zhekai Hu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Xicheng District, Beijing, 100053, China
| | - Weina Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Xicheng District, Beijing, 100053, China
| | - Mina Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Qi Zhou
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Xiang Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
| | - Hongxu Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
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Chandy M, Hill T, Jimenez-Tellez N, Wu JC, Sarles SE, Hensel E, Wang Q, Rahman I, Conklin DJ. Addressing Cardiovascular Toxicity Risk of Electronic Nicotine Delivery Systems in the Twenty-First Century: "What Are the Tools Needed for the Job?" and "Do We Have Them?". Cardiovasc Toxicol 2024; 24:435-471. [PMID: 38555547 DOI: 10.1007/s12012-024-09850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
Cigarette smoking is positively and robustly associated with cardiovascular disease (CVD), including hypertension, atherosclerosis, cardiac arrhythmias, stroke, thromboembolism, myocardial infarctions, and heart failure. However, after more than a decade of ENDS presence in the U.S. marketplace, uncertainty persists regarding the long-term health consequences of ENDS use for CVD. New approach methods (NAMs) in the field of toxicology are being developed to enhance rapid prediction of human health hazards. Recent technical advances can now consider impact of biological factors such as sex and race/ethnicity, permitting application of NAMs findings to health equity and environmental justice issues. This has been the case for hazard assessments of drugs and environmental chemicals in areas such as cardiovascular, respiratory, and developmental toxicity. Despite these advances, a shortage of widely accepted methodologies to predict the impact of ENDS use on human health slows the application of regulatory oversight and the protection of public health. Minimizing the time between the emergence of risk (e.g., ENDS use) and the administration of well-founded regulatory policy requires thoughtful consideration of the currently available sources of data, their applicability to the prediction of health outcomes, and whether these available data streams are enough to support an actionable decision. This challenge forms the basis of this white paper on how best to reveal potential toxicities of ENDS use in the human cardiovascular system-a primary target of conventional tobacco smoking. We identify current approaches used to evaluate the impacts of tobacco on cardiovascular health, in particular emerging techniques that replace, reduce, and refine slower and more costly animal models with NAMs platforms that can be applied to tobacco regulatory science. The limitations of these emerging platforms are addressed, and systems biology approaches to close the knowledge gap between traditional models and NAMs are proposed. It is hoped that these suggestions and their adoption within the greater scientific community will result in fresh data streams that will support and enhance the scientific evaluation and subsequent decision-making of tobacco regulatory agencies worldwide.
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Affiliation(s)
- Mark Chandy
- Robarts Research Institute, Western University, London, N6A 5K8, Canada
| | - Thomas Hill
- Division of Nonclinical Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD, 20993, USA
| | - Nerea Jimenez-Tellez
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94304, USA
| | - S Emma Sarles
- Biomedical and Chemical Engineering PhD Program, Rochester Institute of Technology, Rochester, NY, 14623, USA
| | - Edward Hensel
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY, 14623, USA
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Daniel J Conklin
- Division of Environmental Medicine, Department of Medicine, Center for Cardiometabolic Science, Christina Lee Brown Envirome Institute, University of Louisville, 580 S. Preston St., Delia Baxter, Rm. 404E, Louisville, KY, 40202, USA.
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Umphres SS, Alarabi AB, Ali HEA, Khasawneh FT, Alshbool FZ. Investigation of the impact of thirdhand e-cigarette exposure on platelet function: A pre-clinical study. Tob Induc Dis 2024; 22:TID-22-56. [PMID: 38560550 PMCID: PMC10980912 DOI: 10.18332/tid/185286] [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: 08/28/2023] [Revised: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION The use of e-cigarettes (ECs) has reached unprecedented levels, due to a variety of reasons, including the misconception regarding their safety. Thus, there have been efforts to characterize the effects of EC exposure, including in the context of thirdhand EC (THEC) on a host of disorders, such as cardiovascular disease (CVD). METHODS To address this issue, we sought to characterize the effects of THEC on platelet function and thrombus formation, using a novel mouse exposure protocol that resembles real life scenarios. To assess these effects, a host of related in vivo (i.e. tail bleeding time, and ferric chloride injury induced thrombosis model) assays and in vitro platelet specific (e.g. aggregation, and dense granule secretion) investigative assays were conducted. RESULTS Our in vivo characterization demonstrated that THEC exposed mice exhibited a prothrombotic phenotype reflected by their shortened tail bleeding (THEC: 37 ± 15 seconds, versus clean air: 183 ± 56 s) and occlusion times (THEC: 188 ± 39 s, versus clean air: 519 ± 70 s), relative to those exposed to clean air. Importantly, we found no difference in the platelet counts between the THEC and clean air mice. As for the underlying mechanism, separate experiments revealed significantly enhanced platelet aggregation, dense and alpha granule secretion, as well as integrin/GPIIb-IIIa activation and phosphatidylserine exposure in response to thrombin and ADP agonist stimulation. CONCLUSIONS Taken together, these results provide evidence that THEC does have the capacity to increase the risk of thrombotic disease, which should increase awareness regarding its underappreciated negative health effects.
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Affiliation(s)
- Shelby S. Umphres
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Ahmed B. Alarabi
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Hamdy E. A. Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Fadi T. Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Fatima Z. Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
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Dai Y, Yang W, Song H, He X, Guan R, Wu Z, Jiang X, Li M, Liu P, Chen J. Long-term effects of chronic exposure to electronic cigarette aerosol on the cardiovascular and pulmonary system in mice: A comparative study to cigarette smoke. ENVIRONMENT INTERNATIONAL 2024; 185:108521. [PMID: 38508052 DOI: 10.1016/j.envint.2024.108521] [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: 11/01/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024]
Abstract
Electronic cigarettes (e-cigarettes) have rapidly gained popularity as alternatives to traditional combustible cigarettes. However, their long-term health impact remains uncertain. This study aimed to investigate the effects of chronic exposure to e-cigarette aerosol (ECA) in mice compared to conventional cigarette smoke (CS) exposure. The mice were exposed to air (control), low, medium, or high doses of ECA, or a reference CS dose orally and nasally for eight months. Various cardiovascular and pulmonary assessments have been conducted to determine the biological and prosthetic effects. Histopathological analysis was used to determine structural changes in the heart and lungs. Biological markers associated with fibrosis, inflammation, and oxidative stress were investigated. Cardiac proteomic analysis was applied to reveal the shared and unique protein expression changes in ECA and CS groups, which related to processes such as immune activation, lipid metabolism, and intracellular transport. Overall, chronic exposure to ECA led to adverse cardiovascular and pulmonary effects in mice, although they were less pronounced than those of CS exposure. This study provides evidence that e-cigarettes may be less harmful than combustible cigarettes for the long-term health of the cardiovascular and respiratory systems in mice. However, further human studies are needed to clarify the long-term health risks associated with e-cigarette use.
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Affiliation(s)
- Yuxing Dai
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Wanchun Yang
- Jieyang Medical Research Center, Jieyang People's Hospital, Jieyang, Guangdong, China
| | - Hongjia Song
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Xiangjun He
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Ruoqing Guan
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Zehong Wu
- RELX Science Center, Shenzhen RELX Tech. Co. Ltd., Shenzhen 518101, China
| | - Xingtao Jiang
- RELX Science Center, Shenzhen RELX Tech. Co. Ltd., Shenzhen 518101, China
| | - Min Li
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China; National and Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
| | - Peiqing Liu
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China; National and Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
| | - Jianwen Chen
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China; National and Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
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Granata S, Vivarelli F, Morosini C, Canistro D, Paolini M, Fairclough LC. Toxicological Aspects Associated with Consumption from Electronic Nicotine Delivery System (ENDS): Focus on Heavy Metals Exposure and Cancer Risk. Int J Mol Sci 2024; 25:2737. [PMID: 38473984 DOI: 10.3390/ijms25052737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Tobacco smoking remains one of the leading causes of premature death worldwide. Electronic Nicotine Delivery Systems (ENDSs) are proposed as a tool for smoking cessation. In the last few years, a growing number of different types of ENDSs were launched onto the market. Despite the manufacturing differences, ENDSs can be classified as "liquid e-cigarettes" (e-cigs) equipped with an atomizer that vaporizes a liquid composed of vegetable glycerin (VG), polypropylene glycol (PG), and nicotine, with the possible addition of flavorings; otherwise, the "heated tobacco products" (HTPs) heat tobacco sticks through contact with an electronic heating metal element. The presence of some metals in the heating systems, as well as in solder joints, involves the possibility that heavy metal ions can move from these components to the liquid, or they can be adsorbed into the tobacco stick from the heating blade in the case of HTPs. Recent evidence has indicated the presence of heavy metals in the refill liquids and in the mainstream such as arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), copper (Cu), and lead (Pb). The present review discusses the toxicological aspects associated with the exposition of heavy metals by consumption from ENDSs, focusing on metal carcinogenesis risk.
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Affiliation(s)
- Silvia Granata
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Lucy C Fairclough
- School of Life Sciences, University of Nottingham, East Dr, Nottingham NG7 2TQ, UK
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Sheth P, Mehta F, Jangid G, Anamika FNU, Singh B, Kanagala SG, Jain R. The Rising Use of E-Cigarettes: Unveiling the Health Risks and Controversies. Cardiol Rev 2024:00045415-990000000-00217. [PMID: 38385663 DOI: 10.1097/crd.0000000000000666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
The use of e-cigarettes has tremendously increased in recent times due to the widespread availability of e-cigarettes in diverse flavors, reduced cost compared to regular cigarettes, and misconception of being comparatively safe, which have led to around 2.55 million US middle and high school students smoking e-cigarettes. These devices use a nicotine-rich liquid, which is aerosolized electronically, producing vapors that may also include hazardous chemicals and heavy metals. E-cigarettes are associated with e-cigarette or vaping-associated lung injury, which presents as an acute respiratory ailment mirroring various pulmonary diseases. Additionally, it causes endothelial dysfunction, alters blood lipid profile by elevating circulating levels of low-density lipoprotein cholesterol, increases sympathetic tone, and is found to correlate with arterial stiffening, hence negatively affecting respiratory, cardiovascular, and overall health. We aim to provide a comprehensive analysis of the data on e-cigarettes and their harmful effects on health in comparison to conventional cigarette use by highlighting the pathophysiology of e-cigarette-induced adverse effects and critically analyzing the data both in favor and against its use. Our review concludes that no matter how much nicotine an e-cigarette contains, evidence shows that using it increases the risk of cardiovascular disease, albeit maybe not as much as smoking regular tobacco. Nonetheless, it is crucial to note that the long-term effects of e-cigarette usage are still not fully understood, and existing data have provided opposing viewpoints.
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Affiliation(s)
- Parth Sheth
- From the Internal Medicine, Smt. NHL Municipal Medical College, Ahmedabad, India
| | - Fena Mehta
- From the Internal Medicine, Smt. NHL Municipal Medical College, Ahmedabad, India
| | - Gurusha Jangid
- Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India
| | - F N U Anamika
- Internal Medicine, University College of Medical Sciences, New Delhi, India
| | - Bhupinder Singh
- Internal Medicine, Government Medical College, Amritsar, Punjab, India
| | | | - Rohit Jain
- Internal Medicine, Penn State Hershey Medical Center, Hershey, PA
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Badejo PO, Umphres SS, Ali HEA, Alarabi AB, Qadri S, Alshbool FZ, Khasawneh FT. Exposure to Electronic Waterpipes Increases the Risk of Occlusive Cardiovascular Disease in C57BL/6J Mice. J Cardiovasc Pharmacol Ther 2024; 29:10742484241242702. [PMID: 38592084 DOI: 10.1177/10742484241242702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
INTRODUCTION It is well documented that cardiovascular disease (CVD) is the leading cause of death in the US and worldwide, with smoking being the most preventable cause. Additionally, most smokers die from thrombotic-based diseases, in which platelets play a major role. To this end, because of the proven harm of smoking, several novel tobacco products such as electronic(e)-waterpipe have been gaining popularity among different sectors of the population, partly due to their "false" safety claims. While many investigators have focused on the negative health effects of traditional cigarettes and e-cigarettes on the cardiovascular system, virtually little or nothing is known about e-waterpipes, which we investigated herein. METHODS AND MATERIALS To investigate their occlusive CVD effects, we employed a whole-body mouse exposure model of e-waterpipe vape/smoke and exposed C57BL/6J male mice (starting at 7 weeks of age) for 1 month, with the controls exposed to clean air. Exposures took place seven times a week, according to the well-known Beirut protocol, which has been employed in many studies, as it mimics real-life waterpipe exposure scenarios; specifically, 171 puffs of 530 ml volume of the e-liquid at 2.6 s puff duration and 17 s puff interval. RESULTS The e-waterpipe exposed mice had shortened bleeding and occlusion times, when compared to the clean air controls, indicating a prothrombotic phenotype. As for the mechanism underlying this phenotype, we found that e-waterpipe exposed platelets exhibited enhanced agonist-triggered aggregation and dense granule secretion. Also, flow cytometry analysis of surface markers of platelet activation showed that both P-selectin and integrin GPIIb-IIIa activation were enhanced in the e-waterpipe exposed platelets, relative to the controls. Finally, platelet spreading and Akt phosphorylation were also more pronounced in the exposed mice. CONCLUSION We document that e-waterpipe exposure does exert untoward effects in the context of thrombosis-based CVD, in part, via promoting platelet hyperreactivity.
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Affiliation(s)
- Precious O Badejo
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Shelby S Umphres
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Hamdy E A Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Ahmed B Alarabi
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Shahnaz Qadri
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, TX, USA
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Martínez M, Espinoza VE, Garcia V, Uribe KP, Negishi K, Estevao IL, Carcoba LM, O'Dell LE, Khan AM, Mendez IA. Withdrawal from repeated nicotine vapor exposure increases somatic signs of physical dependence, anxiety-like behavior, and brain reward thresholds in adult male rats. Neuropharmacology 2023; 240:109681. [PMID: 37611823 PMCID: PMC11253717 DOI: 10.1016/j.neuropharm.2023.109681] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
Nicotine vapor consumption via electronic nicotine delivery systems has increased over the last decade. While prior work has shed light on the health effects of nicotine vapor inhalation, its unique effects on the brain and behavior have not been thoroughly explored. In this study we assessed markers of withdrawal following 14 days of nicotine vapor exposure. For Experiment 1, 21 adult male rats were exposed to ambient air or 6, 12, or 24 mg/mL nicotine vapor for 14 consecutive days. Following exposure on day 14, rats were injected with the nicotinic receptor antagonist mecamylamine (3.0 mg/mL) and assessed for somatic withdrawal signs and anxiety-like behavior in the elevated plus maze. For Experiment 2, 12 adult male rats were tested for intracranial self-stimulation (ICSS) immediately following exposure to vehicle vapor (50%/50%, vegetable glycerin/propylene glycol) or 24 mg/mL nicotine vapor, for 14 consecutive days. ICSS behavior was assessed for an additional 14 days, following cessation of repeated vapor exposure. Results reveal that rats with repeated nicotine vapor exposure display an increase in behavioral indicators of withdrawal following injection of mecamylamine (precipitated withdrawal). Additionally, increases in ICSS stimulation thresholds, indicative of reduced brain reward sensitivity, persist following cessation of repeated nicotine vapor exposure (spontaneous withdrawal). These data suggest that repeated e-cigarette use leads to nicotine dependence and withdrawal that affects behavior and brain reward function. Further characterization of the health effects of nicotine vapor is necessary to improve treatment strategies for nicotine use disorder and public health policies related to novel nicotine delivery systems.
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Affiliation(s)
- Michelle Martínez
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Veronika E Espinoza
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Valeria Garcia
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Kevin P Uribe
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Kenichiro Negishi
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Igor L Estevao
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Luis M Carcoba
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Laura E O'Dell
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, 79968, USA; Interdisciplinary Group for Neuroscience Investigation, Training and Education (IGNITE), The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Arshad M Khan
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, 79968, USA; Interdisciplinary Group for Neuroscience Investigation, Training and Education (IGNITE), The University of Texas at El Paso, El Paso, TX, 79968, USA
| | - Ian A Mendez
- School of Pharmacy, Department of Pharmaceutical Sciences, The University of Texas at El Paso, El Paso, TX, 79968, USA; Interdisciplinary Group for Neuroscience Investigation, Training and Education (IGNITE), The University of Texas at El Paso, El Paso, TX, 79968, USA.
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Song MA, Kim JY, Gorr MW, Miller RA, Karpurapu M, Nguyen J, Patel D, Archer KJ, Pabla N, Shields PG, Wold LE, Christman JW, Chung S. Sex-specific lung inflammation and mitochondrial damage in a model of electronic cigarette exposure in asthma. Am J Physiol Lung Cell Mol Physiol 2023; 325:L568-L579. [PMID: 37697923 PMCID: PMC11068405 DOI: 10.1152/ajplung.00033.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/14/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
The prevalence of electronic cigarette (EC) use among adult with asthma has continued to increase over time, in part due to the belief of being less harmful than smoking. However, the extent of their toxicity and the involved mechanisms contributing to the deleterious impact of EC exposure on patients with preexisting asthma have not been delineated. In the present project, we tested the hypothesis that EC use contributes to respiratory damage and worsening inflammation in the lungs of patients with asthma. To define the consequences of EC exposure in established asthma, we used a mouse model with/without preexisting asthma for short-term exposure to EC aerosols. C57/BL6J mice were sensitized and challenged with a DRA (dust mite, ragweed, Aspergillus fumigates, 200 µg/mL) mixture and exposed daily to EC with nicotine (2% nicotine in 30:70 propylene glycol: vegetable glycerin) or filtered air for 2 wk. The mice were evaluated at 24 h after the final EC exposure. After EC exposure in asthmatic mice, lung inflammatory cell infiltration and goblet cell hyperplasia were increased, whereas EC alone did not cause airway inflammation. Our data also show that mitochondrial DNA (mtDNA) content and a key mtDNA regulator, mitochondrial transcription factor A (TFAM), are reduced in asthmatic EC-exposed mice in a sex-dependent manner. Together, these results indicate that TFAM loss in lung epithelium following EC contributes to male-predominant sex pathological differences, including mitochondrial damage, inflammation, and remodeling in asthmatic airways.NEW & NOTEWORTHY Respiratory immunity is dysregulated in preexisting asthma, and further perturbations by EC use could exacerbate asthma severity. However, the extent of their toxicity and the involved mechanisms contributing to the deleterious impact of EC exposure on patients with preexisting asthma have not been delineated. We found that EC has unique biological impacts in lungs and potential sex differences with loss of TFAM, a key mtDNA regulator, in lung epithelial region from our animal EC study.
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Affiliation(s)
- Min-Ae Song
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Ji Young Kim
- Division of Pharmaceutics and Pharmacology, College of Pharmacy and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States
| | - Matthew W Gorr
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Roy A Miller
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - Manjula Karpurapu
- Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, United States
| | - Jackie Nguyen
- Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, United States
| | - Devki Patel
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Kellie J Archer
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, United States
| | - Navjot Pabla
- Division of Pharmaceutics and Pharmacology, College of Pharmacy and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States
| | - Peter G Shields
- Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, Ohio, United States
| | - Loren E Wold
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, United States
| | - John W Christman
- Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, United States
| | - Sangwoon Chung
- Division of Pulmonary, Critical Care and Sleep Medicine, Davis Heart and Lung Research Institute, The Ohio State University, Columbus, Ohio, United States
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Alzahrani T. Electronic Cigarette Use and Myocardial Infarction. Cureus 2023; 15:e48402. [PMID: 38073929 PMCID: PMC10700683 DOI: 10.7759/cureus.48402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Current electronic cigarettes (e-cigarettes) is associated with myocardial infarction, controlling whether the subjects smoke cigarettes. However, no studies have been conducted on subjects who never smoked cigarettes. This study aimed to determine the association between e-cigarette use and myocardial infarction among subjects who have never smoked cigarettes. METHODS The National Health Interview Survey (NHIS) data from 2014 to 2021 was used to evaluate the relationship between e-cigarette use and myocardial infarction in subjects who have never smoked cigarettes after adjusting for risk factors, including age, sex, diabetes, hypertension, hypercholesterolemia, and obesity/overweight, using logistic regression. RESULTS A total of 139,697 subjects were never users, and 1,237 subjects were current e-cigarette users. E-cigarette users were significantly younger than never users. E-cigarette users were less likely to be female (40% vs. 60%, p <0.01), or have diabetes (3% vs. 10%, p <0.01), have hypertension (11% vs. 32%, p <0.01), have hypercholesterolemia (8% vs. 27%, p <0.01), or be overweight or obese (56% vs. 65%, p <0.01) compared to never users. The current e-cigarette users had a 2.6-fold increase in the odds of having a myocardial infarction (OR 2.62, 95% CI 1.44-4.77; p <0.01) after adjusting for sex, age, hypertension, diabetes, hypercholesterolemia, and obesity/overweight. Conclusions: This study suggests that current e-cigarette use increases the risks of cardiovascular disease, including myocardial infarction and stroke, in subjects who never smoked cigarettes. Further longitudinal studies are needed to confirm the results of this study.
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Affiliation(s)
- Talal Alzahrani
- Internal Medicine Department, College of Medicine, Taibah University, Madinah, SAU
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11
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Rose JJ, Krishnan-Sarin S, Exil VJ, Hamburg NM, Fetterman JL, Ichinose F, Perez-Pinzon MA, Rezk-Hanna M, Williamson E. Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association. Circulation 2023; 148:703-728. [PMID: 37458106 DOI: 10.1161/cir.0000000000001160] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Vaping and electronic cigarette (e-cigarette) use have grown exponentially in the past decade, particularly among youth and young adults. Cigarette smoking is a risk factor for both cardiovascular and pulmonary disease. Because of their more limited ingredients and the absence of combustion, e-cigarettes and vaping products are often touted as safer alternative and potential tobacco-cessation products. The outbreak of e-cigarette or vaping product use-associated lung injury in the United States in 2019, which led to >2800 hospitalizations, highlighted the risks of e-cigarettes and vaping products. Currently, all e-cigarettes are regulated as tobacco products and thus do not undergo the premarket animal and human safety studies required of a drug product or medical device. Because youth prevalence of e-cigarette and vaping product use was as high as 27.5% in high school students in 2019 in the United States, it is critical to assess the short-term and long-term health effects of these products, as well as the development of interventional and public health efforts to reduce youth use. The objectives of this scientific statement are (1) to describe and discuss e-cigarettes and vaping products use patterns among youth and adults; (2) to identify harmful and potentially harmful constituents in vaping aerosols; (3) to critically assess the molecular, animal, and clinical evidence on the acute and chronic cardiovascular and pulmonary risks of e-cigarette and vaping products use; (4) to describe the current evidence of e-cigarettes and vaping products as potential tobacco-cessation products; and (5) to summarize current public health and regulatory efforts of e-cigarettes and vaping products. It is timely, therefore, to review the short-term and especially the long-term implications of e-cigarettes and vaping products on cardiopulmonary health. Early molecular and clinical evidence suggests various acute physiological effects from electronic nicotine delivery systems, particularly those containing nicotine. Additional clinical and animal-exposure model research is critically needed as the use of these products continues to grow.
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12
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Fountoulakis P, Theofilis P, Tsalamandris S, Antonopoulos AS, Tsioufis P, Toutouzas K, Oikonomou E, Tsioufis K, Tousoulis D. The cardiovascular consequences of electronic cigarette smoking: a narrative review. Expert Rev Cardiovasc Ther 2023; 21:651-661. [PMID: 37755116 DOI: 10.1080/14779072.2023.2264179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/25/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION E-cigarettes have emerged as a popular alternative to traditional tobacco smoking in recent years. Despite their growing popularity, concerns have arisen regarding the cardiovascular implications of e-cigarette use. AREAS COVERED This narrative review aims to highlight the latest evidence on the impact of e-cigarettes on cardiovascular health. EXPERT OPINION Numerous studies have demonstrated that e-cigarette use can lead to acute adverse cardiovascular effects. Inhalation of e-cigarette aerosols exposes users to a wide range of potentially harmful substances that have been implicated in critical pathophysiologic pathways of cardiovascular disease, namely endothelial dysfunction, oxidative stress, inflammation, sympathetic overdrive, and arterial stiffness. While long-term epidemiological studies specifically focusing on the cardiovascular effects of e-cigarettes are still relatively scarce, early evidence suggests a potential association between e-cigarette use and an increased risk of adverse cardiovascular events. However, it is essential to recognize that e-cigarettes are relatively new products, and the full extent of their long-term cardiovascular impact has not been fully elucidated. In the meantime, promoting tobacco cessation strategies that are evidence-based and regulated, along with rigorous monitoring of e-cigarette use patterns and associated health outcomes, are essential steps in safeguarding cardiovascular health in the face of this emerging public health challenge.
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Affiliation(s)
- Petros Fountoulakis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Theofilis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamandris
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Alexios S Antonopoulos
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Tsioufis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Toutouzas
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
- Cardiology Department, Sotiria Chest Diseases Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Tsioufis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
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13
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Day NJ, Wang J, Johnston CJ, Kim SY, Olson HM, House EL, Attah IK, Clair GC, Qian WJ, McGraw MD. Rat bronchoalveolar lavage proteome changes following e-cigarette aerosol exposures. Am J Physiol Lung Cell Mol Physiol 2023; 324:L571-L583. [PMID: 36881561 PMCID: PMC10085554 DOI: 10.1152/ajplung.00016.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
E-cigarette liquids are complex mixtures of chemicals consisting of humectants, such as propylene glycol (PG) and vegetable glycerin (VG), with nicotine or flavorings added. Published literature emphasizes the toxicity of e-cigarette aerosols with flavorings whereas much less attention has been given to the biologic effects of humectants. The purpose of the current study was to provide a comprehensive view of the acute biologic effects of e-cigarette aerosols on rat bronchoalveolar lavage (BAL) using mass spectrometry-based global proteomics. Sprague-Dawley rats were exposed to e-cigarette aerosol for 3 h/day for three consecutive days. Groups included: PG/VG alone, PG/VG + 2.5% nicotine (N), or PG/VG + N + 3.3% vanillin (V). Right lung lobes were lavaged for BAL and supernatants prepared for proteomics. Extracellular BAL S100A9 concentrations and BAL cell staining for citrullinated histone H3 (citH3) were also performed. From global proteomics, ∼2,100 proteins were identified from rat BAL. The greatest change in number of BAL proteins occurred with PG/VG exposures alone compared with controls with biological pathways enriched for acute phase responses, extracellular trap formation, and coagulation. Extracellular BAL S100A9 concentrations and the number of citH3 + BAL cells also increased significantly in PG/VG and PG/VG + 2.5% N. In contrast to PG/VG or PG/VG + N, the addition of vanillin to PG/VG + N increased BAL neutrophilia and downregulated lipid transport proteins. In summary, global proteomics support e-cigarette aerosol exposures to PG/VG alone as having a significant biologic effect on the lung independent of nicotine or flavoring with increased markers of extracellular trap formation.
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Affiliation(s)
- Nicholas J Day
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Juan Wang
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Carl J Johnston
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - So-Young Kim
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - Heather M Olson
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Emma L House
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - Isaac Kwame Attah
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Geremy C Clair
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Wei-Jun Qian
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Matthew D McGraw
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
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14
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Daiber A, Kuntic M, Oelze M, Hahad O, Münzel T. E-cigarette effects on vascular function in animals and humans. Pflugers Arch 2023:10.1007/s00424-023-02813-z. [PMID: 37084087 DOI: 10.1007/s00424-023-02813-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/22/2023]
Abstract
Smoking tobacco cigarettes is a significant (cardiovascular) health risk factor. Although the number of tobacco cigarette users declined over the last decades, shisha smoking and e-cigarette vaping partially compensated for this health benefit. E-cigarettes may create highly addicted dual users (vaping and smoking). E-cigarettes seem not to represent a healthier alternative to tobacco smoking, although they may be less harmful. E-cigarette vaping causes oxidative stress, inflammation, endothelial dysfunction, and associated cardiovascular sequelae. This is primarily due to a significant overlap of toxic compounds in the vapor compared to tobacco smoke and, accordingly, a substantial overlap of pathomechanistic features between vaping and smoking. Whereas the main toxins in vapor are reactive aldehydes such as formaldehyde and acrolein, the toxic mixture in smoke is more complex, comprising particulate matter, reactive gases, transition metals, volatile organic compounds, and N-nitrosamines. However, it seems that both lifestyle drugs impair endothelial function to a quite similar extent, which may be due to the role of oxidative stress as the central pathomechanism to mediate endothelial dysfunction and vascular damage. Finally, the main selling argument for e-cigarette use that they help to quit smoking and get rid of nicotine addiction may be false because it seems that e-cigarettes instead trigger the opposite-younger entrance age and more frequent use. With our review, we summarize the adverse health impact of tobacco cigarettes and e-cigarettes, emphasizing the detrimental effects on endothelial function and cardiovascular health.
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Affiliation(s)
- Andreas Daiber
- Department of Cardiology 1, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
- German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main, Mainz, Germany.
| | - Marin Kuntic
- Department of Cardiology 1, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main, Mainz, Germany
| | - Matthias Oelze
- Department of Cardiology 1, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Omar Hahad
- Department of Cardiology 1, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology 1, University Medical Center of the Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
- German Center for Cardiovascular Research (DZHK), Partnersite Rhine-Main, Mainz, Germany.
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15
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Snoderly HT, Alkhadrawi H, Panchal DM, Weaver KL, Vito JN, Freshwater KA, Santiago SP, Olfert IM, Nurkiewicz TR, Bennewitz MF. Short-term exposure of female BALB/cJ mice to e-cigarette aerosol promotes neutrophil recruitment and enhances neutrophil-platelet aggregation in pulmonary microvasculature. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:246-262. [PMID: 36859793 PMCID: PMC10081729 DOI: 10.1080/15287394.2023.2184738] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Despite the perception that e-cigarettes are safer than conventional cigarettes, numerous findings demonstrated that e-cigarette aerosol (EC) exposure induced compromised immune functionality, vascular changes even after acute exposure, and lung injury. Notably, altered neutrophil functionality and platelet hemodynamics have been observed post-EC exposure. It was hypothesized that EC exposure initiates an inflammatory response resulting in altered neutrophil behavior and increased neutrophil-platelet interaction in the pulmonary microvasculature. Neutrophil and platelet responses were examined up to 48 hrs following whole-body, short-term EC exposure without flavorants or nicotine in a murine model, which most closely modeled secondhand exposure. This study is the first to investigate the impact of EC exposure through lung intravital imaging. Compared to room air-exposed mice, EC-exposed mice displayed significantly increased 1.7‒1.9-fold number of neutrophils in the pulmonary microvasculature associated with no marked change in neutrophils within whole blood or bronchoalveolar lavage fluid (BALF). Neutrophil-platelet interactions were also significantly elevated 1.9‒2.5-fold in exposed mice. Plasma concentration of myeloperoxidase was markedly reduced 1.5-fold 48 hr following exposure cessation, suggesting suppressed neutrophil antimicrobial activity. Cytokine expression exhibited changes indicating vascular damage. Effects persisted for 48 hr post-EC exposure. Data demonstrated that EC exposure repeated for 3 consecutive days in 2.5 hr intervals in the absence of flavorants or nicotine resulted in modified pulmonary vasculature hemodynamics, altered immune functionality, and a pro-inflammatory state in female BALB/cJ mice.
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Affiliation(s)
- Hunter T. Snoderly
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, USA
| | - Hassan Alkhadrawi
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, USA
| | - Dhruvi M. Panchal
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, USA
| | - Kelly L. Weaver
- Department of Microbiology, Immunology, and Cell Biology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Jenna N. Vito
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, USA
| | - Kasey A. Freshwater
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, USA
| | - Stell P. Santiago
- Department of Pathology, Anatomy, and Laboratory Medicine, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - I. Mark Olfert
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV, USA
- Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV, USA
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Timothy R. Nurkiewicz
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV, USA
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Margaret F. Bennewitz
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, USA
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV, USA
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16
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Kountouras J, Papaefthymiou A, Polyzos SA, Liatsos C, Tzitiridou-Chatzopoulou M, Chatzopoulos D, Vardaka E, Gialamprinou D, Kotronis G, Thavayogarajah T, Doulberis M. Adverse Outcomes of E-cigarette in Inflammatory Bowel Disease. Dig Dis Sci 2023; 68:701-702. [PMID: 35930122 DOI: 10.1007/s10620-022-07642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/19/2022] [Indexed: 12/09/2022]
Affiliation(s)
- Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Macedonia, Greece.
- , 8 Fanariou St, Byzantio, 551 33, Thessaloniki, Macedonia, Greece.
| | - Apostolis Papaefthymiou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Macedonia, Greece
- Department of Gastroenterology, University Hospital of Larisa, 41110, Larisa, Greece
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Macedonia, Greece
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Macedonia, Greece
| | - Christos Liatsos
- Department of Gastroenterology, 401 General Military Hospital of Athens, 54124, Attiki, Greece
| | - Maria Tzitiridou-Chatzopoulou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Macedonia, Greece
- School of Healthcare Sciences, Midwifery Department, University of West Macedonia, Koila, 50100, Kozani, Macedonia, Greece
| | - Dimitrios Chatzopoulos
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Macedonia, Greece
| | - Elisabeth Vardaka
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Macedonia, Greece
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Alexander Campus, 57400, Thessaloniki, Macedonia, Greece
| | - Dimitra Gialamprinou
- Second Neonatal Department and NICU, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56403, Thessaloniki, Macedonia, Greece
| | - Georgios Kotronis
- Department of Internal Medicine, General Hospital Aghios Pavlos of Thessaloniki, 55134, Thessaloniki, Macedonia, Greece
| | - Tharshika Thavayogarajah
- Department of Medical Oncology and Hematology, University Hospital and University of Zurich, 8091, Zurich, Switzerland
| | - Michael Doulberis
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, 54642, Thessaloniki, Macedonia, Greece
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Macedonia, Greece
- Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, 5001, Aarau, Switzerland
- Department of Gastroenterology and Hepatology, University of Zurich, Zurich, Switzerland
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17
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Moheimani RS, Kajbaf J, Chang Chien GC. Patient Factors Affecting Regenerative Medicine Outcomes. Regen Med 2023. [DOI: 10.1007/978-3-030-75517-1_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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18
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Fadeyi O, Randhawa A, Shankar A, Garabetian C, Singh H, Topacio A. Thromboembolism Triggered by a Combination of Electronic Cigarettes and Oral Contraceptives: A Case Report and Review of Literature. J Investig Med High Impact Case Rep 2023; 11:23247096231181072. [PMID: 37314028 DOI: 10.1177/23247096231181072] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Genetic predisposition, oral contraceptive (OCP) use, tobacco smoking, cancers, and trauma are well-known triggers for hypercoagulability and thromboembolism. Multiple reports have been published on the health risk of combining OCP and traditional cigarettes smoking in the context of thromboembolism. However, limited information is available on the health consequences of combining OCP use with electronic cigarettes. Here, we report a case of a young female patient with a past medical history of ovarian cysts and electronic cigarettes use who came into the hospital with a complaint of "recurrent seizures" and tachycardia. This patient was subsequently diagnosed with bilateral pulmonary emboli, subacute cerebrovascular accident (CVA), and possible patent foramen ovale. Therapeutic Lovenox was initiated. Reasons to educate young females on the risks of combining OCP and electronic cigarettes use were explained.
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Affiliation(s)
- Olaniyi Fadeyi
- Internal Medicine Residency Program, West Anaheim Medical Center, Anaheim, CA, USA
| | - Anantbir Randhawa
- Internal Medicine Residency Program, West Anaheim Medical Center, Anaheim, CA, USA
| | - Abhirami Shankar
- Internal Medicine Residency Program, West Anaheim Medical Center, Anaheim, CA, USA
| | - Christine Garabetian
- Internal Medicine Residency Program, West Anaheim Medical Center, Anaheim, CA, USA
| | - Harpreet Singh
- Internal Medicine Residency Program, West Anaheim Medical Center, Anaheim, CA, USA
| | - Antonio Topacio
- Internal Medicine Residency Program, West Anaheim Medical Center, Anaheim, CA, USA
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19
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Hinds DM, Nick HJ, Vallin TM, Bloomquist LA, Christeson S, Bratcher PE, Cooper EH, Brinton JT, Bosco-Lauth A, White CW. Acute vaping in a golden Syrian hamster causes inflammatory response transcriptomic changes. Am J Physiol Lung Cell Mol Physiol 2022; 323:L525-L535. [PMID: 36041220 PMCID: PMC9602905 DOI: 10.1152/ajplung.00162.2022] [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] [Indexed: 11/22/2022] Open
Abstract
E-cigarette vaping is a major aspect of nicotine consumption, especially for children and young adults. Although it is branded as a safer alternative to cigarette smoking, murine and rat models of subacute and chronic e-cigarette vaping exposure have shown many proinflammatory changes in the respiratory tract. An acute vaping exposure paradigm has not been demonstrated in the golden Syrian hamster, and the hamster is a readily available small animal model that has the unique benefit of becoming infected with and transmitting respiratory viruses, including SARS-CoV-2, without genetic alteration of the animal or virus. Using a 2-day, whole body vaping exposure protocol in male golden Syrian hamsters, we evaluated serum cotinine, bronchoalveolar lavage cells, lung, and nasal histopathology, and gene expression in the nasopharynx and lung through reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Depending on the presence of nonnormality or outliers, statistical analysis was performed by ANOVA or Kruskal-Wallis tests. For tests that were statistically significant (P < 0.05), post hoc Tukey-Kramer and Dunn's tests, respectively, were performed to make pairwise comparisons between groups. In nasal tissue, RT-qPCR analysis revealed nicotine-dependent increases in gene expression associated with type 1 inflammation (CCL-5 and CXCL-10), fibrosis [transforming growth factor-β (TGF-β)], nicotine-independent increase oxidative stress response (SOD-2), and a nicotine-independent decrease in vasculogenesis/angiogenesis (VEGF-A). In the lung, nicotine-dependent increases in the expression of genes involved in the renin-angiotensin pathway [angiotensin-converting enzyme (ACE), ACE2], coagulation (tissue factor, Serpine-1), extracellular matrix remodeling (MMP-2, MMP-9), type 1 inflammation (IL-1β, TNF-α, and CXCL-10), fibrosis (TGF-β and Serpine-1), oxidative stress response (SOD-2), neutrophil extracellular traps release (ELANE), and vasculogenesis and angiogenesis (VEGF-A) were identified. To our knowledge, this is the first demonstration that the Syrian hamster is a viable model of e-cigarette vaping. In addition, this is the first report that e-cigarette vaping with nicotine can increase tissue factor gene expression in the lung. Our results show that even an acute exposure to e-cigarette vaping causes significant upregulation of mRNAs in the respiratory tract from pathways involving the renin-angiotensin system, coagulation, extracellular matrix remodeling, type 1 inflammation, fibrosis, oxidative stress response, neutrophil extracellular trap release (NETosis), vasculogenesis, and angiogenesis.
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Affiliation(s)
- Daniel M. Hinds
- 1Department of Pediatrics, University of Iowa, Iowa City, Iowa
| | - Heidi J. Nick
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado,3Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Tessa M. Vallin
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Leslie A. Bloomquist
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Christeson
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Preston E. Bratcher
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado,3Department of Pediatrics, National Jewish Health, Denver, Colorado
| | - Emily H. Cooper
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - John T. Brinton
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado,4Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Angela Bosco-Lauth
- 5Biomedical Sciences Department, Colorado State University, Fort Collins, Colorado
| | - Carl W. White
- 2Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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20
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Liu X, Yuan Z, Ji Y. The association between electronic cigarettes, sleep duration, and the adverse cardiovascular outcomes: Findings from behavioral risk factor surveillance system, 2020. Front Cardiovasc Med 2022; 9:909383. [PMID: 36277785 PMCID: PMC9582666 DOI: 10.3389/fcvm.2022.909383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
The joint effect of electronic cigarette smoking and insufficient sleep duration on cardiovascular disease (CVD) was unclear. This cross-sectional study aimed to evaluate the association between electronic cigarettes, sleep duration, and risk of CVD among American adults. The participants who completed the survey from the behavioral risk factor surveillance system in 2020 were included in this study. The status of electronic cigarette smoking was divided into never, former, and current use. The duration of sleep was categorized into insufficient (<6 h), appropriate (6–9 h), and excessive (>9 h) groups. The CVD group was defined as a patient having any of the following conditions: heart attack, coronary heart disease, or stroke according to self-report. The multivariate logistic regression model was adopted to determine the association between electronic cigarettes, sleep duration, and the risk of CVD. Sensitivity analyses were performed to assess the joint effects on the risk of CVD subtypes, including heart attack, coronary heart disease, and strokes, respectively. Subgroup analyses were performed to estimate the joint effects within the stratum of the age group. The total number of participants included in the present study was 253,561. Of which, 22,908 patients had CVD. In total, 61,293 participants had previously or currently used electronic cigarettes and 37,429 participants had inappropriate sleep duration. Former electronic cigarette users had a 10.8% increased risk of having CVD (OR = 1.108, 95% CI: 1.001–1.227) compared to users who never had electronic cigarettes. Insufficient and excessive sleep durations are associated with increased risks of CVD (OR = 1.592, 95% CI: 1.460–1.735; OR = 1.523, 95% CI: 1.320–1.758). The participants with current vaping status and lack of sleep had a 159.6% increased risk of CVD (OR = 2.596, 95% CI: 1.810–3.723). Sensitivity analyses found similar joint effects of current vaping and insufficient sleep on the risk of heart attack, coronary heart attack, and stroke. The subgroup analyses across each age stratum found that the middle-aged group is most vulnerable to the joint effect of current vaping and insufficient sleep. This study found that both current vaping and inappropriate sleep duration were associated with CVD. Additionally, there was a significant joint effect of current vaping and insufficient sleep on the risk of CVD, especially for middle-aged participants.
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Affiliation(s)
- Xingyou Liu
- First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhichao Yuan
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China,*Correspondence: Yuelong Ji
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China,Zhichao Yuan
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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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Sifat AE, Archie SR, Nozohouri S, Villalba H, Zhang Y, Sharma S, Ghanwatkar Y, Vaidya B, Mara D, Cucullo L, Abbruscato TJ. Short-term exposure to JUUL electronic cigarettes can worsen ischemic stroke outcome. Fluids Barriers CNS 2022; 19:74. [PMID: 36085043 PMCID: PMC9463848 DOI: 10.1186/s12987-022-00371-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The short and long-term health effects of JUUL electronic cigarette (e-Cig) are largely unknown and warrant extensive research. We hypothesized that JUUL exposure could cause cerebrovascular toxicities impacting the progression and outcome of ischemic stroke comparable to tobacco smoke (TS) exposure.
Methods
We exposed male C57 mice to TS/JUUL vapor for 14 days. LCMS/MS was used to measure brain and plasma nicotine and cotinine level. Transient middle cerebral artery occlusion (tMCAO) followed by reperfusion was used to mimic ischemic stroke. Plasma levels of IL-6 and thrombomodulin were assessed by enzyme-linked immunosorbent assay. At the same time, western blotting was used to study blood–brain barrier (BBB) tight junction (TJ) proteins expression and key inflammatory and oxidative stress markers.
Results
tMCAO upregulated IL-6 and decreased plasma thrombomodulin levels. Post-ischemic brain injury following tMCAO was significantly worsened by JUUL/TS pre-exposure. TJ proteins expression was also downregulated by JUUL/TS pre-exposure after tMCAO. Like TS, exposure to JUUL downregulated the expression of the antioxidant Nrf2. ICAM-1 was upregulated in mice subjected to tMCAO following pre-exposure to TS or JUUL, with a greater effect of TS than JUUL.
Conclusions
These results suggest that JUUL exposure could negatively impact the cerebrovascular system, although to a lesser extent than TS exposure.
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Electronic Cigarette and Atherosclerosis: A Comprehensive Literature Review of Latest Evidences. Int J Vasc Med 2022; 2022:4136811. [PMID: 36093338 PMCID: PMC9453087 DOI: 10.1155/2022/4136811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
Coronary artery diseases (CAD), also known as coronary heart disease (CHD), are the world’s leading cause of death. The basis of coronary artery disease is the narrowing of the heart coronary artery lumen due to atherosclerosis. The use of electronic cigarettes has increased significantly over the years. However, harmful effects of electronic cigarettes are still not firm. The aim of this article is to review the impact of electronic cigarette and its role in the pathogenesis of atherosclerosis from recent studies. The results showed that several chemical compounds, such as nicotine, propylene glycol, particulate matters, heavy metals, and flavorings, in electronic cigarette induce atherosclerosis with each molecular mechanism that lead to atherosclerosis progression by formation of ROS, endothelial dysfunction, and inflammation. Further research is still needed to determine the exact mechanism and provide more clinical evidence.
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Rao P, Han DD, Tan K, Mohammadi L, Derakhshandeh R, Navabzadeh M, Goyal N, Springer ML. Comparable Impairment of Vascular Endothelial Function by a Wide Range of Electronic Nicotine Delivery Devices. Nicotine Tob Res 2022; 24:1055-1062. [PMID: 35100430 PMCID: PMC9199952 DOI: 10.1093/ntr/ntac019] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/29/2021] [Accepted: 01/28/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS; ie, vaping devices) such as e-cigarettes, heated tobacco products, and newer coil-less ultrasonic vaping devices are promoted as less harmful alternatives to combustible cigarettes. However, their cardiovascular effects are understudied. We investigated whether exposure to aerosol from a wide range of ENDS devices, including a new ultrasonic vaping device, impairs endothelial function. AIMS AND METHODS We measured arterial flow-mediated dilation (FMD) in rats (n = 8/group) exposed to single session of 10 cycles of pulsatile 5-second exposure over 5 minutes to aerosol from e-liquids with and without nicotine generated from a USONICIG ultrasonic vaping device, previous generation e-cigarettes, 5% nicotine JUUL pods (Virginia Tobacco, Mango, Menthol), and an IQOS heated tobacco product; with Marlboro Red cigarette smoke and clean air as controls. We evaluated nicotine absorption and serum nitric oxide levels after exposure, and effects of different nicotine acidifiers on platelet aggregation. RESULTS Aerosol/smoke from all conditions except air significantly impaired FMD. Serum nicotine varied widely from highest in the IQOS group to lowest in USONICIG and previous generation e-cig groups. Nitric oxide levels were not affected by exposure. Exposure to JUUL and similarly acidified nicotine salt e-liquids did not affect platelet aggregation rate. Despite lack of heating coil, the USONICIG under airflow conditions heated e-liquid to ~77°C. CONCLUSIONS A wide range of ENDS, including multiple types of e-cigarettes with and without nicotine, a heated tobacco product, and an ultrasonic vaping device devoid of heating coil, all impair FMD after a single vaping session comparably to combusted cigarettes. IMPLICATIONS The need to understand the cardiovascular effects of various ENDS is of timely importance, as we have seen a dramatic increase in the use of these products in recent years, along with the growing assumption among its users that these devices are relatively benign. Our conclusion that a single exposure to aerosol from a wide range of ENDS impairs endothelial function comparably to cigarettes indicates that vaping can cause similar acute vascular functional impairment to smoking and is not a harmless activity.
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Affiliation(s)
- Poonam Rao
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel D Han
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Kelly Tan
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Leila Mohammadi
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Ronak Derakhshandeh
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Mina Navabzadeh
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Natasha Goyal
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
| | - Matthew L Springer
- Division of Cardiology, University of California, San Francisco, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, USA
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Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke-A Cross-Sectional Study of NHANES. Neurol Int 2022; 14:441-452. [PMID: 35736618 PMCID: PMC9227824 DOI: 10.3390/neurolint14020037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction: Tobacco use is one of the most significant risk factors for stroke. Besides traditional cigarettes and combustible products, the use of e-cigarettes and electronic nicotine delivery products has been widespread among young adults in the recent era. Furthermore, the trend of vaping has increased over the last decade. However, the relationship between e-cigarettes and stroke is largely unknown. The aim of this study was to evaluate the prevalence and identify the relationship between e-cigarette smoking and stroke. Methods: A cross-sectional study was performed using the NHANES database of the US population. Adults with a history of smoking were considered in our study and divided into three groups, e-cigarette users, traditional, and dual smokers. The Chi-squared test, Wilcoxon rank-sum test, and multivariable logistic regression analysis were used to identify the prevalence and association of e-cigarette consumption and stroke. Results: Out of a total of 266,058 respondents from 2015 to 2018, we found 79,825 respondents who smoked e-cigarettes (9.72%) or traditional (29.37%) or dual smoking (60.91%). Stroke prevalence among e-cigarette smokers was 1.57%. Stroke was more prevalent among traditional smokers than among e-cigarette smokers. (6.75% vs. 1.09%; p < 0.0001) E-cigarette smokers had early onset of stroke in comparison with traditional smokers. (median age: 48 vs. 59 years; p < 0.0001). Among females with stroke, the prevalence of e-cigarette use was higher in comparison with traditional smoking (36.36% vs. 33.91%; p < 0.0001). Among the stroke population, the prevalence of e-cigarette use was higher among Mexican-Americans (21.21% vs. 6.02%) and other Hispanics (24.24% vs. 7.70%) compared with traditional smoking (p < 0.0001). The regression analysis found higher odds of stroke history among e-cigarette users than traditional smokers [aOR: 1.15; 95% CI: 1.15−1.16)]. Conclusion: Though stroke was more prevalent in traditional smokers, the incidence of stroke was early-in-onset and was strongly associated with e-cigarette use compared to traditional smokers. We have also identified vascular effects of e-cigarettes components as possible triggers for the stroke.
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Villalobos-García D, Ali HEA, Alarabi AB, El-Halawany MS, Alshbool FZ, Khasawneh FT. Exposure of Mice to Thirdhand Smoke Modulates In Vitro and In Vivo Platelet Responses. Int J Mol Sci 2022; 23:ijms23105595. [PMID: 35628405 PMCID: PMC9144272 DOI: 10.3390/ijms23105595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
Smoking is a risk factor for a variety of deleterious conditions, such as cancer, respiratory disease and cardiovascular disease. Thrombosis is an important and common aspect of several cardiovascular disease states, whose risk is known to be increased by both first- and secondhand smoke. More recently, the residual cigarette smoke that persists after someone has smoked (referred to as thirdhand smoke or THS) has been gaining more attention, since it has been shown that it also negatively affects health. Indeed, we have previously shown that 6-month exposure to THS increases the risk of thrombogenesis. However, neither the time-dependence of THS-induced thrombus formation, nor its sex dependence have been investigated. Thus, in the present study, we investigated these issues in the context of a shorter exposure to THS, specifically 3 months, in male and female mice. We show that the platelets from 3-month THS-exposed mice exhibited enhanced activation by agonists. Moreover, we also show that mice of both sexes exposed to THS have decreased tail bleeding as well as decreased thrombus occlusion time. In terms of the role of sex, intersex disparities in thrombus development and hemostasis as well as in platelet aggregation were, interestingly, observed. Together, our findings show that exposing mice to THS for 3 months is sufficient to predispose them to thrombosis; which seems to be driven, at least in part, by an increased activity in platelets, and that it does not manifest equally in both sexes.
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Affiliation(s)
- Daniel Villalobos-García
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
| | - Hamdy E. A. Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
| | - Ahmed B. Alarabi
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (A.B.A.); (F.Z.A.)
| | - Medhat S. El-Halawany
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
| | - Fatima Z. Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (A.B.A.); (F.Z.A.)
| | - Fadi T. Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA; (D.V.-G.); (H.E.A.A.); (M.S.E.-H.)
- Correspondence: ; Tel.: +1-361-221-0755
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27
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Getiye Y, Peterson MR, Phillips BD, Carrillo D, Bisha B, He G. E-cigarette exposure with or without heating the e-liquid induces differential remodeling in the lungs and right heart of mice. J Mol Cell Cardiol 2022; 168:83-95. [PMID: 35489388 DOI: 10.1016/j.yjmcc.2022.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 01/12/2023]
Abstract
Various cardiopulmonary pathologies associated with electronic cigarette (EC) vaping have been reported. This study investigated the differential adverse effects of heating-associated by-products versus the intact components of EC aerosol to the lungs and heart of mice. We further dissected the roles of caspase recruitment domain-containing protein 9 (CARD9)-associated innate immune response and NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome in EC exposure-induced cardiopulmonary injury. C57BL/6 wild type (WT), CARD9-/-, and NLRP3-/- mice were exposed to EC aerosol 3 h/day, 5 days/week for 6 month with or without heating the e-liquid with exposure to ambient air as the control. In WT mice, EC exposure with heating (EwH) significantly increased right ventricle (RV) free wall thickness at systole and diastole. However, EC exposure without heating (EwoH) caused a significant decrease in the wall thickness at systole. RV fractional shortening was also markedly reduced following EwH in WT and NLRP3-/- mice. Further, EwH activated NF-κB and p38 MAPK inflammatory signaling in the lungs, but not in the RV, in a CARD9- and NLRP3-dependent manner. Levels of circulatory inflammatory mediators were also elevated following EwH, indicating systemic inflammation. Moreover, EwoH activated TGF-β1/SMAD2/3/α-SMA fibrosis signaling in the lungs but not the RV of WT mice. In conclusion, EC aerosol exposure following EwH or EwoH induced differential cardiopulmonary remodeling and CARD9 innate immune and NLRP3 inflammasome contributed to the adverse effects.
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Affiliation(s)
- Yohannes Getiye
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY 82071, USA
| | - Matthew R Peterson
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY 82071, USA
| | - Brandon D Phillips
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY 82071, USA
| | - Daniel Carrillo
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY 82071, USA
| | - Bledar Bisha
- Department of Animal Science, University of Wyoming, Laramie, WY 82071, USA
| | - Guanglong He
- School of Pharmacy, College of Health Sciences, University of Wyoming, Laramie, WY 82071, USA.
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Impact of Electronic Cigarette Vaping on Cerebral Ischemia: What We Know So Far. Transl Stroke Res 2022; 13:923-938. [DOI: 10.1007/s12975-022-01011-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 01/09/2023]
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Espinoza-Derout J, Shao XM, Lao CJ, Hasan KM, Rivera JC, Jordan MC, Echeverria V, Roos KP, Sinha-Hikim AP, Friedman TC. Electronic Cigarette Use and the Risk of Cardiovascular Diseases. Front Cardiovasc Med 2022; 9:879726. [PMID: 35463745 PMCID: PMC9021536 DOI: 10.3389/fcvm.2022.879726] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022] Open
Abstract
Electronic cigarettes or e-cigarettes are the most frequently used tobacco product among adolescents. Despite the widespread use of e-cigarettes and the known detrimental cardiac consequences of nicotine, the effects of e-cigarettes on the cardiovascular system are not well-known. Several in vitro and in vivo studies delineating the mechanisms of the impact of e-cigarettes on the cardiovascular system have been published. These include mechanisms associated with nicotine or other components of the aerosol or thermal degradation products of e-cigarettes. The increased hyperlipidemia, sympathetic dominance, endothelial dysfunction, DNA damage, and macrophage activation are prominent effects of e-cigarettes. Additionally, oxidative stress and inflammation are unifying mechanisms at many levels of the cardiovascular impairment induced by e-cigarette exposure. This review outlines the contribution of e-cigarettes in the development of cardiovascular diseases and their molecular underpinnings.
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Affiliation(s)
- Jorge Espinoza-Derout
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Xuesi M. Shao
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Candice J. Lao
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Kamrul M. Hasan
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Juan Carlos Rivera
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Maria C. Jordan
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Valentina Echeverria
- Research and Development Service, Bay Pines VA Healthcare System, Bay Pines, FL, United States
- Laboratorio de Neurobiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile
| | - Kenneth P. Roos
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Amiya P. Sinha-Hikim
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Theodore C. Friedman
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Friends Research Institute, Cerritos, CA, United States
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Shelton CM, Black H, Proctor J, Hagemann TM. A Comprehensive Review of Vaping Use in Pediatric Patients and Recent Changes in Regulatory Laws. J Pediatr Pharmacol Ther 2022; 27:109-119. [DOI: 10.5863/1551-6776-27.2.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/09/2021] [Indexed: 11/11/2022]
Abstract
The use of electronic cigarettes (e-cigarettes), also known as vapes, by adolescents and young adults has dramatically increased over the past several years. E-cigarettes continue to be the most used form of tobacco among youth. As a result of this concerning trend, policies at both the state and federal levels have been implemented to limit availability in this population. Additionally, the coronavirus disease 2019 (COVID-19) pandemic has had some positive and negative effects on the youth vaping epidemic with adolescent consumers reporting limited access to retail sites during the stay-at-home executive orders, but easier access with online purchasing because age verification was often not required. Complications resulting from vaping have been reported and include e-cigarette or vaping product use–associated lung injury (EVALI) and thrombotic events. Data suggest that the use of vaping devices can lead to both short- and long-term respiratory morbidity in the pediatric population. This review serves to provide a comprehensive examination of vaping use in pediatric patients and recent changes in regulatory laws to equip pharmacists with the knowledge to be aware of the different devices and products available, ask their pediatric patients regularly about use, and counsel and educate on the potential harmful effects.
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Affiliation(s)
- Chasity M. Shelton
- Department of Clinical Pharmacy and Translational Science (CMS, TMH), The University of Tennessee Health Science Center, Memphis, TN
| | - Haley Black
- College of Pharmacy (HB, JP), The University of Tennessee Health Science Center, Memphis, TN
| | - Johnathon Proctor
- College of Pharmacy (HB, JP), The University of Tennessee Health Science Center, Memphis, TN
| | - Tracy M. Hagemann
- Department of Clinical Pharmacy and Translational Science (CMS, TMH), The University of Tennessee Health Science Center, Memphis, TN
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Alarabi AB, Lozano PA, Khasawneh FT, Alshbool FZ. The effect of emerging tobacco related products and their toxic constituents on thrombosis. Life Sci 2022; 290:120255. [PMID: 34953893 PMCID: PMC9118784 DOI: 10.1016/j.lfs.2021.120255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 02/03/2023]
Abstract
Although conventional cigarette smoking is declining, emerging tobacco related products (ETRPs) are currently gaining ground, especially among the youth. These products include electronic cigarettes, waterpipes/hookah, cigars/cigarillo, smokeless tobacco, and heat-not-burn cigarettes. The observed increase in the use of ETRPs is multifactorial and complex but appears to be mainly driven by efforts from the major tobacco companies to reinvent themselves, and present more appealing and allegedly safe(r) tobacco products. However, it is becoming apparent that these products produce substantial amounts of toxic chemicals, many of which have been shown to exert negative health effects, including in the context of the cardiovascular system. Thus, there has been research efforts, albeit limited in general, to characterize the health impact of these products on occlusive/thrombotic cardiovascular diseases (CVD). In this review, we will discuss the potential impact of ETRPs on thrombosis-based CVD. Specifically, we will review how these products and the major chemicals they produce and/or emit can trigger key players in the process of thrombosis, namely inflammation, oxidative stress, platelets, coagulation, and the vascular endothelium, and the relationship between these effects.
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Affiliation(s)
- Ahmed B Alarabi
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA
| | - Patricia A Lozano
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA.
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A&M University, Kingsville, TX, USA.
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Kopsombut G, Ajjegowda A, Livingston F, Epelman M, Brown B, Werk L, Brogan R. Clinical Findings in Adolescents Hospitalized With EVALI; Novel Report on Coagulopathy. Hosp Pediatr 2022; 12:229-240. [PMID: 35098298 DOI: 10.1542/hpeds.2021-006059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Describe clinical characteristics of adolescents hospitalized with e-cigarette or vaping product use-associated lung injury (EVALI) and to investigate association between EVALI and coagulopathy. METHODS We conducted a retrospective cohort study of adolescents admitted to the general inpatient or ICUs at 2 major tertiary children's hospitals from January 2019 to June 2021. We included analysis of demographics, clinical findings, laboratory and imaging results, and outcomes. RESULTS Forty-four hospitalizations met diagnostic criteria for inclusion per Centers for Disease Control and Prevention guidelines, with 55% of patients admitted after April 2020. Compared with adults, pediatric patients were less likely to present with pulmonary symptoms. Significant laboratory work included elevated white blood cell count of 14.3 k/uL (confidence interval [CI], 13.7-15.0) with neutrophilic predominance, C-reactive protein of 25.2 mg/dL (CI, 22.1-28.2), and erythrocyte sedimentation rate of 66.7 mm/hour (CI, 26.9-76.4). Chest radiographs were poor predictors of disease in 53% of our patients but computed tomography was 100% sensitive. Significant coagulation abnormalities included prothrombin time of 17.7 seconds (CI, 16.4-19.1) and international normalized ratio of 1.54 (CI, 1.43-1.66). Coagulation studies improved with vitamin K and steroid administration. Nine of 16 patients (56%) had abnormal diffusing capacity of the lung for carbon monoxide divided by alveolar volume <80% predicted, suggesting evidence of pulmonary vascular disease, or >100%, suggesting pulmonary hemorrhage. CONCLUSIONS EVALI continues to be an important differential diagnosis in the adolescent population. EVALI is likely a result of systemic inflammation with consequences beyond the pulmonary system. The novel report of coagulopathy among adolescents with EVALI in this cohort reveals an opportunity to detect coagulopathy and initiate early therapy.
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Affiliation(s)
| | | | | | | | | | - Lloyd Werk
- General Academic Pediatrics, Nemours Children's Hospital, Orlando, Florida
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Giner P, Maynez-Anchondo L, Liley AE, Uribe KP, Frietze GA, Simon NW, Mendez IA. Increased Risky Choice and Reduced CHRNB2 Expression in Adult Male Rats Exposed to Nicotine Vapor. Int J Mol Sci 2022; 23:1231. [PMID: 35163155 PMCID: PMC8835719 DOI: 10.3390/ijms23031231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
While the cognitive enhancing effects of nicotine use have been well documented, it has also been shown to impair decision making. The goal of this study was to determine if exposure to nicotine vapor increases risky decision making. The study also aims to investigate possible long-term effects of nicotine vapor exposure on the expression of genes coding for cholinergic and dopaminergic receptors in brain. Thirty-two adult male Sprague Dawley rats were exposed to 24 mg/mL nicotine vapor or vehicle control, immediately followed by testing in the probability discounting task for 10 consecutive days. Fifty-four days after the 10-day vapor exposure, animals were sacrificed and expression of genes coding for the α4 and β2 cholinergic receptor subunits, and dopamine D1 and D2 receptors, were analyzed using RT-PCR. Exposure to nicotine vapor caused an immediate and transient increase in risky choice. Analyses of gene expression identified significant reductions in CHRNB2 and DRD1 in the nucleus accumbens core and CHRNB2 and DRD2 in the medial prefrontal cortex of rats previously exposed to nicotine vapor, relative to vehicle controls. Results provide data on the negative cognitive effects of nicotine vapor exposure and identify cholinergic and dopaminergic mechanisms that may affected with repeated use.
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Affiliation(s)
- Priscilla Giner
- Department of Psychology, The University of Texas at El Paso, El Paso, TX 79968, USA; (P.G.); (L.M.-A.); (K.P.U.)
| | - Liliana Maynez-Anchondo
- Department of Psychology, The University of Texas at El Paso, El Paso, TX 79968, USA; (P.G.); (L.M.-A.); (K.P.U.)
| | - Anna E. Liley
- Department of Psychology, The University of Memphis, Memphis, TN 38111, USA; (A.E.L.); (N.W.S.)
| | - Kevin P. Uribe
- Department of Psychology, The University of Texas at El Paso, El Paso, TX 79968, USA; (P.G.); (L.M.-A.); (K.P.U.)
| | - Gabriel A. Frietze
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, TX 79968, USA;
| | - Nicholas W. Simon
- Department of Psychology, The University of Memphis, Memphis, TN 38111, USA; (A.E.L.); (N.W.S.)
| | - Ian A. Mendez
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El Paso, El Paso, TX 79968, USA;
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Abstract
Since the spread of tobacco from the Americas hundreds of years ago, tobacco cigarettes and, more recently, alternative tobacco products have become global products of nicotine addiction. Within the evolving alternative tobacco product space, electronic cigarette (e-cigarette) vaping has surpassed conventional cigarette smoking among adolescents and young adults in the United States and beyond. This review describes the experimental and clinical evidence of e-cigarette toxicity and deleterious health effects. Adverse health effects related to e-cigarette aerosols are influenced by several factors, including e-liquid components, physical device factors, chemical changes related to heating, and health of the e-cigarette user (e.g., asthmatic). Federal, state, and local regulations have attempted to govern e-cigarette flavors, manufacturing, distribution, and availability, particularly to underaged youths. However, the evolving e-cigarette landscape continues to impede timely toxicological studies and hinder progress made toward our understanding of the long-term health consequence of e-cigarettes.
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Affiliation(s)
- Terry Gordon
- Department of Environmental Medicine, NYU School of Medicine, New York, NY 10010, USA;
| | - Emma Karey
- Department of Environmental Medicine, NYU School of Medicine, New York, NY 10010, USA;
| | - Meghan E Rebuli
- Department of Pediatrics and Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
| | - Yael-Natalie H Escobar
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
| | - Ilona Jaspers
- Department of Pediatrics and Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina 27599, USA
| | - Lung Chi Chen
- Department of Environmental Medicine, NYU School of Medicine, New York, NY 10010, USA;
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Cash A, Minhas AMK, Pasadyn V, Nazir S, Ariss RW, Gupta R. Trends in pulmonary embolism mortality rates by age group in the United States, 1999-2019. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 13:100103. [PMID: 38560063 PMCID: PMC10978166 DOI: 10.1016/j.ahjo.2022.100103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 04/04/2024]
Abstract
Introduction Acute pulmonary embolism (PE) is a major cause of mortality in the United States. Recent reports indicate that PE-related mortality rates have increased among individuals younger than 65 years old. It remains unclear whether this increase in PE-related mortality is evenly distributed. A narrowly focused and clinically meaningful age group analysis is necessary. Methods Death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database were examined to determine all-cause PE mortality trends from 1999 to 2019 among adults 25-39, 40-54, 55-69, 70-84, and ≥85 years old. The crude death rates for individual years and annual percentage change (APC) were calculated to determine trends. Results PE-related mortality rates increased among those 25-39, 40-54, and 55-69. Among individuals 25-39 years old, death rate increased from 1.8 to 2.0 (APC 0.7 [95% confidence interval (CI) 0.2 to 1.1]) between 1999 and 2014 and continued to increase from 2.0 to 2.4 (APC 4.1 [95% CI 1.8 to 6.5]) between 2014 and 2019. Among those 40-54 years old, the crude death rate increased from 5.7 to 7.5 (APC 2.0 [95% CI, 1.6 to 2.5]) between 2007 and 2019. Among those 55-69 years old the crude death rate increased from 15.6 to 18.5 (APC 2.2 [95% CI, 1.9 to 2.5]) between 2010 and 2019. Recent death rates decreased or plateaued among individuals older than 70. Conclusions Individuals younger than 70 years had increase in PE-related mortality between 1999 and 2019 with marked increase among those 25-39 years old.
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Affiliation(s)
- Ayla Cash
- University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
| | | | - Vanessa Pasadyn
- University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
| | - Salik Nazir
- University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
- Division of Cardiovascular Medicine, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
| | - Robert W. Ariss
- University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
| | - Rajesh Gupta
- University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
- Division of Cardiovascular Medicine, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Toledo, OH 43614, USA
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36
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Snoderly HT, Nurkiewicz TR, Bowdridge EC, Bennewitz MF. E-Cigarette Use: Device Market, Study Design, and Emerging Evidence of Biological Consequences. Int J Mol Sci 2021; 22:12452. [PMID: 34830344 PMCID: PMC8619996 DOI: 10.3390/ijms222212452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022] Open
Abstract
Electronic cigarettes are frequently viewed as a safer alternative to conventional cigarettes; however, evidence to support this perspective has not materialized. Indeed, the current literature reports that electronic cigarette use is associated with both acute lung injury and subclinical dysfunction to the lung and vasculature that may result in pathology following chronic use. E-cigarettes can alter vascular dynamics, polarize innate immune populations towards a proinflammatory state, compromise barrier function in the pulmonary endothelium and epithelium, and promote pre-oncogenic phenomena. This review will summarize the variety of e-cigarette products available to users, discuss current challenges in e-cigarette study design, outline the range of pathologies occurring in cases of e-cigarette associated acute lung injury, highlight disease supporting tissue- and cellular-level changes resulting from e-cigarette exposure, and briefly examine how these changes may promote tumorigenesis. Continued research of the mechanisms by which e-cigarettes induce pathology benefit users and clinicians by resulting in increased regulation of vaping devices, informing treatments for emerging diseases e-cigarettes produce, and increasing public awareness to reduce e-cigarette use and the onset of preventable disease.
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Affiliation(s)
- Hunter T. Snoderly
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV 26506, USA;
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
| | - Timothy R. Nurkiewicz
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Elizabeth C. Bowdridge
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Margaret F. Bennewitz
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV 26506, USA;
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
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Re DB, Hilpert M, Saglimbeni B, Strait M, Ilievski V, Coady M, Talayero M, Wilmsen K, Chesnais H, Balac O, Glabonjat RA, Slavkovich V, Yan B, Graziano J, Navas-Acien A, Kleiman NJ. Exposure to e-cigarette aerosol over two months induces accumulation of neurotoxic metals and alteration of essential metals in mouse brain. ENVIRONMENTAL RESEARCH 2021; 202:111557. [PMID: 34245728 PMCID: PMC8578258 DOI: 10.1016/j.envres.2021.111557] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 05/15/2023]
Abstract
Despite a recent increase in e-cigarette use, the adverse human health effects of exposure to e-cigarette aerosol, especially on the central nervous system (CNS), remain unclear. Multiple neurotoxic metals have been identified in e-cigarette aerosol. However, it is unknown whether those metals accumulate in the CNS at biologically meaningful levels. To answer this question, two groups of mice were whole-body exposed twice a day, 5 days a week, for two months, to either a dose of e-cigarette aerosol equivalent to human secondhand exposure, or a 5-fold higher dose. After the last exposure, the olfactory bulb, anterior and posterior frontal cortex, striatum, ventral midbrain, cerebellum, brainstem, remaining brain tissue and spinal cord were collected for metal quantification by inductively coupled plasma mass spectrometry and compared to tissues from unexposed control mice. The two-month exposure caused significant accumulation of several neurotoxic metals in various brain areas - for some metals even at the low exposure dose. The most striking increases were measured in the striatum. For several metals, including Cr, Cu, Fe, Mn, and Pb, similar accumulations are known to be neurotoxic in mice. Decreases in some essential metals were observed across the CNS. Our findings suggest that chronic exposure to e-cigarette aerosol could lead to CNS neurotoxic metal deposition and endogenous metal dyshomeostasis, including potential neurotoxicity. We conclude that e-cigarette-mediated metal neurotoxicity may pose long-term neurotoxic and neurodegenerative risks for e-cigarette users and bystanders.
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Affiliation(s)
- Diane B Re
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA; Center for Motor Neuron Biology and Disease, Columbia University, New York, NY, 10032, USA.
| | - Markus Hilpert
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA.
| | - Brianna Saglimbeni
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA; Center for Motor Neuron Biology and Disease, Columbia University, New York, NY, 10032, USA
| | - Madeleine Strait
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA; Center for Motor Neuron Biology and Disease, Columbia University, New York, NY, 10032, USA
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Maxine Coady
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; Master in Public Health Program, Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Maria Talayero
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Kai Wilmsen
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; Master in Public Health Program, Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Helene Chesnais
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA
| | - Olgica Balac
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Ronald A Glabonjat
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Vesna Slavkovich
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Beizhan Yan
- NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA; Lamont-Doherty Earth Observatory, Geochemistry Department, 203 Comer, 61 Route 9W - PO Box 1000, Palisades, NY, 10964-8000, USA
| | - Joseph Graziano
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA
| | - Norman J Kleiman
- Department of Environmental Health Sciences, Columbia University, New York, NY, 10032, USA; NIEHS Center for Environmental Health in Northern Manhattan, Columbia University, New York, NY, 10032, USA.
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Ali HA, Alarabi AB, Karim ZA, Rodriguez V, Hernandez KR, Lozano PA, El-Halawany MS, Alshbool FZ, Khasawneh FT. In utero thirdhand smoke exposure modulates platelet function in a sex-dependent manner. Haematologica 2021; 107:312-315. [PMID: 34525795 PMCID: PMC8719073 DOI: 10.3324/haematol.2021.279388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Hamdy A Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy Texas A/M University, Kingsville, TX
| | - Ahmed B Alarabi
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A/M University, Kingsville, TX
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El- Paso, El Paso, TX
| | - Victor Rodriguez
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El- Paso, El Paso, TX
| | - Keziah R Hernandez
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas at El- Paso, El Paso, TX
| | - Patricia A Lozano
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A/M University, Kingsville, TX
| | - Medhat S El-Halawany
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy Texas A/M University, Kingsville, TX
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel College of Pharmacy Texas A/M University, Kingsville, TX
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy Texas A/M University, Kingsville, TX.
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Bonner E, Chang Y, Christie E, Colvin V, Cunningham B, Elson D, Ghetu C, Huizenga J, Hutton SJ, Kolluri SK, Maggio S, Moran I, Parker B, Rericha Y, Rivera BN, Samon S, Schwichtenberg T, Shankar P, Simonich MT, Wilson LB, Tanguay RL. The chemistry and toxicology of vaping. Pharmacol Ther 2021; 225:107837. [PMID: 33753133 PMCID: PMC8263470 DOI: 10.1016/j.pharmthera.2021.107837] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/19/2021] [Accepted: 03/01/2021] [Indexed: 12/20/2022]
Abstract
Vaping is the process of inhaling and exhaling an aerosol produced by an e-cigarette, vape pen, or personal aerosolizer. When the device contains nicotine, the Food and Drug Administration (FDA) lists the product as an electronic nicotine delivery system or ENDS device. Similar electronic devices can be used to vape cannabis extracts. Over the past decade, the vaping market has increased exponentially, raising health concerns over the number of people exposed and a nationwide outbreak of cases of severe, sometimes fatal, lung dysfunction that arose suddenly in otherwise healthy individuals. In this review, we discuss the various vaping technologies, which are remarkably diverse, and summarize the use prevalence in the U.S. over time by youths and adults. We examine the complex chemistry of vape carrier solvents, flavoring chemicals, and transformation products. We review the health effects from epidemiological and laboratory studies and, finally, discuss the proposed mechanisms underlying some of these health effects. We conclude that since much of the research in this area is recent and vaping technologies are dynamic, our understanding of the health effects is insufficient. With the rapid growth of ENDS use, consumers and regulatory bodies need a better understanding of constituent-dependent toxicity to guide product use and regulatory decisions.
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Affiliation(s)
- Emily Bonner
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Yvonne Chang
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Emerson Christie
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Victoria Colvin
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Brittany Cunningham
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Daniel Elson
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Christine Ghetu
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Juliana Huizenga
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Sara J Hutton
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Siva K Kolluri
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Stephanie Maggio
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Ian Moran
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Bethany Parker
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Yvonne Rericha
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Brianna N Rivera
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Samantha Samon
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Trever Schwichtenberg
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Prarthana Shankar
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Michael T Simonich
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Lindsay B Wilson
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA
| | - Robyn L Tanguay
- Department of Environmental and Molecular Toxicology, Sinnhuber Aquatic Research Laboratory, Environmental Health Sciences Center, Oregon State University, Corvallis, OR, USA.
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40
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Benowitz NL, St.Helen G, Liakoni E. Clinical Pharmacology of Electronic Nicotine Delivery Systems (ENDS): Implications for Benefits and Risks in the Promotion of the Combusted Tobacco Endgame. J Clin Pharmacol 2021; 61 Suppl 2:S18-S36. [PMID: 34396553 PMCID: PMC9239851 DOI: 10.1002/jcph.1915] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/22/2021] [Indexed: 11/11/2022]
Abstract
Electronic nicotine delivery systems (ENDS) such as e-cigarettes and heated tobacco products are novel battery-operated devices that deliver nicotine without combustion of tobacco. Because cigarette smoking is sustained by nicotine addiction and the toxic combustion products are mainly responsible for the harmful effects of smoking, ENDS could be used to promote smoking cessation while exposing users to lower levels of toxicants compared with conventional cigarettes. The currently available evidence from clinical and observational studies indicates a potential role of e-cigarettes as smoking cessation aids, although many continue to use e-cigarettes long after quitting smoking. Nicotine and toxicant delivery vary considerably by device and depend on the characteristics of the e-liquid formulation. Because smokers tend to titrate their nicotine intake to maintain their desired pharmacologic effects, device and liquid characteristics need to be considered when using ENDS as an aid to quit smoking. Factors potentially limiting their use are the currently still unknown long-term safety of these products and concerns regarding widespread use among youth. Implications of clinical pharmacology data on ENDS for the cigarette endgame and regulation by the U.S. Food and Drug administration are discussed.
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Affiliation(s)
- Neal L. Benowitz
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, University of California, San Francisco
- Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Gideon St.Helen
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, University of California, San Francisco
- Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Evangelia Liakoni
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland
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41
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Flores RJ, Alshbool FZ, Giner P, O'Dell LE, Mendez IA. Exposure to nicotine vapor produced by an electronic nicotine delivery system causes short-term increases in impulsive choice in adult male rats. Nicotine Tob Res 2021; 24:358-365. [PMID: 34232312 DOI: 10.1093/ntr/ntab141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/05/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Traditional cigarette use influences cost-benefit decision making by promoting impulsive choice. However, the impact of exposure via electronic nicotine delivery systems on impulsive choice remains unclear. Hence, the present study examined the short- and long-term effects of nicotine vapor on impulsive choice. METHODS Twenty-four adult male rats were trained in the delay discounting task, to choose between small, immediate food rewards or large, delayed food rewards. After 24 days of training in the task, rats were exposed to vapor containing either 0, 12, or 24 mg/mL of nicotine, for ten days. To validate inhalation of nicotine vapor, serum cotinine levels were analyzed on exposure days 1, 5, and 10 using enzyme-linked immunosorbent assay (ELISA). Following vapor exposure, rats were retrained in the discounting task until rats displayed stable responding, and the effects of nicotine vapor on choice preference were assessed. RESULTS Rats exposed to 12 and 24 mg/mL nicotine vapor displayed higher serum cotinine levels than control rats exposed to 0 mg/mL vapor. There were no differences in impulsive choice between any vapor exposure groups when tested 15 days after exposure, across 6 days of stable responding, suggesting that nicotine vapor does not have long lasting effects on impulsive choice. Interestingly, a subsequent nicotine vapor challenge revealed short-term increases in impulsive choice immediately following a single exposure to 24 mg/mL nicotine vapor, relative to choice preference immediately following exposure to 0 mg/mL vapor. CONCLUSIONS These results suggest that exposure to nicotine vapor causes immediate, short-term increases in impulsive choice. IMPLICATIONS E-cigarette use is increasing at an alarming rate, particularly among adolescents and young adults. This is concerning given the lack of research into the effects of nicotine vapor exposure on the brain and behavior. The present study describes a viable rodent model of human e-cigarette use and suggest that exposure to nicotine vapor produces short-term increases in impulsive choice.
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Affiliation(s)
- Rodolfo J Flores
- The University of Texas at El Paso, Department of Psychology, El Paso, Texas, USA
| | - Fatima Z Alshbool
- Texas A&M University, Irma Lerma Rangel College of Pharmacy, Department of Pharmacy Practice, Kingsville, Texas, USA
| | - Priscilla Giner
- The University of Texas at El Paso, School of Pharmacy, Department of Pharmaceutical Sciences, El Paso, Texas, USA
| | - Laura E O'Dell
- The University of Texas at El Paso, Department of Psychology, El Paso, Texas, USA
| | - Ian A Mendez
- The University of Texas at El Paso, School of Pharmacy, Department of Pharmaceutical Sciences, El Paso, Texas, USA
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42
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Burrage EN, Aboaziza E, Hare L, Reppert S, Moore J, Goldsmith WT, Kelley EE, Mills A, Dakhlallah D, Chantler PD, Olfert IM. Long-term cerebrovascular dysfunction in the offspring from maternal electronic cigarette use during pregnancy. Am J Physiol Heart Circ Physiol 2021; 321:H339-H352. [PMID: 34170194 DOI: 10.1152/ajpheart.00206.2021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Electronic cigarettes (E-cigs) have been promoted as harm-free or less risky than smoking, even for women during pregnancy. These claims are made largely on E-cig aerosol having fewer number of toxic chemicals compared with cigarette smoke. Given that even low levels of smoking are found to produce adverse birth outcomes, we sought to test the hypothesis that vaping during pregnancy (with or without nicotine) would not be harm-free and would result in vascular dysfunction that would be evident in offspring during adolescent and/or adult life. Pregnant female Sprague Dawley rats were exposed to E-cig aerosol (1 h/day, 5 days/wk, starting on gestational day 2 until pups were weaned) using e-liquid with 0 mg/mL (E-cig0) or 18 mg/mL nicotine (E-cig18) and compared with ambient air-exposed controls. Body mass at birth and at weaning were not different between groups. Assessment of middle cerebral artery (MCA) reactivity revealed a 51%-56% reduction in endothelial-dependent dilation response to acetylcholine (ACh) for both E-cig0 and E-cig18 in 1-mo, 3-mo (adolescent), and 7-mo-old (adult) offspring (P < 0.05 compared with air, all time points). MCA responses to sodium nitroprusside (SNP) and myogenic tone were not different across groups, suggesting that endothelial-independent responses were not altered. The MCA vasoconstrictor response (5-hydroxytryptamine, 5-HT) was also not different across treatment and age groups. These data demonstrate that maternal vaping during pregnancy is not harm-free and confers significant cerebrovascular health risk/dysfunction to offspring that persists into adult life. NEW & NOTEWORTHY These data established that vaping electronic cigarettes during pregnancy, with or without nicotine, is not safe and confers significant risk potential to the cerebrovascular health of offspring in early and adult life. A key finding is that vaping without nicotine does not protect offspring from cerebrovascular dysfunction and results in the same level of cerebrovascular dysfunction (compared with maternal vaping with nicotine), indicating that the physical and/or chemical properties from the base solution (other than nicotine) are responsible for the cerebrovascular dysfunction that we observed. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/maternal-vaping-impairs-vascular-function-in-theoffspring/.
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Affiliation(s)
- E N Burrage
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Department of Neuroscience, West Virginia University, Morgantown, West Virginia
| | - E Aboaziza
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, West Virginia
| | - L Hare
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia
| | - S Reppert
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia
| | - J Moore
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia
| | - W T Goldsmith
- Center for Inhalation Toxicology, West Virginia University, Morgantown, West Virginia.,Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - E E Kelley
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - A Mills
- Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
| | - D Dakhlallah
- Department of Microbiology, Immunology and Cell Biology, West Virginia University, Morgantown, West Virginia
| | - P D Chantler
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,Department of Neuroscience, West Virginia University, Morgantown, West Virginia.,West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia
| | - I M Olfert
- West Virginia University School of Medicine, West Virginia University, Morgantown, West Virginia.,West Virginia Clinical and Translational Science Institute, West Virginia University, Morgantown, West Virginia.,Division of Exercise Physiology, West Virginia University, Morgantown, West Virginia.,Center for Inhalation Toxicology, West Virginia University, Morgantown, West Virginia.,Department of Physiology and Pharmacology, West Virginia University, Morgantown, West Virginia
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43
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McClelland ML, Sesoko CS, MacDonald DA, Davis LM, McClelland SC. The Immediate Physiological Effects of E-Cigarette Use and Exposure to Secondhand E-Cigarette Vapor. Respir Care 2021; 66:943-950. [PMID: 33785550 PMCID: PMC10027181 DOI: 10.4187/respcare.08596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Vaping continues to grow as an alternative to smoking and as a recreational activity for people of all ages, including minors. The billion-dollar industry offers users a plethora of flavors, nicotine concentrations, e-juice combinations, and devices. While some studies suggest vaping is beneficial for certain ailments and as a smoking cessation tool, many studies report concerning health outcomes associated with vape use. Recent FDA regulations have banned certain vaping products following an increase of vaping-related lung injuries reported in 2019. Health care providers need to better understand the physiological effects of vaping-specific products and the impact of secondhand vapor. The specific aims of the present study were to understand the immediate effects on heart rate, breathing frequency, blood pressure, blood sugar, [Formula: see text], pulmonary function, and oral temperature following e-cigarette use and secondhand vapor exposure. METHODS A total of 149 volunteers participated in this study; 76 subjects vaped mint-flavored e-cigarettes with 5% nicotine for 20 min while seated next to 73 nonvaping subjects who agreed to be exposed to the vapor. Health variables including heart rate, blood pressure, breathing frequency, blood glucose, FVC, [Formula: see text], and oral temperature were obtained prior to vaping or exposure to vapor and again after 20 min. RESULTS Subjects who vaped had significantly higher heart rate, breathing frequency, and oral temperature, and significantly lower blood oxygenation levels (ie, [Formula: see text]) after vaping for 20 min. Nonvaping subjects exposed to vapor had significantly higher oral temperature after 20 min of exposure. Blood sugar and FVC were not significantly affected by vaping or exposure to vapor. CONCLUSIONS Vaping with mint-flavored e-cigarettes with 5% nicotine for 20 min resulted in significant immediate physiological changes. Exposure to e-cigarette vapor significantly increased oral temperature within the same amount of time.
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Affiliation(s)
| | - Channing S Sesoko
- College of Liberal Arts and Education, University of Detroit Mercy, Detroit, Michigan
| | - Douglas A MacDonald
- College of Liberal Arts and Education, University of Detroit Mercy, Detroit, Michigan
| | - Louis M Davis
- College of Liberal Arts and Education, University of Detroit Mercy, Detroit, Michigan
| | - Steven C McClelland
- College of Health Professions, University of Detroit Mercy, Detroit, Michigan.
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44
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Kuntic M, Oelze M, Steven S, Kröller-Schön S, Stamm P, Kalinovic S, Frenis K, Vujacic-Mirski K, Bayo Jimenez MT, Kvandova M, Filippou K, Al Zuabi A, Brückl V, Hahad O, Daub S, Varveri F, Gori T, Huesmann R, Hoffmann T, Schmidt FP, Keaney JF, Daiber A, Münzel T. Short-term e-cigarette vapour exposure causes vascular oxidative stress and dysfunction: evidence for a close connection to brain damage and a key role of the phagocytic NADPH oxidase (NOX-2). Eur Heart J 2021; 41:2472-2483. [PMID: 31715629 PMCID: PMC7340357 DOI: 10.1093/eurheartj/ehz772] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/12/2019] [Accepted: 10/19/2019] [Indexed: 12/19/2022] Open
Abstract
AIMS Electronic (e)-cigarettes have been marketed as a 'healthy' alternative to traditional combustible cigarettes and as an effective method of smoking cessation. There are, however, a paucity of data to support these claims. In fact, e-cigarettes are implicated in endothelial dysfunction and oxidative stress in the vasculature and the lungs. The mechanisms underlying these side effects remain unclear. Here, we investigated the effects of e-cigarette vapour on vascular function in smokers and experimental animals to determine the underlying mechanisms. METHODS AND RESULTS Acute e-cigarette smoking produced a marked impairment of endothelial function in chronic smokers determined by flow-mediated dilation. In mice, e-cigarette vapour without nicotine had more detrimental effects on endothelial function, markers of oxidative stress, inflammation, and lipid peroxidation than vapour containing nicotine. These effects of e-cigarette vapour were largely absent in mice lacking phagocytic NADPH oxidase (NOX-2) or upon treatment with the endothelin receptor blocker macitentan or the FOXO3 activator bepridil. We also established that the e-cigarette product acrolein, a reactive aldehyde, recapitulated many of the NOX-2-dependent effects of e-cigarette vapour using in vitro blood vessel incubation. CONCLUSIONS E-cigarette vapour exposure increases vascular, cerebral, and pulmonary oxidative stress via a NOX-2-dependent mechanism. Our study identifies the toxic aldehyde acrolein as a key mediator of the observed adverse vascular consequences. Thus, e-cigarettes have the potential to induce marked adverse cardiovascular, pulmonary, and cerebrovascular consequences. Since e-cigarette use is increasing, particularly amongst youth, our data suggest that aggressive steps are warranted to limit their health risks.
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Affiliation(s)
- Marin Kuntic
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Matthias Oelze
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Sebastian Steven
- Center for Cardiology, University Medical Center, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center, Mainz, German
| | | | - Paul Stamm
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Sanela Kalinovic
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Katie Frenis
- Center for Cardiology, University Medical Center, Mainz, Germany
| | | | | | | | | | - Ahmad Al Zuabi
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Vivienne Brückl
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Omar Hahad
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Steffen Daub
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Franco Varveri
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - Tommaso Gori
- Center for Cardiology, University Medical Center, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main
| | - Regina Huesmann
- Institute for Inorganic and Analytical Chemistry, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thorsten Hoffmann
- Institute for Inorganic and Analytical Chemistry, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Frank P Schmidt
- Center for Cardiology, University Medical Center, Mainz, Germany
| | - John F Keaney
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Andreas Daiber
- Center for Cardiology, University Medical Center, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main
| | - Thomas Münzel
- Center for Cardiology, University Medical Center, Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center, Mainz, German.,German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main
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45
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Harada HA, Liu J, Shortell JD, Beesley SJ. A 20-Year-Old Man with e-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and Thrombotic Coagulopathy. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929915. [PMID: 33854029 PMCID: PMC8056776 DOI: 10.12659/ajcr.929915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND In 2019, the US Centers for Disease Control and Prevention (CDC) described the criteria for the diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI), which may be caused by contamination of delta-9-tetrahydrocannabinoid (THC) e-liquids with vitamin E acetate. This report describes a case of a 20-year-old man with a history of recreational drug use that included vaping, who presented with EVALI and a coagulopathy associated with thrombotic events. CASE REPORT We present a 20-year-old patient who worked at a cannabidiol (CBD) manufacturing facility with a history of e-cigarette use and polysubstance abuse in remission who presented with respiratory and gastrointestinal symptoms accompanied by 50-pound weight loss over 6 months. The patient had been vaping with nicotine and THC-containing e-cigarettes multiple times per day for 1.5 years. He met the CDC surveillance criteria for EVALI, consisting of respiratory symptoms and infiltrates on imaging within 90 days of vaping, and was found to have eosinophilic pneumonia secondary to THC-containing e-cigarette use. Additionally, thrombi were detected in the pulmonary arteries, right saphenous vein, and right ventricle. A segmental infarct was noted in the inferior pole of the left kidney. CONCLUSIONS We present the second case report potentially linking e-cigarette use with clinically significant thrombogenesis, the first with both arterial and venous thromboses. This report demonstrates the importance of taking a history of e-cigarette use in patients presenting with lung injury. Although EVALI and the diagnostic criteria have only recently been described, systemic effects, including coagulopathy, are now being reported.
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Affiliation(s)
- Holly A Harada
- Department of Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Jeremy Liu
- Department of Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
| | - Justin D Shortell
- Department of Medicine, Intermountain Medical Center, Murray, UT, USA
| | - Sarah J Beesley
- Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT, USA.,Pulmonary Division, University of Utah School of Medicine, Salt Lake City, UT, USA
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46
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Yan B, Zagorevski D, Ilievski V, Kleiman NJ, Re DB, Navas-Acien A, Hilpert M. Identification of newly formed toxic chemicals in E-cigarette aerosols with Orbitrap mass spectrometry and implications on E-cigarette control. EUROPEAN JOURNAL OF MASS SPECTROMETRY (CHICHESTER, ENGLAND) 2021; 27:141-148. [PMID: 34448631 PMCID: PMC9035225 DOI: 10.1177/14690667211040207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The increasing use of electronic nicotine delivery systems (ENDS) is of concern due to multiple emerging adverse health effects. Most analyses of the harmful chemicals of ENDS have targeted metals or carbonyls generated by thermal decomposition of carrier liquids such as propylene glycol. However, new complex compounds not routinely identified and with unknown health consequences could be formed. ENDS aerosol samples were collected by the direct aerosol droplet deposition method. Untargeted analysis was performed using Orbitrap mass spectrometry with high mass accuracy. We identified more than 30 "features" in the aerosol characterized by pairs of the mass-to-charge ratio "m/z" of the compound and the retention time. We identified several compounds containing nicotine and propylene glycol (NIC-PG), whose abundance relative to nicotine increased along with vaping power used. On the basis of the prediction by the Environmental Protection Agency Toxicity Estimation Software Tool, these compounds exert developmental toxicity. In addition, a nitrogen-containing compound, likely tributylamine (a known lung irritant), was identified based on the molecular weight. This compound has not been previously identified in ENDS e-liquids and aerosols. ENDS produce not only small toxic compounds such as aldehydes, but also large complex toxic compounds such as NIC-PG. Predicted development toxicity for NIC-PG is concerning for fetal development in pregnant women who use ENDS, children exposed to secondhand or thirdhand ENDS aerosols, and teenage ENDS users whose brains are still developing. The strong positive association between NIC-PG levels and ENDS power output supports regulating high-powered ENDS.
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Affiliation(s)
- Beizhan Yan
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, NY, 10964, USA
| | - Dimitri Zagorevski
- Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy NY, 12180, USA
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Norman J. Kleiman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Diane B. Re
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Markus Hilpert
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
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47
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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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48
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Tarran R, Barr RG, Benowitz NL, Bhatnagar A, Chu HW, Dalton P, Doerschuk CM, Drummond MB, Gold DR, Goniewicz ML, Gross ER, Hansel NN, Hopke PK, Kloner RA, Mikheev VB, Neczypor EW, Pinkerton KE, Postow L, Rahman I, Samet JM, Salathe M, Stoney CM, Tsao PS, Widome R, Xia T, Xiao D, Wold LE. E-Cigarettes and Cardiopulmonary Health. FUNCTION 2021; 2:zqab004. [PMID: 33748758 PMCID: PMC7948134 DOI: 10.1093/function/zqab004] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 01/06/2023] Open
Abstract
E-cigarettes have surged in popularity over the last few years, particularly among youth and young adults. These battery-powered devices aerosolize e-liquids, comprised of propylene glycol and vegetable glycerin, typically with nicotine, flavors, and stabilizers/humectants. Although the use of combustible cigarettes is associated with several adverse health effects including multiple pulmonary and cardiovascular diseases, the effects of e-cigarettes on both short- and long-term health have only begun to be investigated. Given the recent increase in the popularity of e-cigarettes, there is an urgent need for studies to address their potential adverse health effects, particularly as many researchers have suggested that e-cigarettes may pose less of a health risk than traditional combustible cigarettes and should be used as nicotine replacements. This report is prepared for clinicians, researchers, and other health care providers to provide the current state of knowledge on how e-cigarette use might affect cardiopulmonary health, along with research gaps to be addressed in future studies.
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Affiliation(s)
- Robert Tarran
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
| | - R Graham Barr
- Department of Medicine, Columbia University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Neal L Benowitz
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Aruni Bhatnagar
- Department of Medicine, American Heart Association Tobacco Regulation Center University of Louisville, Louisville, KY, USA
| | - Hong W Chu
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Pamela Dalton
- Monell Chemical Senses Center, Philadelphia, PA, USA
| | - Claire M Doerschuk
- Department of Medicine, Marsico Lung Institute, University of North Carolina, Chapel Hill, NC, USA
| | - M Bradley Drummond
- Department of Medicine, Marsico Lung Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health and the Channing Division of Network Medicine, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Eric R Gross
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA
| | - Nadia N Hansel
- Division of Pulmonary & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Robert A Kloner
- Huntington Medical Research Institutes, Pasadena, CA, USA
- Department of Medicine, Cardiovascular Division, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Vladimir B Mikheev
- Individual and Population Health, Battelle Memorial Institute, Columbus, OH, USA
| | - Evan W Neczypor
- Biomedical Science Program, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Kent E Pinkerton
- Center for Health and the Environment, University of California, Davis, CA, USA
| | - Lisa Postow
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Matthias Salathe
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Catherine M Stoney
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Philip S Tsao
- Division of Cardiovascular Medicine, VA Palo Alto Health Care System, Stanford University School of Medicine, Stanford, CA, USA
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Tian Xia
- Department of Medicine, University of California, Los Angeles, CA, USA
| | - DaLiao Xiao
- Department of Basic Sciences, Lawrence D Longo, MD Center for Perinatal Biology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Loren E Wold
- Dorothy M. Davis Heart and Lung Research Institute, Colleges of Medicine and Nursing, The Ohio State University, Columbus, OH, USA
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49
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Priemer DS, Gravenmier C, Batouli A, Hooper JE. Overview of Pathologic Findings of Vaping in the Context of an Autopsy Patient With Chronic Injury. Arch Pathol Lab Med 2020; 144:1408-1413. [PMID: 32383974 DOI: 10.5858/arpa.2019-0637-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Electronic cigarettes are handheld devices that heat an inner liquid containing chemicals to be aerosolized and inhaled, and have become a popular alternative to conventional cigarettes. Their use, termed vaping, has been linked to severe injury, with 2711 cases of associated lung injury and 60 deaths reported to the Centers for Disease Control and Prevention at the time of writing. Published case reports and series have emerged detailing clinical and imaging characteristics of vaping-induced lung injury. However, the pathologic characteristics of these induced injuries are still being established, particularly findings occurring over time. OBJECTIVE.— To illustrate the autopsy findings of an older patient who died of vaping-induced injury after prolonged symptomology and to provide a review of the most recent literature regarding the basic science, epidemiology, clinical presentation, imaging characteristics, and pathology of vaping-induced lung injury. DATA SOURCES.— Autopsy case and peer-reviewed literature. CONCLUSIONS.— Vaping-induced lung injury has emerged as a public health issue, and this case represents a rare opportunity to evaluate this issue at autopsy. Most commonly, the injury has been attributed to tetrahydrocannabinol product use as opposed to nicotine. This case demonstrates that as today's young and relatively healthy "vapers" grow older and develop the comorbidities that come with advanced age, there is serious risk of chronic lung damage from vaping that could result in death. Further observations and studies, particularly autopsy evidence, are clearly important to understand the possible outcomes.
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Affiliation(s)
- David S Priemer
- From the Department of Pathology (Priemer, Gravenmier, Hooper), Johns Hopkins University, Baltimore, Maryland
| | - Curtis Gravenmier
- From the Department of Pathology (Priemer, Gravenmier, Hooper), Johns Hopkins University, Baltimore, Maryland
| | - Amir Batouli
- the Department of Radiology (Batouli), Johns Hopkins University, Baltimore, Maryland
| | - Jody E Hooper
- From the Department of Pathology (Priemer, Gravenmier, Hooper), Johns Hopkins University, Baltimore, Maryland
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50
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Kaur G, Gaurav A, Lamb T, Perkins M, Muthumalage T, Rahman I. Current Perspectives on Characteristics, Compositions, and Toxicological Effects of E-Cigarettes Containing Tobacco and Menthol/Mint Flavors. Front Physiol 2020; 11:613948. [PMID: 33329065 PMCID: PMC7710937 DOI: 10.3389/fphys.2020.613948] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/23/2020] [Indexed: 11/13/2022] Open
Abstract
Electronic nicotine delivery systems/devices (ENDS) such as electronic cigarettes (e-cigarettes) have been made available globally, with the intent to reduce tobacco smoking. To make these products more appealing to young adults, many brands have added flavoring agents. However, these flavoring agents are shown to progressively result in lung toxicity when inhaled via e-cigarettes. While recent federal regulations have banned the sale of flavored e-cigarettes other than tobacco or menthol flavors, concerns have been raised about the health effects of even these flavors. In this review, we evaluate the current toxicological data with regard to effects upon exposure in animal models and in vitro cell culture for these popular flavorants. We have tabulated the current e-cigarette products containing these most common flavors (menthol, mint, and tobacco) in the market. We have also indicated the prevalence of tobacco and menthol-flavor use among e-cigarette users and highlighted the possible challenges and benefits that will result from new federal regulations.
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Affiliation(s)
- Gurjot Kaur
- School of Pharmaceutical Sciences, Shoolini University, Solan, India
| | - Anshuman Gaurav
- School of Pharmaceutical Sciences, Shoolini University, Solan, India
| | - Thomas Lamb
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Melanie Perkins
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Thivanka Muthumalage
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
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