1
|
Bowsher R, Marczylo TH, Gooch K, Bailey A, Wright MD, Marczylo EL. Smoking and vaping alter genes related to mechanisms of SARS-CoV-2 susceptibility and severity: a systematic review and meta-analysis. Eur Respir J 2024; 64:2400133. [PMID: 38991709 PMCID: PMC11269771 DOI: 10.1183/13993003.00133-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/23/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Evidence for the impact of smoking on coronavirus disease 2019 (COVID-19) is contradictory, and there is little research on vaping. Here we provide greater clarity on mechanisms perturbed by tobacco cigarette, electronic cigarette and nicotine exposures that may impact the risks of infection and/or disease severity. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the Ovid and Web of Science databases were searched. Study design and exposure-induced gene expression changes were extracted. Each study was quality assessed and higher confidence scores were assigned to genes consistently changed across multiple studies following the same exposure. These genes were used to explore pathways significantly altered following exposure. RESULTS 125 studies provided data on 480 genes altered by exposure to tobacco cigarettes, e-cigarettes, nicotine or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Genes involved in both SARS-CoV-2 viral-entry and inflammation were changed following exposure. Pathway analysis revealed that many of those genes with high confidence scores are involved in common cellular processes relating to hyperinflammatory immune responses. CONCLUSION Exposure to tobacco cigarettes, e-cigarettes or nicotine may therefore impact initial host-pathogen interactions and disease severity. Smokers and vapers of e-cigarettes with nicotine could potentially be at increased risk of SARS-CoV-2 infection, associated cytokine storm, and acute respiratory distress syndrome. However, further research is required, particularly on e-cigarettes, to determine the biological mechanisms involved in perturbation of viral-entry genes and host-pathogen interactions and subsequent responses within the respiratory tract. This will improve our physiological understanding of the impact of smoking and vaping on COVID-19, informing public health advice and providing improved guidance for management of SARS-CoV-2 and other respiratory viruses.
Collapse
Affiliation(s)
- Rachel Bowsher
- Toxicology Department, UK Health Security Agency, Chilton, UK
- Pharmacology Section, St George's University of London, London, UK
| | | | - Karen Gooch
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Salisbury, UK
| | - Alexis Bailey
- Pharmacology Section, St George's University of London, London, UK
| | | | - Emma L Marczylo
- Toxicology Department, UK Health Security Agency, Chilton, UK
| |
Collapse
|
2
|
Phandthong R, Wong M, Song A, Martinez T, Talbot P. Does vaping increase the likelihood of SARS-CoV-2 infection? Paradoxically yes and no. Am J Physiol Lung Cell Mol Physiol 2024; 326:L175-L189. [PMID: 38147795 PMCID: PMC11280677 DOI: 10.1152/ajplung.00300.2022] [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: 09/14/2022] [Revised: 10/30/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023] Open
Abstract
Data on the relationship between electronic cigarettes (ECs) and SARS-CoV-2 infection are limited and contradictory. Our objectives were to investigate the impact of EC aerosols on SARS-CoV-2 infection of human bronchial epithelial cells and identify the causative chemical(s). Fully differentiated human bronchial epithelial tissues (hBETs) were exposed at the air-liquid interface (ALI) to aerosols produced from JUUL "Virginia Tobacco" and BLU ECs, as well as nicotine, propylene glycol (PG), vegetable glycerin (VG), and benzoic acid, and infection was then evaluated with SARS-CoV-2 pseudoparticles. Pseudoparticle infection of hBETs increased with aerosols produced from PG/VG, PG/VG plus nicotine, or BLU ECs; however, JUUL EC aerosols did not increase infection compared with controls. Increased infection in PG/VG alone was due to enhanced endocytosis, whereas increased infection in PG/VG plus nicotine or in BLU ECs was caused by nicotine-induced elevation of the aerosol's pH, which correlated with increased transmembrane protease, serine 2 (TMPRSS2) activity. Notably, benzoic acid in JUUL aerosols mitigated the enhanced infection caused by PG/VG or nicotine, offering protection that lasted for at least 48 h after exposure. In conclusion, the study demonstrates that EC aerosols can impact susceptibility to SARS-CoV-2 infection depending on their specific ingredients. PG/VG alone or PG/VG plus nicotine enhanced infection through different mechanisms, whereas benzoic acid in JUUL aerosols mitigated the increased infection caused by certain ingredients. These findings highlight the complex relationship between ECs and SARS-CoV-2 susceptibility, emphasizing the importance of considering the specific aerosol ingredients when evaluating the potential effects of ECs on infection risk.NEW & NOTEWORTHY Data on the relationship between electronic cigarettes (ECs) and SARS-CoV-2 infection are limited and contradictory. We investigated the impact of EC aerosols and their ingredients on SARS-CoV-2 infection of human bronchial epithelial cells. Our data show that specific ingredients in EC aerosols impact the susceptibility to SARS-CoV-2 infection. Propylene glycol (PG)/vegetable glycerin (VG) alone or PG/VG plus nicotine enhanced infection through different mechanisms, whereas benzoic acid in JUUL aerosols mitigated the increased infection caused by these ingredients.
Collapse
Affiliation(s)
- Rattapol Phandthong
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Man Wong
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Ann Song
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Teresa Martinez
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Prue Talbot
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| |
Collapse
|
3
|
Warren KJ, Beck EM, Callahan SJ, Helms MN, Middleton E, Maddock S, Carr JR, Harris D, Blagev DP, Lanspa MJ, Brown SM, Paine R. Alveolar macrophages from EVALI patients and e-cigarette users: a story of shifting phenotype. Respir Res 2023; 24:162. [PMID: 37330506 PMCID: PMC10276465 DOI: 10.1186/s12931-023-02455-w] [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: 11/17/2022] [Accepted: 05/19/2023] [Indexed: 06/19/2023] Open
Abstract
Exposure to e-cigarette vapors alters important biologic processes including phagocytosis, lipid metabolism, and cytokine activity in the airways and alveolar spaces. Little is known about the biologic mechanisms underpinning the conversion to e-cigarette, or vaping, product use-associated lung injury (EVALI) from normal e-cigarette use in otherwise healthy individuals. We compared cell populations and inflammatory immune populations from bronchoalveolar lavage fluid in individuals with EVALI to e-cigarette users without respiratory disease and healthy controls and found that e-cigarette users with EVALI demonstrate a neutrophilic inflammation with alveolar macrophages skewed towards inflammatory (M1) phenotype and cytokine profile. Comparatively, e-cigarette users without EVALI demonstrate lower inflammatory cytokine production and express features associated with a reparative (M2) phenotype. These data indicate macrophage-specific changes are occurring in e-cigarette users who develop EVALI.
Collapse
Affiliation(s)
- Kristi J Warren
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA.
- George E. Wahlen VA Medical Center, 500 Foothill Dr, Salt Lake City, UT, 84148, USA.
| | - Emily M Beck
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA
- George E. Wahlen VA Medical Center, 500 Foothill Dr, Salt Lake City, UT, 84148, USA
| | - Sean J Callahan
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA
- George E. Wahlen VA Medical Center, 500 Foothill Dr, Salt Lake City, UT, 84148, USA
| | - My N Helms
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA
| | - Elizabeth Middleton
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA
| | - Sean Maddock
- George E. Wahlen VA Medical Center, 500 Foothill Dr, Salt Lake City, UT, 84148, USA
- Division of Pulmonary and Critical Care Medicine, National Jewish Health, Denver, CO, 80206, USA
| | - Jason R Carr
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA
- Intermountain Healthcare, Department of Pulmonary & Critical Care Medicine, Murray, UT, 84107, USA
| | - Dixie Harris
- Intermountain Healthcare, Department of Pulmonary & Critical Care Medicine, Murray, UT, 84107, USA
| | - Denitza P Blagev
- Intermountain Healthcare, Department of Pulmonary & Critical Care Medicine, Murray, UT, 84107, USA
| | - Michael J Lanspa
- Intermountain Healthcare, Department of Pulmonary & Critical Care Medicine, Murray, UT, 84107, USA
| | - Samuel M Brown
- Intermountain Healthcare, Department of Pulmonary & Critical Care Medicine, Murray, UT, 84107, USA
| | - Robert Paine
- Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Utah, Salt Lake City, UT, 84132, USA
- George E. Wahlen VA Medical Center, 500 Foothill Dr, Salt Lake City, UT, 84148, USA
| |
Collapse
|
4
|
Ali N, Xavier J, Engur M, Pv M, Bernardino de la Serna J. The impact of e-cigarette exposure on different organ systems: A review of recent evidence and future perspectives. JOURNAL OF HAZARDOUS MATERIALS 2023; 457:131828. [PMID: 37320902 DOI: 10.1016/j.jhazmat.2023.131828] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
The use of electronic cigarettes (e-cigs) is rapidly increasing worldwide and is promoted as a smoking cessation tool. The impact of traditional cigs on human health has been well-defined in both animal and human studies. In contrast, little is known about the adverse effects of e-cigs exposure on human health. This review summarizes the impact of e-cigs exposure on different organ systems based on the rapidly expanding recent evidence from experimental and human studies. A number of growing studies have shown the adverse effects of e-cigs exposure on various organ systems. The summarized data in this review indicate that while e-cigs use causes less adverse effects on different organs compared to traditional cigs, its long-term exposure may lead to serious health effects. Data on short-term organ effects are limited and there is no sufficient evidence on long-term organ effects. Moreover, the adverse effects of secondhand and third hand e-cigs vapour exposure have not been thoroughly investigated in previous studies. Although some studies demonstrated e-cigs used as a smoking cessation tool, there is a lack of strong evidence to support it. While some researchers suggested e-cigs as a safer alternative to tobacco smoking, their long-term exposure health effects remain largely unknown. Therefore, more epidemiological and prospective studies including mechanistic studies are needed to address the potential adverse health effects of e-cigs to draw a firm conclusion about their safe use. A wide variation in e-cigs products and the lack of standardized testing methods are the major barriers to evaluating the existing data. Specific regulatory guidelines for both e-cigs components and the manufacturing process may be effective to protect consumer health.
Collapse
Affiliation(s)
- Nurshad Ali
- National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, London SW7 2AZ, UK; Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh.
| | - Joseph Xavier
- National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, London SW7 2AZ, UK; Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India.
| | - Melih Engur
- National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, London SW7 2AZ, UK
| | - Mohanan Pv
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India.
| | | |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Saaoud F, Shao Y, Cornwell W, Wang H, Rogers TJ, Yang X. Cigarette Smoke Modulates Inflammation and Immunity via Reactive Oxygen Species-Regulated Trained Immunity and Trained Tolerance Mechanisms. Antioxid Redox Signal 2023; 38:1041-1069. [PMID: 36017612 PMCID: PMC10171958 DOI: 10.1089/ars.2022.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
Significance: Cigarette smoke (CS) is a prominent cause of morbidity and death and poses a serious challenge to the current health care system worldwide. Its multifaceted roles have led to cardiovascular, respiratory, immunological, and neoplastic diseases. Recent Advances: CS influences both innate and adaptive immunity and regulates immune responses by exacerbating pathogenic immunological responses and/or suppressing defense immunity. There is substantial evidence pointing toward a critical role of CS in vascular immunopathology, but a comprehensive and up-to-date review is lacking. Critical Issues: This review aims to synthesize novel conceptual advances on the immunomodulatory action of CS with a focus on the cardiovascular system from the following perspectives: (i) the signaling of danger-associated molecular pattern (DAMP) receptors contributes to CS modulation of inflammation and immunity; (ii) CS reprograms immunometabolism and trained immunity-related metabolic pathways in innate immune cells and T cells, which can be sensed by the cytoplasmic (cytosolic and non-nuclear organelles) reactive oxygen species (ROS) system in vascular cells; (iii) how nuclear ROS drive CS-promoted DNA damage and cell death pathways, thereby amplifying inflammation and immune responses; and (iv) CS induces endothelial cell (EC) dysfunction and vascular inflammation to promote cardiovascular diseases (CVDs). Future Directions: Despite significant progress in understanding the cellular and molecular mechanisms linking CS to immunity, further investigations are warranted to elucidate novel mechanisms responsible for CS-mediated immunopathology of CVDs; in particular, the research in redox regulation of immune functions of ECs and their fate affected by CS is still in its infancy.
Collapse
Affiliation(s)
- Fatma Saaoud
- Cardiovascular Research Center, Department of Cardiovascular Sciences, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ying Shao
- Cardiovascular Research Center, Department of Cardiovascular Sciences, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - William Cornwell
- Center for Inflammation and Lung Research, Department of Microbiology, Immunology & Inflammation, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Hong Wang
- Metabolic Disease Research and Thrombosis Research Centers, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Thomas J. Rogers
- Center for Inflammation and Lung Research, Department of Microbiology, Immunology & Inflammation, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Xiaofeng Yang
- Cardiovascular Research Center, Department of Cardiovascular Sciences, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
- Metabolic Disease Research and Thrombosis Research Centers, Department of Cardiovascular Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Maan M, Abuzayeda M, Kaklamanos EG, Jamal M, Dutta M, Moharamzadeh K. Molecular insights into the role of electronic cigarettes in oral carcinogenesis. Crit Rev Toxicol 2023; 53:1-14. [PMID: 37051806 DOI: 10.1080/10408444.2023.2190764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Electronic cigarette (EC) usage or vaping has seen a significant rise in recent years across various parts of the world. They have been publicized as a safe alternative to smoking; however, this is not supported strongly by robust research evidence. Toxicological analysis of EC liquid and aerosol has revealed presence of several toxicants with known carcinogenicity. Oral cavity is the primary site of exposure of both cigarette smoke and EC aerosol. Role of EC in oral cancer is not as well-researched as that of traditional smoking. However, several recent studies have shown that it can lead to a wide range of potentially carcinogenic molecular events in oral cells. This review delineates the oral carcinogenesis potential of ECs at the molecular level, providing a summary of the effects of EC usage on cancer therapy resistance, cancer stem cells (CSCs), immune evasion, and microbiome dysbiosis, all of which may lead to increased tumor malignancy and poorer patient prognosis. This review of literature indicates that ECs may not be as safe as they are perceived to be, however further research is needed to definitively determine their oncogenic potential.
Collapse
Affiliation(s)
- Meenu Maan
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
| | - Moosa Abuzayeda
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
- School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
- School of Dentistry, European University Cyprus, Nicosia, Cyprus
| | - Mohamed Jamal
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
| | - Mainak Dutta
- Department of Biotechnology, BITS Pilani, Dubai Campus, Academic City, Dubai, UAE
| | - Keyvan Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, UAE
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| |
Collapse
|
9
|
Phandthong R, Wong M, Song A, Martinez T, Talbot P. New insights into how popular electronic cigarette aerosols and aerosol constituents affect SARS-CoV-2 infection of human bronchial epithelial cells. Sci Rep 2023; 13:5807. [PMID: 37037851 PMCID: PMC10086046 DOI: 10.1038/s41598-023-31592-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/14/2023] [Indexed: 04/12/2023] Open
Abstract
The relationship between the use of tobacco products and SARS-CoV-2 infection is poorly understood and controversial. Few studies have examined the effect of electronic cigarettes (ECs) on SARS-CoV-2 infection. We tested the hypothesis that EC fluids and aerosols with nicotine promote SARS-COV-2 infection by increasing viral entry into human respiratory epithelial cells. Responses of BEAS-2B cells to JUUL aerosols or their individual constituents were compared using three exposure platforms: submerged culture, air-liquid-interface (ALI) exposure in a cloud chamber, and ALI exposure in a Cultex system, which produces authentic heated EC aerosols. In general, nicotine and nicotine + propylene glycol/vegetable glycerin aerosols increased ACE2 (angiotensin converting enzyme 2) levels, the SARS-CoV-2 receptor; and increased the activity of TMPRSS2 (transmembrane serine protease 2), an enzyme essential for viral entry. Lentivirus pseudoparticles with spike protein were used to test viral penetration. Exposure to nicotine, EC fluids, or aerosols altered the infection machinery and increased viral entry into cells. While most data were in good agreement across the three exposure platforms, cells were more responsive to treatments when exposed at the ALI in the Cultex system, even though the exposures were brief and intermittent. While both nicotine and JUUL aerosols increased SARS-CoV-2 infection, JUUL significantly decreased the effect of nicotine alone. These data support the idea that vaping can increase the likelihood of contracting COVID-19 and that e-liquid composition may modulate this effect.
Collapse
Affiliation(s)
- Rattapol Phandthong
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA, 92521, USA
| | - Man Wong
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA, 92521, USA
| | - Ann Song
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA, 92521, USA
| | - Teresa Martinez
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA, 92521, USA
| | - Prue Talbot
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA, 92521, USA.
| |
Collapse
|
10
|
Kelesidis T, Sharma M, Satta S, Tran E, Gupta R, Araujo JA, Middlekauff HR. Ectodomain shedding of proteins important for SARS-CoV-2 pathogenesis in plasma of tobacco cigarette smokers compared to electronic cigarette vapers: a cross-sectional study. J Mol Med (Berl) 2023; 101:327-335. [PMID: 36759357 PMCID: PMC9911331 DOI: 10.1007/s00109-023-02286-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/11/2023] [Accepted: 01/14/2023] [Indexed: 02/11/2023]
Abstract
The impact of tobacco cigarette (TCIG) smoking and electronic cigarette (ECIG) vaping on the risk of development of severe COVID-19 is controversial. The present study investigated levels of proteins important for SARS-CoV-2 pathogenesis present in plasma because of ectodomain shedding in smokers, ECIG vapers, and non-smokers (NSs). Protein levels of soluble angiotensin-converting enzyme 2 (ACE2), angiotensin (Ang) II (the ligand of ACE2), Ang 1-7 (the main peptide generated from Ang II by ACE2 activity), furin (a protease that increases the affinity of the SARS-CoV-2 spike protein for ACE2), and products of ADAM17 shedding activity that predict morbidity in COVID-19 (IL-6/IL-6R alpha (IL-6/IL-6Rα) complex, soluble CD163 (sCD163), L-selectin) were determined in plasma from 45 NSs, 30 ECIG vapers, and 29 TCIG smokers using ELISA. Baseline characteristics of study participants did not differ among groups. TCIG smokers had increased sCD163, L-selectin compared to NSs and ECIG vapers (p < 0.001 for all comparisons). ECIG vapers had higher plasma furin compared to both NSs (p < 0.001) and TCIG smokers (p < 0.05). ECIG vaping and TCIG smoking did not impact plasma ACE2, Ang 1-7, Ang II, and IL-6 levels compared to NSs (p > 0.1 for all comparisons). Further studies are needed to determine if increased furin activity and ADAM17 shedding activity that is associated with increased plasma levels of sCD163 and L-selectin in healthy young TCIG smokers may contribute to the future development of severe COVID-19 and cardiovascular complications of post-acute COVID-19 syndrome.
Collapse
Affiliation(s)
- Theodoros Kelesidis
- Department of Medicine, Division of Infectious Disease, David Geffen School of Medicine at UCLA, 47-100 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
| | - Madhav Sharma
- Department of Medicine, Division of Infectious Disease, David Geffen School of Medicine at UCLA, 47-100 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA
| | - Sandro Satta
- Department of Medicine, Division of Infectious Disease, David Geffen School of Medicine at UCLA, 47-100 CHS, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA
| | - Elizabeth Tran
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Rajat Gupta
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jesus A Araujo
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department of Environmental Health Sciences, Fielding School of Public Health at UCLA, Los Angeles, CA, USA
| | - Holly R Middlekauff
- Department of Medicine, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| |
Collapse
|
11
|
Been T, Alakhtar B, Traboulsi H, Tsering T, Bartolomucci A, Heimbach N, Paoli S, Burnier J, Mann KK, Eidelman DH, Baglole CJ. Chronic low-level JUUL aerosol exposure causes pulmonary immunologic, transcriptomic, and proteomic changes. FASEB J 2023; 37:e22732. [PMID: 36694994 DOI: 10.1096/fj.202201392r] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/18/2022] [Accepted: 12/14/2022] [Indexed: 01/26/2023]
Abstract
E-cigarettes currently divide public opinion, with some considering them a useful tool for smoking cessation and while others are concerned with potentially adverse health consequences. However, it may take decades to fully understand the effects of e-cigarette use in humans given their relative newness on the market. This highlights the need for comprehensive preclinical studies investigating the effects of e-cigarette exposure on health outcomes. Here, we investigated the impact of chronic, low-level JUUL aerosol exposure on multiple lung outcomes. JUUL is a brand of e-cigarettes popular with youth and young adults. To replicate human exposures, 8- to 12-week-old male and female C57BL/6J mice were exposed to commercially available JUUL products (containing 59 mg/ml nicotine). Mice were exposed to room air, PG/VG, or JUUL daily for 4 weeks. After the exposure period, inflammatory markers were assessed via qRT-PCR, multiplex cytokine assays, and differential cell count. Proteomic and transcriptomic analyses were also performed on samples isolated from the lavage of the lungs; this included unbiased analysis of proteins contained within extracellular vesicles (EVs). Mice exposed to JUUL aerosols for 4 weeks had significantly increased neutrophil and lymphocyte populations in the BAL and some changes in cytokine mRNA expression. However, BAL cytokines did not change. Proteomic and transcriptomic analysis revealed significant changes in numerous biological pathways including neutrophil degranulation, PPAR signaling, and xenobiotic metabolism. Thus, e-cigarettes are not inert and can cause significant cellular and molecular changes in the lungs.
Collapse
Affiliation(s)
- Terek Been
- Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Bayan Alakhtar
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Hussein Traboulsi
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Thupten Tsering
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - Alexandra Bartolomucci
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - Nicole Heimbach
- Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Sofia Paoli
- Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Julia Burnier
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - Koren K Mann
- Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada.,Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - David H Eidelman
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Carolyn J Baglole
- Department of Pharmacology & Therapeutics, McGill University, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.,Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada.,Department of Pathology, McGill University, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
12
|
Hamon R, Ween MP. E-Cigarette Vapour Increases ACE2 and TMPRSS2 Expression in a Flavour- and Nicotine-Dependent Manner. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14955. [PMID: 36429673 PMCID: PMC9691196 DOI: 10.3390/ijerph192214955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
COVID-19 infects via the respiratory system, but it can affect multiple systems and lead to multi system failure. There is growing evidence that smoking may be associated with higher rates of COVID-19 infections and worse outcomes due to increased levels of ACE2 in lung epithelial cells, but it is unknown whether E-cigarette use may lead to increased risk of COVID-19 infection from the SARS-CoV-2 virus. In this study, healthy donor bronchial epithelial cells (NHBE) and monocyte-derived macrophages (MDM) were exposed to cigarette smoke extract (CSE) or nicotine or flavoured E-cigarette vapour extract (EVE) before the assessment of SARS-CoV-2 recognition receptors ACE2 and TMPRSS2 genes. MDMs exposed to CSE and Tobacco EVE showed increased ACE2 expression; however, no treatment altered the TMPRSS2 expression. ACE2 was found to be upregulated by >2-fold in NHBE cells exposed to CSE, as well as nicotine, banana, or chocolate EVE, while TMPRSS2 was only upregulated by CSE or nicotine EVE exposure. These findings suggesting that flavourings can increase ACE2 expression in multiple cell types, while TMPRSS2 expression increases are limited to the epithelial cells in airways and may be limited to nicotine and/or cigarette smoke exposure. Therefore, increased risk of COVID-19 infection cannot be ruled out for vapers.
Collapse
Affiliation(s)
- Rhys Hamon
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide 5000, Australia
| | - Miranda P. Ween
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide 5000, Australia
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide 5000, Australia
| |
Collapse
|
13
|
Giovacchini CX, Crotty Alexander LE, Que LG. Electronic Cigarettes: A Pro-Con Review of the Current Literature. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2843-2851. [PMID: 35872217 DOI: 10.1016/j.jaip.2022.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 05/11/2023]
Abstract
Electronic cigarettes (e-cigarettes, e-cigs, or electronic nicotine delivery systems) are battery-operated devices typically containing glycerol and/or propylene glycol-based solutions with varying nicotine content, known as e-liquids. Although e-cigarettes were originally developed as a potentially less harmful alternative to traditional combustible tobacco cigarette smokers, several factors have driven their popularity among smokers and nonsmokers alike, including their sleek product designs, innumerable appealing flavors, lack of combustible smoke and odor, and high potential nicotine concentrations. Furthermore, many advocates have promoted the idea that e-cigarettes are safe to use, or at least safer than conventional tobacco, despite limited longitudinal data to support these claims. Here, we examine what is known about the impacts of e-cigarette use on traditional cigarette smoking cessation, lung health, and youth and young adult tobacco product exposure. Upon review of the currently available literature, the negative effects of e-cigarette use seem to outweigh any potential benefit, because the available evidence does not confirm the use of e-cigarettes as an effective strategy for supporting traditional combustible tobacco cigarette smoking cessation, particularly given the emerging adverse effects on lung health and the potential future public health effects of e-cigarette adoption among a burgeoning new generation of tobacco product users.
Collapse
Affiliation(s)
- Coral X Giovacchini
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC
| | - Laura E Crotty Alexander
- Pulmonary Critical Care Section, VA San Diego Healthcare System, San Diego, Calif; Division of Pulmonary, Critical Care, Sleep, and Physiology, University of California San Diego, San Diego, Calif.
| | - Loretta G Que
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC.
| |
Collapse
|
14
|
Phandthong R, Wong M, Song A, Martinez T, Talbot P. New Insights into How JUUL™ Electronic Cigarette Aerosols and Aerosol Constituents Affect SARS-CoV-2 Infection of Human Bronchial Epithelial Cells. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2022:2022.08.23.505031. [PMID: 36052374 PMCID: PMC9435402 DOI: 10.1101/2022.08.23.505031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Background The relationship between the use of tobacco products and SARS-CoV-2 infection is poorly understood and controversial. Most studies have been done with tobacco cigarettes, while few have examined the effect of electronic cigarettes (ECs) on SARS-CoV-2 infection. We tested the hypothesis that EC fluids and aerosols with high concentrations of nicotine promote SARS-COV-2 infection by increasing viral entry into human respiratory epithelial cells. Methods Responses of BEAS-2B cells to authentic JUUL™ aerosols or their individual constituents (propylene glycol (PG)/vegetable glycerin (VG) and nicotine) were compared using three exposure platforms: submerged culture, air-liquid-interface (ALI) exposure in a cloud chamber, and ALI exposure in a Cultex® system, which produces authentic heated EC aerosols. SARS-CoV-2 infection machinery was assessed using immunohistochemistry and Western blotting. Specifically, the levels of the SARS-CoV-2 receptor ACE2 (angiotensin converting enzyme 2) and a spike modifying enzyme, TMPRSS2 (transmembrane serine protease 2), were evaluated. Following each exposure, lentivirus pseudoparticles with spike protein and a green-fluorescent reporter were used to test viral penetration and the susceptibility of BEAS-2B cells to infection. Results Nicotine, EC fluids, and authentic JUUL™ aerosols increased both ACE2 levels and TMPRSS2 activity, which in turn increased viral particle entry into cells. While most data were in good agreement across the three exposure platforms, cells were more responsive to treatments when exposed at the ALI in the Cultex system, even though the exposures were brief and intermittent. In the Cultex system, PG/VG, PG/VG/nicotine, and JUUL™ aerosols significantly increased infection above clean air controls. However, both the PG/VG and JUUL™ treatments were significantly lower than nicotine/PG/VG. PG/VG increased infection only in the Cultex® system, which produces heated aerosol. Conclusion Our data are consistent with the conclusion that authentic JUUL™ aerosols or their individual constituents (nicotine or PG/VG) increase SARS-CoV-2 infection. The strong effect produced by nicotine was modulated in authentic JUUL aerosols, demonstrating the importance of studying mixtures and aerosols from actual EC products. These data support the idea that vaping increases the likelihood of contracting COVID-19.
Collapse
Affiliation(s)
- Rattapol Phandthong
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA 92521, USA
| | - Man Wong
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA 92521, USA
| | - Ann Song
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA 92521, USA
| | - Teresa Martinez
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA 92521, USA
| | - Prue Talbot
- Department of Molecular, Cell and System Biology, University of California, Riverside, CA 92521, USA
| |
Collapse
|
15
|
Labro G, Tubach F, Belin L, Dubost JL, Osman D, Muller G, Quenot JP, Da Silva D, Zarka J, Turpin M, Mayaux J, Lamer C, Doyen D, Chevrel G, Plantefeve G, Demeret S, Piton G, Manzon C, Ochin E, Gaillard R, Dautzenberg B, Baldacini M, Lebbah S, Miyara M, Pineton de Chambrun M, Amoura Z, Combes A. Nicotine patches in patients on mechanical ventilation for severe COVID-19: a randomized, double-blind, placebo-controlled, multicentre trial. Intensive Care Med 2022; 48:876-887. [PMID: 35676335 PMCID: PMC9177407 DOI: 10.1007/s00134-022-06721-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/27/2022] [Indexed: 01/08/2023]
Abstract
Purpose Epidemiologic studies have documented lower rates of active smokers compared to former or non-smokers in symptomatic patients affected by coronavirus disease 2019 (COVID-19). We assessed the efficacy and safety of nicotine administered by a transdermal patch in critically ill patients with COVID-19 pneumonia. Methods In this multicentre, double-blind, placebo-controlled trial conducted in 18 intensive care units in France, we randomly assigned adult patients (non-smokers, non-vapers or who had quit smoking/vaping for at least 12 months) with proven COVID-19 pneumonia receiving invasive mechanical ventilation for up to 72 h to receive transdermal patches containing either nicotine at a daily dose of 14 mg or placebo until 48 h following successful weaning from mechanical ventilation or for a maximum of 30 days, followed by 3-week dose tapering by 3.5 mg per week. Randomization was stratified by centre, non- or former smoker status and Sequential Organ Function Assessment score (< or ≥ 7). The primary outcome was day-28 mortality. Main prespecified secondary outcomes included 60-day mortality, time to successful extubation, days alive and free from mechanical ventilation, renal replacement therapy, vasopressor support or organ failure at day 28. Results Between November 6th 2020, and April 2nd 2021, 220 patients were randomized from 18 active recruiting centers. After excluding 2 patients who withdrew consent, 218 patients (152 [70%] men) were included in the analysis: 106 patients to the nicotine group and 112 to the placebo group. Day-28 mortality did not differ between the two groups (30 [28%] of 106 patients in the nicotine group vs 31 [28%] of 112 patients in the placebo group; odds ratio 1.03 [95% confidence interval, CI 0.57–1.87]; p = 0.46). The median number of day-28 ventilator-free days was 0 (IQR 0–14) in the nicotine group and 0 (0–13) in the placebo group (with a difference estimate between the medians of 0 [95% CI -3–7]). Adverse events likely related to nicotine were rare (3%) and similar between the two groups. Conclusion In patients having developed severe COVID-19 pneumonia requiring invasive mechanical ventilation, transdermal nicotine did not significantly reduce day-28 mortality. There is no indication to use nicotine in this situation. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-022-06721-1.
Collapse
Affiliation(s)
- Guylaine Labro
- Service de Médecine Intensive-Réanimation Groupement Hospitalier Régional Mulhouse Et Sud Alsace, Hôpital Emile Muller, 68100, Mulhouse, France
| | - Florence Tubach
- Département de Santé Publique, Unité de Recherche Clinique PSL-CFX, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1901, 75013, Paris, France
| | - Lisa Belin
- Département de Santé Publique, Unité de Recherche Clinique PSL-CFX, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1901, 75013, Paris, France
| | - Jean-Louis Dubost
- Centre Hospitalier René Dubos, 6, avenue de l'Ile de, 95303, Cergy-Pontoise, France
| | - David Osman
- CHU Bicêtre, 78 Rue du Général Leclerc, 94270, Le Kremlin-Bicêtre, France
| | - Grégoire Muller
- Service de Médecine Intensive Réanimation, Centre Hospitalier Régional d'Orléans, Orléans, France
| | - Jean-Pierre Quenot
- Department of Intensive Care, Burgundy University Hospital, Dijon, France.,Lipness Team, INSERM Research Center LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, France.,INSERM CIC 1432, Clinical Epidemiology, University of Burgundy, Dijon, France
| | - Daniel Da Silva
- Service de Médecine Intensive Réanimation du Centre, Hospitalier de Saint-Denis, Saint-Denis, France
| | - Jonathan Zarka
- Service de Réanimation Polyvalente, Grand Hôpital de L'Est Francilien, site de Marne-La-Vallée, Jossigny, France
| | - Matthieu Turpin
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive RéanimationHôpital Tenon, Sorbonne Université, Paris, France
| | - Julien Mayaux
- Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Médecine Intensive Et Réanimation (Département R3S), AP-HP, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Sorbonne Université, Paris, France
| | - Christian Lamer
- Service de RéanimationInstitut Mutualiste Montsouris, 42 Bd Jourdan, 75014, Paris, France
| | - Denis Doyen
- Médecine Intensive RéanimationHôpital L'Archet 1, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Guillaume Chevrel
- Service de Réanimation; Centre Hospitalier Sud Francilien (CHSF), 40 Avenue Serge Dassault, Corbeil-Essonne, France
| | - Gaétan Plantefeve
- Service de Médecine Intensive-Réanimation, Centre Hospitalier Victor Dupouy, 95107, Argenteuil, France
| | - Sophie Demeret
- Médecine Intensive Réanimation À Orientation Neurologique - Site Pitié Salpêtrière - Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Gaël Piton
- Service de Réanimation Médicale, CHRU de Besançon, Boulevard Fleming, Besançon, France
| | - Cyril Manzon
- Service de Réanimation, Médipole Lyon Villeurbanne. Service de Réanimation, 158 rue Léon Blum, 69100, Villeurbanne, France
| | - Evelina Ochin
- Service de Médecine Intensive-Réanimation Hôpital Simone Veil, Eaubonne, France
| | - Raphael Gaillard
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014, Paris, France.,Université de Paris, 75006, Paris, France
| | - Bertrand Dautzenberg
- Sorbonne Université APHP (La Pitié-Salpêtrière), 75013, Paris, France.,Tabacologue Institut Arthur Vernes, Paris, France
| | - Mathieu Baldacini
- Service de Médecine Intensive-Réanimation Groupement Hospitalier Régional Mulhouse Et Sud Alsace, Hôpital Emile Muller, 68100, Mulhouse, France
| | - Said Lebbah
- Département de Santé Publique, Unité de Recherche Clinique PSL-CFX, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1901, 75013, Paris, France
| | - Makoto Miyara
- Service de Médecine Interne 2, Institut E3M, CRMR Lupus. SAPL Et Autres Maladies Auto-Immunes, Hôpital Pitié Salpêtrière Et Université Paris 6, Paris, France
| | - Marc Pineton de Chambrun
- Service de Médecine Intensive-Réanimation, Institut de Cardiologie, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France.,INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne Université, 47, Boulevard de l'Hôpital, 75013, Paris, France
| | - Zahir Amoura
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, 75014, Paris, France
| | - Alain Combes
- Service de Médecine Intensive-Réanimation, Institut de Cardiologie, APHP Hôpital Pitié-Salpêtrière, 75013, Paris, France. .,INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, Sorbonne Université, 47, Boulevard de l'Hôpital, 75013, Paris, France.
| | | |
Collapse
|
16
|
E Culbreth R, J Brandenberger K, Battey-Muse CM, Gardenhire DS. 2021 Year in Review: E-Cigarettes, Hookah Use, and Vaping Lung Injuries During the COVID-19 Pandemic. Respir Care 2022; 67:709-714. [PMID: 35606003 PMCID: PMC9994204 DOI: 10.4187/respcare.09919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Electronic cigarettes (e-cigarettes) and hookah smoking have gained tremendous popularity over the past decade. With the constantly evolving e-cigarette market and potential impact of the COVID-19 pandemic on users of these tobacco products, research is needed to assess the prevalence and safety of these devices as well as potential public health implications and cessation tools. For this year in review, PubMed was searched from January 2021-December 14, 2021, for articles related to e-cigarettes, vaping-related lung injury, and hookah smoking. Relevant articles addressing the objectives were included in this review. This review focused primarily on articles based on United States populations. Gray literature and nonpublished articles were not included in this review. The 2020 pandemic resulted in a decline in e-cigarette usage among youth (potentially due to the COVID-19 pandemic); however, recent research in 2021 suggests that e-cigarette usage is increasing again among youth. Conflicting evidence exists for e-cigarettes and the risk of COVID-19 infection, but biological plausibility suggests that e-cigarette users are more susceptible to COVID-19 infection and more severe COVID-19 infection compared to non-e-cigarette users. Hookah smoking has remained stable across the past several years and remains a primarily social activity among youth. New e-cigarette devices are constantly emerging, resulting in an increased demand to understand the safety of these devices. Additionally, hookah smoking continues to be a concerning public health issue with the increase in hookah bars and venues coupled with lack of policy regulations for hookah smoking.
Collapse
Affiliation(s)
- Rachel E Culbreth
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia.
| | - Kyle J Brandenberger
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| | - Corinne M Battey-Muse
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| | - Douglas S Gardenhire
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| |
Collapse
|
17
|
Mittal A, Du A, Merz W, Myers MG, Crotty Alexander LE, Doran N. Impulsivity-Related Personality Traits as Predictors of E-Cigarette Use among Young Adults over Time. Subst Use Misuse 2022; 57:1007-1013. [PMID: 35382679 PMCID: PMC9214665 DOI: 10.1080/10826084.2022.2046101] [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: 10/18/2022]
Abstract
Introduction: There has been rising concern about e-cigarette usage among teenagers and young adults. As knowledge about the adverse health effects of e-cigarettes accumulates, it is critical to identify factors that may increase risk of vaping initiation and frequency of use. One potential risk factor known to increase risk for other substance use is impulsivity. This study tested the hypothesis that impulsivity prospectively predicts vaping over time. Methods: Active e-cigarette users (n = 137; 51.8% male; Mean age 20 years at baseline) completed 8 waves of assessment over 21 months (2017-2020). The S-UPPS-P impulse behavior scale was used at baseline to measure impulsivity, and frequency of e-cigarette, cigarette, marijuana and alcohol use was calculated at each wave thereafter. Results: Vaping frequency declined over time [Incidence Rate Ratio (IRR) = 0.92]. There were significant, stable, positive associations between e-cigarette use and lack of premeditation (IRR = 1.06) and sensation seeking (IRR = 1.09). Vaping frequency was inversely associated with negative urgency (IRR = 0.95). Positive urgency and lack of perseverance were not associated with frequency of vaping. Conclusion: These findings suggest that young adults who have higher impulsivity of certain types may use e-cigarettes more frequently. Thus, vaping interventions for young adults should address these factors to ensure the greatest impact on public health.
Collapse
Affiliation(s)
- Ankita Mittal
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Ashley Du
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - William Merz
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Mark G. Myers
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- Psychology Service, Veterans Affairs San Diego Healthcare System, La Jolla, CA, United States
| | - Laura E. Crotty Alexander
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
- Section of Pulmonary and Critical Care Medicine, La Jolla, CA, United States
| | - Neal Doran
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- Psychology Service, Veterans Affairs San Diego Healthcare System, La Jolla, CA, United States
| |
Collapse
|
18
|
Gao L, Li GS, Li JD, He J, Zhang Y, Zhou HF, Kong JL, Chen G. Identification of the susceptibility genes for COVID-19 in lung adenocarcinoma with global data and biological computation methods. Comput Struct Biotechnol J 2021; 19:6229-6239. [PMID: 34840672 PMCID: PMC8605816 DOI: 10.1016/j.csbj.2021.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
Introduction The risk of infection with COVID-19 is high in lung adenocarcinoma (LUAD) patients, and there is a dearth of studies on the molecular mechanism underlying the high susceptibility of LUAD patients to COVID-19 from the perspective of the global differential expression landscape. Objectives To fill the research void on the molecular mechanism underlying the high susceptibility of LUAD patients to COVID-19 from the perspective of the global differential expression landscape. Methods Herein, we identified genes, specifically the differentially expressed genes (DEGs), correlated with the susceptibility of LUAD patients to COVID-19. These were obtained by calculating standard mean deviation (SMD) values for 49 SARS-CoV-2-infected LUAD samples and 24 non-affected LUAD samples, as well as 3931 LUAD samples and 3027 non-cancer lung samples from 40 pooled RNA-seq and microarray datasets. Hub susceptibility genes significantly related to COVID-19 were further selected by weighted gene co-expression network analysis. Then, the hub genes were further analyzed via an examination of their clinical significance in multiple datasets, a correlation analysis of the immune cell infiltration level, and their interactions with the interactome sets of the A549 cell line. Results A total of 257 susceptibility genes were identified, and these genes were associated with RNA splicing, mitochondrial functions, and proteasomes. Ten genes, MEA1, MRPL24, PPIH, EBNA1BP2, MRTO4, RABEPK, TRMT112, PFDN2, PFDN6, and NDUFS3, were confirmed to be the hub susceptibility genes for COVID-19 in LUAD patients, and the hub susceptibility genes were significantly correlated with the infiltration of multiple immune cells. Conclusion In conclusion, the susceptibility genes for COVID-19 in LUAD patients discovered in this study may increase our understanding of the high risk of COVID-19 in LUAD patients.
Collapse
Key Words
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease 2019
- DEG
- DEG, differentially expressed genes
- FC, fold change
- FPKM, fragments per kilobase per million
- GTEx, Genotype-tissue Expression
- HPA, human protein atlas
- IHC, immunohistochemistry
- Immune infiltration
- LUAD
- LUAD, lung adenocarcinoma
- PPI, protein-to-protein interaction
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SMD, standard mean difference
- SROC, summarized receiver’s operating characteristics
- Susceptibility
- TF, transcription factor
- TPM, transcripts per million reads
- WGCNA
- WGCNA, weighted gene co-expression network analysis
Collapse
Affiliation(s)
- Li Gao
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Guo-Sheng Li
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Jian-Di Li
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Juan He
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Yu Zhang
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324. Jingwu Rd, Jinan, Shandong 250021, PR China
| | - Hua-Fu Zhou
- Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Jin-Liang Kong
- Ward of Pulmonary and Critical Care Medicine, Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| | - Gang Chen
- Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Rd, Nanning, Guangxi Zhuang Autonomous Region 530021, PR China
| |
Collapse
|
19
|
Ghosh A, Girish V, Yuan ML, Coakley RD, Wrennall JA, Alexis NE, Sausville EL, Vasudevan A, Chait AR, Sheltzer JM, Tarran R. Combustible and Electronic Cigarette Exposures Increase ACE2 Activity and SARS-CoV-2 Spike Binding. Am J Respir Crit Care Med 2021; 205:129-133. [PMID: 34748720 PMCID: PMC8865588 DOI: 10.1164/rccm.202106-1377le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Arunava Ghosh
- University of North Carolina at Chapel Hill School of Medicine, 6797, Department of Cell Biology and Physiology, Chapel Hill, North Carolina, United States
| | - Vishruth Girish
- Cold Spring Harbor Laboratory, 2595, Cold Spring Harbor, New York, United States
| | - Monet Lou Yuan
- Cold Spring Harbor Laboratory, 2595, Cold Spring Harbor, New York, United States.,Johns Hopkins University, 1466, Baltimore, Maryland, United States
| | - Raymond D Coakley
- University of North Carolina at Chapel Hill School of Medicine, 6797, Chapel Hill, North Carolina, United States
| | - Joe A Wrennall
- University of North Carolina at Chapel Hill School of Medicine, 6797, Department of Cell Biology & Physiology, Chapel Hill, North Carolina, United States
| | - Neil E Alexis
- University of North Carolina at Chapel Hill, 2331, Center for Environmental Medicine Asthma and Lung Biology, Chapel Hill, North Carolina, United States
| | - Erin L Sausville
- Cold Spring Harbor Laboratory, 2595, Cold Spring Harbor, New York, United States
| | - Anand Vasudevan
- Cold Spring Harbor Laboratory, 2595, Cold Spring Harbor, New York, United States
| | - Alexander R Chait
- Cold Spring Harbor Laboratory, 2595, Cold Spring Harbor, New York, United States.,University of Rochester, 6927, School of Medicine and Dentistry, Rochester, New York, United States
| | - Jason M Sheltzer
- Cold Spring Harbor Laboratory, 2595, Cold Spring Harbor, New York, United States
| | - Robert Tarran
- University of North Carolina at Chapel Hill School of Medicine, 6797, Department of Cell Biology & Physiology, Chapel Hill, North Carolina, United States.,University of North Carolina at Chapel Hill, 2331, Marsico Lung Institute, Chapel Hill, North Carolina, United States;
| |
Collapse
|
20
|
Abstract
The development of mouse models for coronavirus disease 2019 (COVID-19) has enabled testing of vaccines and therapeutics and defining aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesis. SARS-CoV-2 disease is severe in K18 transgenic mice (K18-hACE2 Tg) expressing human angiotensin-converting enzyme 2 (hACE2), the SARS-CoV-2 receptor, under an ectopic cytokeratin promoter, with high levels of infection measured in the lung and brain. Here, we evaluated SARS-CoV-2 infection in hACE2 knock-in (KI) mice that express hACE2 under an endogenous promoter in place of murine ACE2 (mACE2). Intranasal inoculation of hACE2 KI mice with SARS-CoV-2 WA1/2020 resulted in substantial viral replication within the upper and lower respiratory tracts with limited spread to extrapulmonary organs. However, SARS-CoV-2-infected hACE2 KI mice did not lose weight and developed limited pathology. Moreover, no significant differences in viral burden were observed in hACE2 KI mice infected with B.1.1.7 or B.1.351 variants compared to the WA1/2020 strain. Because the entry mechanisms of SARS-CoV-2 in mice remain uncertain, we evaluated the impact of the naturally occurring, mouse-adapting N501Y mutation by comparing infection of hACE2 KI, K18-hACE2 Tg, ACE2-deficient, and wild-type C57BL/6 mice. The N501Y mutation minimally affected SARS-CoV-2 infection in hACE2 KI mice but was required for viral replication in wild-type C57BL/6 mice in a mACE2-dependent manner and augmented pathogenesis in the K18-hACE2 Tg mice. Thus, the N501Y mutation likely enhances interactions with mACE2 or hACE2 in vivo. Overall, our study highlights the hACE2 KI mice as a model of mild SARS-CoV-2 infection and disease and clarifies the requirement of the N501Y mutation in mice. IMPORTANCE Mouse models of SARS-CoV-2 pathogenesis have facilitated the rapid evaluation of countermeasures. While the first generation of models developed pneumonia and severe disease after SARS-CoV-2 infection, they relied on ectopic expression of supraphysiological levels of human ACE2 (hACE2). This has raised issues with their relevance to humans, as the hACE2 receptor shows a more restricted expression pattern in the respiratory tract. Here, we evaluated SARS-CoV-2 infection and disease with viruses containing or lacking a key mouse-adapting mutation in the spike gene in hACE2 KI mice, which express hACE2 under an endogenous promoter in place of murine ACE2. While infection of hACE2 KI mice with multiple strains of SARS-CoV-2 including variants of concern resulted in viral replication within the upper and lower respiratory tracts, the animals did not sustain severe lung injury. Thus, hACE2 KI mice serve as a model of mild infection with both ancestral and emerging SARS-CoV-2 variant strains.
Collapse
|